SCOTS die younger than in any other country in Western Europe, a damning report has revealed, amid claims there is an "absence of a clear national strategy" for public health.
Life expectancy north of the Border has been rising more slowly than other European countries since the 1950s but there is "no single explanation" for the nation's poor mortality record.
Published yesterday, the 2015 Review of Public Health paints a bleak picture of Scotland's battle against obesity and health inequalities that sees the country's life expectancy rates lagging significantly behind its European neighbours.
It suggests the so-called 'Glasgow Effect' - coined for the west coast's high rates of cancer, strokes and heart attacks - continues to skew Scotland's overall health record and that 64 per cent of adult Scots are overweight with 27 per cent classified as obese.
A total of £227 million per year is being spent on public health staff.
Commissioned by the Scottish Government, the review canvassed opinions of public health professionals from across the sectors and was chaired by former NHS executive director Dr Hamish Wilson.
It said: "Mortality rates in Scotland are higher than would be expected on the basis of population characteristics and levels of socio-economic deprivation.
"This phenomenon of 'excess mortality’ is evident for Scotland as a whole, but is particularly concentrated in West Central Scotland."
According to the findings, there are a "striking (and increasing) number of people" living with multiple health conditions which sets in up to 15 years earlier in the most deprived populations compared with the most affluent areas of Scotland.
And it warned that soaring obesity levels "have the potential to overturn the life expectancy gains" achieved through better lifestyle choices and medical advances in combating heart disease and diabetes.
Concerns were raised that the workforce is "dispersed, risks further dilution, and lacks a clear programme and structure for development".
The Scottish Government said it would draw on the findings to devise a new public health strategy to focus efforts on improving the population's health.
The review group recommended an enhanced role for public health professionals in new integrated joint boards linking the NHS and local authorities, and achieving greater input from public health academics.
But Labour MSP Dr Richard Simpson, shadow minister for public services, said a failure to tackle obesity rates could "reverse some of the increases in life expectancy".
"After nine years of SNP government not only does Scotland have the worst record on life expectancy but there is a wider gap than ever in health inequalities between the richest and poorest.
"The gap in 'healthy' lives between richest and poorest is also greater than ever at over 20 years.
"Whilst smoking levels have reduced it remains the most immediate challenge.
"But obesity has not reduced in these nine years and the SNP have done little to tackle the problem."
To reverse obesity levels and boost mortality rates, greater "national cohesion, accountability and leadership" is recommended with closer ties between public health bodies.
The strategy will set national priorities, and help to coordinate the contributions of public health professionals and the wider public health workforce working across the NHS and other sectors.
Maureen Watt MSP, Minister for Public Health, said only a broad response would help to tackle the health crisis.
She said: “Scotland has a strong reputation in public health, and substantial progress has been made in a number of areas.
"However, deep-seated issues, including obesity, mental health problems and health inequalities still need to be tackled.
"As this report recognises, this requires a wide response from across society, beyond the traditional boundaries of the NHS."
One of the key passages of the review said that while life expectancy was increasing it was not doing so equally.
It adds: "Our more deprived citizens live shorter lives and more years in poor health. Moreover, the greatest health benefits from services, programmes and opportunities often fall to the more affluent."
Mental illness is associated with a 15-year reduction in life expectancy in Scotland, and the report also highlights the "increasing prevalence" of suicide among middle-aged men - especially those aged 35 to 55.
Lorna Kelly, associate director of the Glasgow Centre for Population Health, added: “The GCPH welcomes the review, its focus on inequalities and the broader determinants of health, and the need for strong partnership working at local level. We look forward to supporting further work on the Review’s recommendations, including a clear Public Health strategy.”
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