Danny Dorling’s scientific contributions

Relationships between health inequalities and social disadvantage are well established, but less is known about spatial variations in health. Most geographical studies of health in Ireland have been conducted at a county level. Counties are too large to identify more localised pockets of poor health, whereas electoral districts (EDs) can be too small to permit stable estimates of the underlying rates, due to the small number of deaths each year. This paper reports the findings of an analysis of deaths in 2006 and 2011 using a new set of 407 areas intermediate in size between counties and EDs. The areas having the lowest and the highest age standardised death rates were mostly in Dublin and the other larger cities, but there is at least a 3-fold difference which demonstrates inequalities in health outcomes. Further modelling is required to establish whether this simply reflects the geography of social status.

Relationships between social disadvantage and health outcomes in the advanced capitalist world are now well documented but less is known about the uneven development over space of mortality and morbidity. As one of the more unequal and socially stratified countries in the OECD, it is to be suspected that Ireland is burdened by particularly acute social and geographical health inequalities. Yet, remarkably little is known about the Irish case. This paper is one of the first to explore the nexus between Ireland’s emergence as a neoliberalising, small but radically open economy and its attendant social and spatial inequalities, and the geographical structure of its mortality. Offered as a methodological and mapping intervention upon which future longitudinal and tracking studies might be built, this paper reports the findings of an analysis of mortality in Ireland between 2006 and 2011, using an innovative newly-produced set of 407 areas intermediate in size between counties and Electoral Divisions. Our preliminary findings show that there exists both: (a) urban, rural, and what we term ‘isolated rural’ variations in age standardised death rates; and (b) sharp health inequalities within Irish cities and, in particular, in Dublin. We conclude that, whilst further modelling will be required to establish the extent to which socio-economic inequalities are driving geographies of health in Ireland, progress might be made if attention is given to the relationships which exist between neoliberalism, boom, bust, austerity, and recovery and the workings of socio-economic constraints, lifestyle and behaviour, health selection, and the accessibility of health care facilities.

Inequality and injustice have distinctively geographical aspects in modern Ireland. ''Spatial justice and the Irish Crisis'', describes and explains the socially, economically, and geographically differentiated outcomes of one of the most far-reaching economic calamities experienced by any developed country in the past century.