IT is a promise that Scottish Governments keep on making, that they will tackle the health inequalities between the rich and the poor, but sadly no government in recent years has made any significant difference. It is still the case in Scotland that a child born in a nice suburb will probably live for up to 30 years more than one born in a deprived area. A Scot is also more likely to fare better with cancer and heart disease if they are better-off and the picture with alcohol-related illness is much the same. Scotland’s health inequalities are profound and deep and, in many cases, they are getting worse.
The most up-to-date situation is laid out in the Chief Statistician’s new report on health inequalities and it is depressing reading. On coronary heart disease, the death rate in Scotland is a third of what it was in 1997 but deaths in 45-74 year olds are 4.6 times greater among the most deprived compared to the least deprived.
As for alcohol-related illness, hospital admissions among under-75s are six times more common in the most deprived areas. The gap between the poorest and the national average has been narrowing, but in 2016 it widened again and the gap is now the biggest it has been since 2003.
The figures on cancer are just as troubling. Among 45 to 74-year-olds, mortality is 2.4 times higher in the most deprived compared to least deprived areas, which is worse than it was 20 years ago when the rates were 2.0 times higher in the most deprived areas. Among other disturbing statistics in the report is the fact that premature mortality among 15 to 44-year-olds from suicides, drug deaths, and assaults is six times higher in the most deprived areas and has been increasing over the past two years.
The Government is right to say in its response to the report that the reason for the health inequalities run very deep, but its record on tackling the problem is mixed. On the positive side, the new cancer strategy is promising. It will take several years before we are likely to see any results, but the £100million is being spent in many of the right areas: new radiotherapy equipment for instance and the recruitment of new and better qualified staff.
But in another important area, the Government is not doing enough. The investment in cancer services is welcome, but we know there are deep social inequalities in the uptake of screening and treatment. Better-off patients are much more likely to take advantage of any improvements to health services – indeed, this might explain why, as healthcare improves, so too do inequalities.
The answer is one that the Government seems reluctant to accept: the targeting of healthcare where it can make the most difference. The primary care needs are greater in poorer communities, and yet the investment there is scarcely more than it is in more affluent areas. This is the wrong way round. The new figures from the Chief Statistician this week have underlined the great health inequalities in our country; we will only begin to tackle them by targeting healthcare much more at where it is needed most.
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here