RESIDENTS on the Western Isles are nearly twice as likely as Shetlanders to suffer an avoidable death despite the island communities having the same deprivation rating.

While Orkney and Shetland had some of the lowest rates of early deaths in Scotland in 2016, new figures show that the Western Isles ranked closer to Glasgow and Dundee.

An expert in rural health said it was "likely" there was a genuine problem of excess deaths in the Outer Hebrides - but said further research was needed.

Avoidable deaths have been used since the 1970s as a measure of healthcare and are generally associated with poverty.

They are classed as deaths occurring before the age of 74 which are considered preventable if individuals have access to “timely and effective healthcare” or “public health interventions”.

Causes can include suicide, accidents, infections such as HIV or measles, heart disease, some cancers, respiratory diseases and type 2 diabetes.

Typically they are illnesses exacerbated by unhealthy lifestyles, such as smoking, excess alcohol consumption, obesity, poor diet and lack of exercise.

Scotland has a higher rate of avoidable deaths than England, Wales or Northern Ireland, and in 2016 the North and East Ayrshire council areas had the highest rate of avoidable deaths in Scotland at 373 and 360 per 100,000 population respectively.

The Herald:

(Source: BBC Shared Data Unit)

However, the figures for 2016 also point to a mystery health gap between the Western Isles and Scotland's other island communities.

While Shetland recorded 43 avoidable deaths - a rate of 185 per 100,000 population - on the Western Isles that rate was 335 per 100,000.

That was equivalent to 90 preventable deaths across the Outer Hebrides of Lewis, Barra, Benbecula, Harris and the North and South Uists.

On Orkney, there were 49 avoidable deaths in 2016 - or 224 per 100,000 population.

The figures have been compiled by the BBC Shared Data Unit based on statistics from the National Records of Scotland and ranking all local authorities, from the most to least affluent, according to the Scottish Multiple Index of Deprivation (SIMD).

Orkney, Shetland and the Western Isles scored joint 30th as the three least deprived council areas.

Shetland also had the lowest rate of avoidable deaths in Scotland, while Orkney had the third lowest after East Renfrewshire.

In contrast, the Western Isles ranked ninth for avoidable deaths, immediately behind North Lanarkshire.

The Western Isles also exceeded the other island communities for avoidable deaths in 2014 and 2015. 

In 2014, there were 342 avoidable deaths per 100,000 population in the Western Isles compared to 279 in Orkney and 280 in Shetland. 

In 2015, the figure was 364 for the Western Isles compared to 306 for Shetland and 261 for Orkney. 

Professor Philip Wilson, director of the Centre for Rural Health at the University of Aberdeen, said an analysis of the three-year figures using a statistical test known as a Chi Square indicated that there was only a 0.02 per cent chance that the difference in mortality between the island communities arose by chance. 

However, he stressed that further research would be needed. 

Prof Wilson said: "Using the Chi Square test there is a 0.02 per cent chance that this difference arose by chance. 

"In other words a 99.98 per cent likelihood that there is a genuine excess death rate over three years in Western Isles. But the figures would need correcting for population age etc. 

"So there is probably something there but the figures would need checking."

Warnings have previously been issued over death toll from alcohol on the Outer Hebrides.

In 2015, it emerged that the number of alcohol-related deaths on the Western Isles was the highest in decades and double the Scottish average.

A spokeswoman for NHS Western Isles said: "All deaths in our hospitals are reviewed comprehensively and carefully to gather any learning about our care and services provided for patients.

"Any improvement actions are implemented.

"Our recent reviews which focus on deaths occurring in hospital have not raised any issues of concern."

Dr Andrew Fraser, director of Public Health Science at NHS Health Scotland, said health inequalities nationally must be tackled.

He said: “It’s not right that, in a country like Scotland, there are such dramatic differences in life expectancy due to circumstances largely beyond a person’s control.

"We know that people in poorer areas experience more harm from alcohol, tobacco and fast food than those in more affluent areas.

"Part of the reason for this is that it is easier to access the things that harm our health in those areas.

“To prevent death, disease and harm we need to take actions where and when they are needed. We must address harm from alcohol, tobacco, being overweight or obese.”

Bruce Whyte, public health programme manager at the Glasgow Centre for Population Health, added: “With health outcomes there’s a very strong association with ill health and deprivation – lots of studies have shown that.

“You tend to get a strong association of higher mortality with areas which have got high concentrations of deprivation – you see that for lots of health outcomes.”

A Scottish Government spokesman said: “The largest single cause of avoidable death in Scotland is smoking, followed by obesity, and both have strong links to poverty.

"Smoking related illnesses kill two out of every three long-term smokers and so we have a world-leading ambition to create a tobacco-free generation by 2034.

"We are also aiming to halve the number of children who are obese by 2030. 

“We want to build a fairer and more prosperous Scotland for all and are taking forward a number of bold measures to achieve this – from our new Child Poverty Act, establishing Scotland as the only part of the UK with targets to tackle child poverty, to our Fairer Scotland Action Plan.

“UK Government welfare cuts are taking money from the pockets of low income families, pushing them into crisis, debt and poverty.

"This year alone we will invest more than £125 million to mitigate the worst impacts of their cuts.”