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In 1996, the Centre for Health Promotion Studies (CHPS) at NUI Galway published a research report, Substance Misuse in the Western Health Board: Prevalence, Practice and Proposals . In addition to reporting the findings of the surveys of alcohol and illicit drug use that had been conducted up to that date, the CHPS study also gathered information and opinions from a wide range of service providers and other interested parties in the region (Nic Gabhainn & Comer, 1996). The indications at the time, in relation to substance misuse prevalence, were that

• Alcohol misuse was the biggest problem, and had a significant impact on services
• Underage drinking was common, and alcohol problems were occurring earlier
• Use of illegal drugs was widespread
• Complacency, inaction and "the drink culture" were to blame for continuing alcohol problems
• Boredom and social alienation among young people were major risk factors for substance abuse.

ince that time, Ireland has experienced significant social changes, including large population growth in some areas, net immigration and an overall dramatic increase in affluence. It is not intended in this report to attempt a detailed analysis, in the context of these socio-demographic developments, of any changes that may have occurred in the nature and extent of alcohol and drug misuse. In order to provide a demographic perspective for considering relevant regional and national prevalence data on substance misuse, CSO census data on population changes are presented first, followed by summaries of available alcohol and drug data.

For well-known historical reasons, Ireland has one of the lowest population densities in the enlarged EU, with the exception of the Nordic countries and some states formerly in the Soviet Union . Since most of Ireland 's population is concentrated in the East, the average density in counties Galway, Mayo and Roscommon (GMR) is even lower, and is similar to that of Sweden : c. 21/km 2 . The GMR area comprises one fifth of the land mass of Ireland , but has only one tenth of the population. If the region had the same population density as the EU average, the population would be approximately 2 million, double that again if the density was the same as that of the UK, and around 7 million if that of Holland. The total area of the three counties is around 14000 km 2 , roughly half the size of Belgium (population 10 million). The actual number of GMR inhabitants recorded in the 2002 census was just over 0.38 million.

Though the socioeconomic impact of historical mass emigration is still being felt in some areas of the country, net immigration is now the norm, albeit on a much smaller scale. While starting from a low base, the recent growth in population in some areas has been dramatic, and it needs to be considered whether service provision has kept pace. Census data from 1996 and 2002, and ongoing CSO monitoring of births and immigration, show that the population of Ireland has risen to its highest level since 1871 (Central Statistics Office, 2003). This trend is of course evident in the GMR region, where the overall population has increased by 8% since 1996. Central Statistics Office projections for the area suggest that the population will rise to 400,000 or more by 2011 if current trends continue. However, as might be expected, growth to date has not been uniformly distributed (see Figure 1) and the higher levels are seen in the larger urban areas and their neighbouring towns.

Figure 1: Population percentage changes in Galway, Mayo & Roscommon 1996-2002

As shown in Tables 1-3, some localities have experienced very large percentage increases in population, although in many cases the populations were small to begin with. Nevertheless, it is not inconceivable that large relative increases in small populations may give rise to local problems or concerns depending on local circumstances. Also, it is necessary to consider a town's catchment area: for example, while CSO census data gives the population for specific towns, there may be a much larger number of people dispersed in surrounding areas who rely on those towns for services and amenities. It is also possible that a small town may have more resources, services or community development activity than a larger one.

For these reasons, it may be necessary going forward to consider each locality (in each county) case-by-case. Using the Electoral Division (ED) as the basic unit of analysis, in conjunction with local knowledge and as wide a range of data sets as possible, may be advantageous in this regard. Such analyses are beyond the scope of the present report. The feasibility and potential value of using Geographical Information Systems for more detailed and multidimensional analyses could be considered in the future, bearing in mind research needs and the cost and complexity of accessing the technology.

Table 1: Population changes 1996-2002 in County Galway villages and towns with over 400 inhabitants, in order of population size

Galway has seen rapid growth in the last decade or so. An increase of 15% on the largest population base in the region translates into a sizeable absolute increase in numbers, with potential implications for service demand and provision. Elsewhere in the county, double or even triple digit percentage increases in local populations (see Table 1) are not necessarily as noteworthy if the absolute numbers are low.

Overall, Mayo's population increased by 5.3% between 1996 and 2002. The number of people living in villages and towns with over 400 inhabitants increased by nearly a fifth, while the population living outside these areas decreased slightly. Castlebar grew by a third, Westport and Ballinrobe by a quarter, and Ballina by a fifth in this period. However, five Mayo towns registered a decrease in population, according to CSO census data (see Table 2).

Table 2: Population changes 1996-2002 in County Mayo villages and towns with over 400 inhabitants, in order of population size

The overall population increase in County Roscommon (3.5%) was the lowest of the three counties. Table 3 shows the population changes in six Roscommon villages/towns with over 400 inhabitants, plus the Environs of Athlone (the term the CSO uses to refer to that part of the Athlone population officially listed under Roscommon).

Table 3: Population changes 1996-2002 in County Roscommon towns with over 400 inhabitants, in order of population size, plus the Environs of Athlone

Approximately 60 per cent of the total Irish population are living in urban areas (defined by the CSO as towns with a population of 1500 or more). The situation in the GMR region is quite the reverse. Despite the phenomenon of larger relative increases in town populations, rural dwelling continues to be a very important feature of settlement patterns in the region. As Figure 3 shows, while the overall trend since 1996 has been a slight shift to urban areas, the majority of GMR inhabitants (66% overall) continue to live in small towns, villages and the countryside. More than half of the citizens of County Galway reside in rural areas, three quarters of those in County Mayo , and 8 out of 10 of those in County Roscommon . (Of course, apart from lifestyle choices, many people living in rural areas do so because they cannot afford to buy houses in urban areas; this may be a more significant phenomenon in Co. Galway.)

"Villages with populations less than 500 are under threat of losing their services and becoming less viable [and] it is crucially important that these villages be strengthened so that they can continue to serve their rural hinterlands" (Galway County Development Board, 2002:11). There are also the Gaeltacht areas and several inhabited islands off the coasts of Galway and Mayo, and the needs of their communities must be met also. The significance of the rurality of the region is discussed in Chapter 4.

Figure 3: Proportion of GMR population living in rural and urban areas 1996-2002*

* Environs of Athlone included in the figures for Roscommon urban areas

As well as population distribution, population composition must also be considered. For a variety of reasons, Ireland still has one of the youngest populations in Europe (although gradually ageing, in keeping with international trends). Because of the mass emigration in the first half of the 20 th century there are very few old people around in Ireland today. However, the traditionally high birth rate began to decline in the 1980s. Thus there are now a relatively high number of 15 to 25 year olds compared to other age cohorts. Dramatic economic growth in the last decade (itself due in part to the large numbers of employable young people), and the ensuing high level of immigration, has also had an impact on the demographic profile.

Figure 4 illustrates the youthful age composition of the population (using the CSO's 5-year intervals from Census 2002), and shows a 'bulge' around the 15-24 age group. The very high proportion of people in their 20s from all areas drawn to Galway City is to a major extent due to the existence in Galway of two third level educational institutions. The presence of several major employers and the city's reputation as the arts and entertainment capital of the West have had a major effect also.

third of the GMR population lives in towns with more than 1500 inhabitants. Table 4 shows both the actual numbers (CSO figures, Census 2002) and proportions for five different age groups in each of these towns.

Figure 4: Percentage population by county & age group in 2002

Table 4: Population in 2002 of towns with =1500 inhabitants, in order of size, by age