THE health gap between the poorest and richest Scots is widening with the most deprived significantly more likely to die from alcohol abuse, coronary heart disease and cancer.

The impact of welfare cuts and nearly a decade of austerity have been blamed for reversing previous declines in health inequalities, with the better off also tending to benefit disproportionately from investment in strategies such as new cancer screening programmes.

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The latest health statistics for Scotland show that the gap in deaths from cancer between the most and least deprived has also increased over the last 20 years, from being twice as high in 1996 to 2.4 times higher in 2016.

Evidence consistently shows that the uptake of routine cancer screening such as breast and bowel checks is higher among the more affluent, who are also much more likely to visit their GP earlier about cancer symptoms.

As a result, while increased Government investment in cancer detection and drugs improves overall survival it can also exacerbate health inequalities, at least temporarily.

Trisha Hatt, from Macmillan Cancer Support, said: “It’s disappointing to see that those in deprived areas are still so much more likely to die from cancer than those in the rest of Scotland. It’s especially worrying to see this relative survival gap is higher now than in 1996.

“Tackling health inequalities is a central aim of the Scottish Government’s cancer plan and this report shows it’s more vital than ever that the plan’s promises are delivered.”

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Premature mortality between the most and least deprived Scots is also wider than it was when current records began 20 years ago.

More than 21,000 people in Scotland died before the age of 75 in 2016, but the rate was 3.7 times higher among the poorest Scots compared to the most affluent - up from 2.7 in 1997.

Since 2008, the gap in hospital admissions for heart attacks between the poorest and wealthiest under-75s has been widening and is now as high as it was in 2003, the previous peak year, with the most deprived Scots accounting for 2.6 times more admissions than the least deprived.

Deaths among those aged 15 to 44 - which tend to include high numbers of suicides, fatal drug overdoses and assaults - are also six times higher among the poorest ten per cent of Scots compared to the wealthiest decile.

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After steadily reducing between 2006 and 2014, the mortality rate in this age group has increased during the past two years - largely driven by an upturn in drug deaths.

Coronary heart disease deaths were 4.6 times higher among the poorest Scots than the least deprived, a gulf that has been edging upwards during the past three years.

The ravages of alcohol harm are also starkest among Scotland's least well-off. Alcohol-related deaths among Scots aged 45 to 74 in 2016 were the second highest since 1997, and nine times higher among the poorest than the wealthiest.

Much of this ill health and mortality can be traced back to stubborn lifestyle factors such as persistently higher rates of smoking, obesity, and alcohol consumption in poorer areas, although the Scottish Government's new policies on minimum alcohol-pricing and a proposed crackdown on cheap junk food deals are aimed at reversing this.

It comes as a separate report today by NHS Health Scotland warned that replacing means-tested benefits with a universal income would require "very substantial tax increases".

The policy, which is being explored by the Scottish Government through four pilot schemes in Scotland, is seen by supporters as a major weapon against health inequalities because it has the potential to eradicate poverty.

However, Dr Gerry McCartney, Head of Public Health Observatory at NHS Health Scotland said: “For wealthy countries like Scotland, socio-economic inequalities are the most important factor in determining the extent of health inequalities.

"Reducing income and wealth inequality in Scotland is therefore a crucial part of any approach to achieving improved health for all.”

Public Health Minister Aileen Campbell said: “It is clear that deeply ingrained health inequalities persist in Scotland, and reducing the gap between those in our most and least deprived areas is a significant challenge – but one we are working across government to rise to.

"At its root this is an issue of social and economic inequality, and we need a shift in emphasis from dealing with the consequences to tackling the causes.

“We are taking concrete action to tackle poverty and inequality – from mitigating the worst impacts of the UK Government’s austerity and welfare cuts, setting statutory targets to reduce and ultimately eradicate child poverty, and investing in our social commitments like free school meals and expanded childcare.

"And when all the evidence shows the impact income inequalities can have on health, we are delivering record numbers of staff in our NHS, backed by record levels of investment, ensuring people receive the right treatment, at the right time, and in a setting that best meets their needs."