Research by the Economic and Social Research Institute (ESRI) has found that while mortality rates have fallen substantially over time in Ireland, inequalities between different groups in the population remain a concern.
The research, focused on two broad dimensions of inequality: socio-economic status and ethnicity or country of birth/nationality.
Funded by the Institute of Public Health (IPH), the research entitled 'Unequal Chances? Inequalities in Mortality in Ireland' examined inequalities in mortality in Ireland since 2000.
The study shows that the crude mortality rate for those aged 15 and over declined from 10.5 per 1,000 population in 2000 to 8.1 in 2018, with males having higher rates than females throughout the period.
In 2000, 41% of adult deaths were due to circulatory disease, with cancers (25%), respiratory disease (16%) and other causes (18%) accounting for the remainder of deaths.
By 2018, the proportion of total deaths attributed to circulatory disease (29%) had declined sharply, while there was also a decline in the share of deaths accounted for by respiratory disease (to 13%).
The proportion of deaths attributable to cancers (30%) and other causes (28%) had a corresponding increase.
One of the authors of the report, Anne Nolan, said: "Despite the overall improvement in mortality rates in Ireland in recent decades, the findings in this report highlight a number of groups that are vulnerable to higher mortality rates, and which require policy attention."
The analysis of inequalities due to socio-economic status showed that the standardised mortality rate for those in the least advantaged group was twice as high as those in the most advantaged group in 2018.
"For example people who worked in manual occupations had twice the risk of mortality as those working in more advantaged occupations ... people working in employment groups or managerial occupations," said Ms Nolan.
An analysis of adult inequalities across ethnic, country of birth and nationality groups revealed a substantially lower mortality rate in non-White Irish ethnic groups, as well as in those born outside Ireland or with non-Irish nationality.
An analysis of emerging patterns in relation to Covid-19 mortality was also undertaken, which showed that from March 2020 to May 2021, those in less advantaged socio-economic groups accounted for higher proportions of deaths in the population aged 65 and older.
While the numbers of Covid-related deaths in non-White groups were very small overall, those with Black or Asian Irish ethnicity or being from Eastern Europe, accounted for slightly higher proportions of Covid-19 deaths.
The research also found there has been a substantial decline in the perinatal mortality rate (the number of stillbirths and deaths in the first week of life per 1,000 births) since 2000.
The rate was 8.3 in 2000 and dropped to 5.4 in 2019, but this improvement was not experienced equally by all groups.
The rate for unemployed mothers was between 1.6 and 2.2 times the rate of mothers in the higher professional group, and this rate remained elevated throughout the time period.
African-born mothers experienced significantly higher rates of perinatal mortality, between 1.5 and 2 times higher than mothers born in Ireland.
IPH Director of Policy Helen McEvoy said that the report reveals new insights, and updates the understanding of how social and economic disadvantage can influence when and how people died.
"A robust health information system is needed to better monitor health inequalities and to meet the health equity goals of policies like Healthy Ireland and Sláintecare," she said.