INTRODUCTION Scotland's health - time for a change
In last year's Annual Report, I indicated that, although life expectancy ( LE) has continued to improve in Scotland, other western European countries have experienced faster increases in the health of their populations. Most of our closest European neighbours are reporting longer life expectancy at birth for both men and women than in Scotland. However, wealthier Scots continue to experience a faster growth in life expectancy than their neighbours in poorer areas and in the past year, these trends have continued. Since 1999, life expectancy in males living in the poorest 15% of areas in Scotland has increased by 1.4 years while life expectancy for males living in the rest of Scotland has increased by 2.1 years. The corresponding figures for females are 1.2 years for those living in the poorest areas and 1.6 years for the rest of Scotland.
The widening gap is even more apparent when considering healthy life expectancy - the length of time an individual might expect to live in good health. Since 1999, residents of the poorest 15% of areas have seen a gain in healthy life expectancy ( HLE) of 2.1 years for men and 1.1 years for women while men and women in the rest of Scotland have seen increases in HLE of 2.9 and 2.3 years respectively. The pattern of slow improvements in health status in poor areas of Scotland with the wealthier improving faster, mirrors Scotland's international position. Countries in Western Europe with higher life expectancies than ours are often improving at a faster rate. Unless Scotland accelerates gains in life expectancy, particularly amongst the poorest communities, it will continue to fall behind other countries. Many of the policies and projects currently underway have been designed to produce a change in approach and to accelerate improvements. However, we need to do more. At a time of economic uncertainty, threats to the health of disadvantaged individuals increase and, if Scotland is to continue to progress and to do so at accelerated pace, new approaches to health creation need to be considered.
DR Harry Burns
The Chief Medical Officer for Scotland