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Revealed: Scotland's health divide

THE gulf between the health of the affluent and the poor in Scotland is exposed in a new report which shows the divide is wider in Scotland than most other countries in Europe.

Only Hungary and the Czech Republic report a deeper contrast between the death rates experienced by men who left school with no qualifications and those who graduated from college or university.

The gap between women from the different academic backgrounds is greater in Scotland than any of the other 20 countries included in the research.

It is the first time Scottish data has been submitted in this way for the landmark European Global Burden of Disease (EGBD) project.

Dr Gerry McCartney, head of the Public Health Observatory Division for health improvement agency NHS Health Scotland, said: “This report shows that Scotland has higher inequalities than the rest of Western and Central Europe. Tackling this problem needs to remain a priority for the Scottish Government for the foreseeable future.”

He said the issue is so serious that NHS Health Scotland has revised its own strategy to make tackling health inequalities their primary focus.

He continued: “We are no longer saying the average population health is the most important thing. The most important thing we are trying to do is reduce that inequality...

“It is a massive injustice. If you are a child born just a mile from where I live you have got a 50:50 chance of making it to your 65th birthday. That is an appalling record.”

The EGBD study, which runs to hundreds of pages and involved 70 researchers, looked at how death rates from a number of conditions differed among the deprived and the more affluent in the participating nations. The level of inequality in each country was then compared.

Scotland was not only one of the worst performers when educational achievement was used as a measure of social status. There were 501 more deaths per 100,000 men per year among 30 to 59-year-old Scottish male manual workers, than among non-manual staff. This was a greater difference than in all the 13 other European countries included in this aspect of the research. In England and Wales the difference was 222 deaths, and in Switzerland it was 121.

The report authors note that Scotland is among those with the most profound inequalities when it comes to heart disease and cancer deaths particularly.

They say: “Finland, Lithuania and Scotland showed particularly high absolute inequalities in cardiovascular mortality. Cardiovascular mortality rates were highest in Lithuania, Finland and Scotland.”

Dr McCartney said the way the decline of heavy industry in the UK was managed has been put forward as one reason for the persistently poor health suffered by deprived communities in Scotland. Everyone lost industrial jobs, he said, but active labour market policies and different welfare systems provided a better safety net for those affected on the continent. In Scotland, he said, people lost jobs, there was a rise in incapacity benefit claims, a rise in alcohol related disease and an increase in one-parent families.

However, he said, improving housing, improving transport links and spreading opportunities could help to address the divide.

He said: “We are doing so badly compared to the rest of Western and Central Europe, but we can do something about it.”

Public Health Minister Michael Matheson said: “Overall, health in Scotland is improving, but health inequalities between our more affluent and more deprived communities still exist. We continue to address these long-standing problems that won’t be solved overnight - we are taking significant action to cut alcohol consumption, reduce smoking rates, encourage active living, healthy eating, and promote positive mental health.

“We have shifted the emphasis of our approach from dealing with the consequences of health inequalities to tackling the underlying causes such as poverty, employment, support for families and improving physical and social environments.”

However, he added that key leavers for tackling poverty, such as the welfare system, still lie with the UK government.

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