Finally, some good news: Scotland's getting healthier

Columnist

Sunday 23 December 2012

IT'S not the end of the world.

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Iain Macwhirter

There seemed to be a slight air of disappointment when our date with Mayan destiny passed on Friday without apocalypse. So, we have to just keep on carrying on as the world goes to Hell in a handcart. Except that, in many respects, things continue to get better, even in Scotland. In the midst of the worst recession in 80 years this might seem a strange, even perverse thought to end the year, but bear with me.

One neglected statistic that caught my eye recently was that, in Scotland, deaths from coronary heart disease have fallen by 43% in 10 years. The standardised death rate from stroke is also down 42%. Given Scotland's problems of the heart, this is a considerable, if largely unacknowledged achievement. Yes, 8000 Scots still die from heart disease each year and we still have the worst coronary rate in Europe, but the fact that fewer people are dying from it is surely a cause for mild celebration. Especially in a year in which the dying Scotsman has become a staple joke on programmes such as Have I Got News For You. Outside the parliamentary constituencies in and around Glasgow, Scotland is almost as healthy as England. Heart disease is a very west-coast phenomenon. But the good news is that Glasgow is where the biggest falls in mortality have been recorded – a 10% drop in heart deaths in a year. For my money, that's one of the best pieces of news that's come out of the city in the last two decades. The improvement is down to a combination of factors: enlightened public policy – the smoking ban in 2005; advancements in medical care – we have some of the best heart surgeons in Europe; a decade of health promotion; and, most importantly, a conscious decision by many Scots to stay alive. All those people out running and cycling. It shows that people really can change, even in Scotland, and in a surprisingly short time. It's not entirely clear why this change of heart has happened, but the existence of the Scottish Parliament certainly helped to alter the climate of passivity and neglect that had allowed Scotland's health problems to go unchecked for four decades. Another factor is the decline in drinking, especially among men. Bet you didn't realise that Scotland is going on the wagon, but according to the 2011 Scottish Government health survey, the number of Scottish adults drinking more than recommended limits has fallen by a quarter in the last 10 years, from 28% to 21%. Mean weekly consumption among men has declined from 20 units to 15. That's a very real change, but one that has had almost zero publicity. Nor has the fact that Scots, especially women, in upper income groups are nearly twice as likely to be problem drinkers than people in the lower income groups. So much for the popular image, peddled by soap operas such as Shameless, that the poor spend all their money on drink. I'm not making this up. It's all on the web. But I bet if you asked the average man or woman in the street, or the average MP in Westminster, they would tell you that just living in Scotland is seriously bad for your health, that lack of exercise and bad diet are sending us to an early grave, and that young people are brought up on a combination of Buckfast and skunk weed. In fact, young people especially seem to be turning away from alcohol and drugs. The number of under-15s taking drink or drugs once a week has fallen by a third in 10 years, and the number using cannabis has halved. What seems to be happening is that the booze generation – the people who were lured early into heavy drinking by the promotion of alcopops in the 1990s – are now suffering the consequences, in the rise of drink-related illnesses. Heroin addicts tend to be older people in their 40s – and yes, even they are living longer. But the message is finally getting across: cirrhosis and addiction aren't cool.However, we usually find a way of presenting health improvements negatively. It's been pointed out that the drop in the heart death rate has left Scotland with the costly "burden" of caring for some 250,000 people living with heart problems. Well, as someone who is part of that burden, since I was stricken by the Scottish disease some years ago, I'd have to say that it's a price worth paying. Most people with heart disease can still live perfectly normal and productive lives. It is only among the elderly that care costs seriously increase – but this again is a "problem" we should welcome. Few things annoy me more than reading about the "ageing crisis", the "demographic time-bomb" and other complaints about the fact we are all living longer. There was another eruption of negativity last week following the latest census figures, which show there are now more people living in Scotland who are over 65 than under 16. Oh dear – how will we cope with all these oldies sitting at home alone eating cat food? Where are the young people to come from to pay their social costs through their taxes? Well, one response is just not to get old. Look at the Rolling Stones, who are still rocking into their 70s. Not only are people like Keith Richards a demonstration of just how resilient the human body can be even after a lifetime of abuse, they show that it is possible to keep working almost indefinitely. Our idea of work remains locked in the past. Age, and even physical infirmity, is no longer the barrier it used to be in the days when most people worked in physically demanding occupations. In future, most of us will be working on computers. As for the cost of caring for the infirm elderly – the perennial lament of public-sector bureaucrats – well, one solution may be at hand. The census surprised everyone by showing that Scotland's population has actually risen by 5% in the last decade, after generations of decline. The fact that people are wanting to come here may be an answer to those commentators who like to present Scotland as a wasteland beyond hope. Immigrants tend to be young and have large families – producing in the process the workers who will pay the taxes of the future. That's if they aren't sent away again by the anti-immigration policies of a Conservative Government. So, be of good cheer. Living in Scotland is not a death sentence. In fact, some people quite like it here.

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Finally, some good news: Scotland's getting healthier

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