Glasgow and Dundee death rates higher than 20 years ago

Chik Collins the new director of Glasgow Centre for Population Health (GCPH), which led the research, said Scotland was in the grip of a "social emergency" that required urgent action from government.

Figures show the death rate for women under 65 from the most deprived areas of Glasgow was 452 per 100,000 population in 2001. In 2021, it had risen to 455 per 100,000, compared to 113 per 100,000 in the most affluent areas.

Mortality rates had previously declined to 342.6 before 2010, when the Conservative Government oversaw a policy of deep spending cuts with comparatively small increases in tax.

There is evidence that reductions in social security and loss of services disproportionately affected women.

Premature death rates amongst men living in the poorest areas began to steadily increase around 2012, rising from 724 per 100,000 population to 894 in 2021 and there are fears they too could rise to exceed rates last seen twenty years ago.

The figures are all the more concerning, said Mr Collins, who is a professor of applied social science, because they pre-date the cost-of-living crisis.

It's probably unrealistic to think that the Westminster Government is going to use the levers it controls to organise things in a more egalitarian way.

New modelling suggests that even after taking into account UK Government mitigation measures including reductions in household energy costs and additional cost-of-living support payments premature mortality is likely to increase by over 6% in Scotland this year, with the impact even greater among the country’s more deprived populations.

READ MORE: Agenda: We must look at longer-term measures to tackle health inequalities

Prof Collins said the Scottish Government had done "some useful things" including introducing the Scottish Child Payment and could do more but was also limited in its powers.

"We need to move before its too late," said Prof Collins, who said there was a reluctance to face up to the scale of the crisis.

"All of the evidence indicates that health inequalities are the ultimate expression of underlying social inequalities of income, wealth and power."

Previous analysis by GCPH, using data up to 2017, has shown that improvements in life expectancy stalled after 2010.

Worsening mortality rates were observed "for almost all causes of death."

The latest research, using statistics up to 2021,and taking in the pandemic, shows a continuing widening of inequalities in alcohol and drug-related deaths and, to a lesser degree, suicide.

Similar adverse trends can also be seen for heart disease, particularly among men.

Less clear trends are evident for deaths from stroke and all cancers, while there has been a small improvement in lung cancer mortality 

GCPH said sharp increases in premature death rates among those living in the 20% poorest neighbourhoods can be seen very clearly in different parts of Scotland, but particularly in Glasgow and Dundee, where they are higher now than 20 years ago.

The particularly sharp increases in the most recent period have been shown to be influenced by austerity policies.

The study concludes that "The appalling trends, and broader evidence, reported here require urgent action."

READ MORE: Health inequalities widening between most and least deprived children in Scotland 

"We have become very used to the idea that mortality rates fall, life expectancy increases," said Prof Collins.

"While it might not always be increasing for the poorest as fast as it is for the richest, everyone is in a certain sense on some sort of improving trajectory.

"But of course that starkly began to change around a decade ago and while people at one level know it and increasingly there is an awareness of the causes of it and the policies which could address it, there is a reluctance to face up to the scale and the unprecedented nature of the thing and to really about what can be done in the current circumstances.

"For the people who are living in these really difficult - at best - circumstances, what kinds of problems are being stored up for the future in all aspects of their lives and probably crystalised in terms of their health."

Previous research by Dr David Walsh, Public Health Programme Manager at GCPH and Gerry McCartney, a Professor of Wellbeing Economy at the University of Glasgow, made 40 policy recommendations, including a more "comprehensive and protective" social security system and more progressive taxation.

"What you need are the types of policies and institutional arrangements which are conducive to a more equal society," said Prof Collins.

READ MORE: 'Scotland will only solve inequalities with more power'

"It's very easy and logical to be recommending those things but those things have been recommended for some time.

"They weren't adopted in better circumstances that we currently face.

"It's probably unrealistic to think that the Westminster Government is going to use the levers it controls to organise things in a more egalitarian way.

"There are limits of the powers which are present at Holyrood. The Government there has done some useful things. There are probably more things it could be doing."

Prof Collins has recently returned to GCPH after three years in the Faro Islands, where he was university rector, the equivalent of the vice-chancellor in the Scottish higher education system.

Prior to that he was at the University of the West of Scotland, where from 2009 he began to focus his research in Scotland's excess mortality rates, collaborating with GCPH.

He cited a report by the Scottish Trades Union Congress ( STUC) published last year which concluded that an extra £3.3billion could be raised to help fund Scotland's public services if a wealth tax was introduced.

He said: "What you would really like is for people to take account of all that context, viewing the scale of the unfolding social emergency and consider it an emergency and respond appropriately and who and what can mobilised to mitigate the worst of the harms."

A spokeswoman for the UK Government said: “Health policy is devolved to the Scottish Government and they have a record block grant of more than £40 billion a year which they can use to deliver public services in Scotland, including health, social care and housing.

“In addition, the Scottish Government now have powers over a range of welfare befits, and can use them to support vulnerable people. The UK Government is supporting households across the UK this winter, with our energy price cap.”