People in deprived areas still trail in life prospects despite welfare initiatives

THE gap in standards of health between people in the richest and most deprived areas of Scotland has grown rather than diminished in the past two decades.

Despite numerous medical breakthroughs and health initiatives, a new study has revealed how disparities in wellbeing among different sectors of society have improved little since the 1980s.

While male life expectancy increased overall during the 20-year period, the gap between the richest and poorest widened from five years to seven and a half years during that time. In addition, there was a doubling of the gap in heart disease hospitalisation rates between the most and least deprived areas.

In the early 1980s, the percentage of low-birthweight babies being born to mothers in poor areas was 6.7%, which was 2.9% more than those in the least deprived category. But by the late 1990s, the difference had grown to a 3.4% gap.

Report co-author Dr David Gordon, head of the public health observatory division at NHS Health Scotland, described the statistics as unsurprising and "rather depressing".

He said: "Overall, patterns were consistent over the 20-year period, but the gap between the lowest group and the highest group was growing."

Gordon said that although the study - which has been published online by the journal Public Health, had not examined statistics from this decade, it was unlikely there would have been a significant change in the past few years.

"There are always going to be health inequalities, the question is how steep the gradient should be," he said. "I think there is a general consensus just now that it is too steep. There has been consistent work of trying to tackle inequalities at least going back to the early 1980s; quite a bit of research has shown that is not closing the gap.

"We really need to rethink what we do and work in a much more focused way at addressing the inequalities."

Professor Phil Hanlon, public health expert at Glasgow University, pointed out that differences in the health of the rich and the poor had existed for hundreds of years. But he added it was disappointing that government efforts in the past 15 years in Scotland had not succeeded in closing the gap.

"In some senses the issue is what on earth is it going to take?" he said. "It's frustrating and it is, I think, time for a reappraisal. It is not that anti-poverty or regeneration programmes haven't had an effect. Many interventions have been tried, but the fundamental pattern of inequality still remains stubborn."

Hanlon suggested one way in which the problem could be tackled would be through interventions targeting young children, with a view to leading to improvements in 10 or 20 years' time.

But he added: "Alcohol is a rising problem and unless we turn that and drugs around, then we are not going to improve health in the most disadvantaged areas."

Peter Kelly, director of the Poverty Alliance, said that people had to be supported to change "ingrained" behaviours in order to bring about improvements in their health.

"These poorer health outcomes are not solely the responsibility of individual action and behaviours, but are the outcome of larger social processes," he said.

Ben McKendrick, of the British Heart Foundation Scotland, called for more resources to be invested in improving the health of people living in the nation's poorest areas.

He said: "Heart disease is a particular problem for people living in deprivation and this report shows there are still stark inequalities in terms of prevalence and mortality, even within a country as small as Scotland."

Health secretary Nicola Sturgeon said inequalities would be tackled through efforts to increase physical activity, improve diet and reduce smoking and alcohol intakes. She added: "Poor health has underlying causes involving education, housing, planning and the economy, and the new government will bring forward action to address all of these so the whole of Scotland can benefit."