The Irish health disadvantage in England: contribution of structure and identity components of Irish ethnicity.

BACKGROUND: Irish people living in Britain face a significant health disadvantage when compared to the white British host population.
OBJECTIVES: Using recent survey data, determine whether there is an 'Irish health disadvantage' independent of socio-economic factors and explore whether there is an Irish ethnic identity effect which operates on health.
DESIGN: Data from the Census 2001 Individual Licensed SARs was analysed using binary logistic regression to study the relationship between the self-reported Irish ethnicity measure (which is presumed to reflect self-identification with Irish culture and community), considering country of birth subgroups, and the self-reported health measures of general health and limiting long-term illness. The analysis was adjusted for key demographic and socio-economic factors.
RESULTS: When compared to the white British reference population, the self-reported 'white Irish' population overall, the Irish born in Northern Ireland, and UK-born Irish, show a significantly increased risk of both self-reported poor general health and limiting long-term illness. The increased risk of poor health of the Irish born in the Republic of Ireland is greatly diminished after the socio-economic adjustments, and only statistically significant in the case of general health. Finally, the Irish born in Northern Ireland who self-report as Irish are significantly more likely than those who self-report as British to report poor general health, which may suggest an Irish ethnic identity effect.
CONCLUSIONS: The findings demonstrate a persistent ethnic health disadvantage for first generation and UK-born Irish people living in England with respect to self-reported general health and limiting long-term illness, which cannot be fully explained by demographic and key socio-economic factors. Aspects of ethnicity related to both structure and identity may affect Irish self-reported health.