Scottish Index of Multiple Deprivation: 2009 General Report
Scottish Index of Multiple Deprivation 2009: General Report
6. Health Domain
6.1. The health domain identifies areas with a higher than expected level of ill-health or mortality for the age-sex profile of the population. The indicators used in the health domain are listed in annex B along with their relative weights.
Changes since SIMD 2006
6.2. The indicators used are the same as for SIMD 2006, although some changes have been made to the codes used in the indicators for both hospital episodes relating to alcohol use and hospital episodes relating to drug use. Analysis of the impact of this change on the domain is available on the SIMD website.
6.3. The health domain in SIMD 2009 is very highly correlated with the SIMD 2006 Health Domain, with a Pearson's correlation coefficient of 0.97.
Health Deprivation by Local Authority
6.4. Chart 6.1 shows the spread of the 15% most deprived datazones in the health domain, by Local Authority area. Almost half of the datazones in Glasgow City are in the 15% most deprived on the Health domain, although this proportion has fallen since SIMD 2006. Inverclyde has the second highest percentage and has seen an increase between SIMD 2006 and SIMD 2009.
6.5. Some Local Authorities such as North, South and East Ayrshire and West Lothian have seen large increases in the percentage of their datazones in the 15% most deprived. These changes are apparent even when using the old codes for the alcohol and drug indicators so it is not this change driving the increase and shows a relative worsening over time.
6.6. Glasgow, Stirling, South Lanarkshire, Clackmannanshire, Dundee and Eilean Siar have all seen falls in the number of datazones in the 15% most deprived on the health domain.
Chart 6.1: Proportion of datazones in the 15% most deprived on the health domain of SIMD 2009 by Local Authority
Health Deprivation by Health Board
6.7. Table 6.1 shows the percentage of datazones in each Community Health Partnership and Health Board area that were in the 15% most deprived in the health domain in SIMD 2006 and SIMD 2009.
6.8. The Health Board that has seen the biggest increase in deprived datazones is Ayrshire and Arran (increasing from 16.0% of datazones in the 15% most deprived, to 20.6%). Forth Valley and Tayside have seen the largest drops. Greater Glasgow & Clyde has also seen a drop but remains the Health board with the highest levels of deprivation with a third of its datazones in the 15% most deprived and containing half of the deprived datazones in Scotland.
6.9. The Community Health Partnerships with the highest proportion of their datazones in the 15% most deprived are North Glasgow and East Glasgow, with 58.8% and 64.3% respectively, though this is a fall for both from two thirds of their datazones in the 15% most deprived in SIMD 2006.
Change over time
6.10. There have been changes in methodology used in the health domain over the three versions of the SIMD, so care needs to be taken when comparing the Health Domain over time. However it is possible to look at the three versions of the index to identify, for those areas in the 15% most deprived in the health domain on SIMD 2009, the numbers of versions of the domain for which they've been in the 15% most deprived (1, 2 or 3).
Table 6.1: Local and National share of datazones in the 15% most deprived on the health domain, by Health Board and Community Health Partnership
Community Health Partnership / Health Board name (Health Boards in bold) |
Total number of data zones |
15% Most deprived data zones |
|||||
|---|---|---|---|---|---|---|---|
SIMD 2006 |
SIMD 2009 |
||||||
No. of data zones |
% of local area |
% of Scotland |
No. of data zones |
% of local area |
% of Scotland |
||
East Ayrshire Community Health Partnership |
154 |
31 |
20.1% |
3.2% |
39 |
25.3% |
4.0% |
North Ayrshire Community Health Partnership |
179 |
31 |
17.3% |
3.2% |
38 |
21.2% |
3.9% |
South Ayrshire Community Health Partnership |
147 |
15 |
10.2% |
1.5% |
22 |
15.0% |
2.3% |
Ayrshire & Arran |
480 |
77 |
16.0% |
7.9% |
99 |
20.6% |
10.1% |
Scottish Borders Community Health & Care Partnership |
130 |
4 |
3.1% |
0.4% |
6 |
4.6% |
0.6% |
Borders |
130 |
4 |
3.1% |
0.4% |
6 |
4.6% |
0.6% |
Dumfries & Galloway Community Health Partnership |
193 |
11 |
5.7% |
1.1% |
10 |
5.2% |
1.0% |
Dumfries & Galloway |
193 |
11 |
5.7% |
1.1% |
10 |
5.2% |
1.0% |
Dunfermline & West Fife Community Health Partnership |
174 |
4 |
2.3% |
0.4% |
5 |
2.9% |
0.5% |
Glenrothes & North East Fife Community Health Partnership |
155 |
2 |
1.3% |
0.2% |
3 |
1.9% |
0.3% |
Kirkcaldy & Levenmouth Community Health Partnership |
124 |
8 |
6.5% |
0.8% |
9 |
7.3% |
0.9% |
Fife |
453 |
14 |
3.1% |
1.4% |
17 |
3.8% |
1.7% |
Clackmannanshire Community Health Partnership |
64 |
10 |
15.6% |
1.0% |
8 |
12.5% |
0.8% |
Falkirk Community Health Partnership |
197 |
12 |
6.1% |
1.2% |
7 |
3.6% |
0.7% |
Stirling Community Health Partnership |
110 |
13 |
11.8% |
1.3% |
9 |
8.2% |
0.9% |
Forth Valley |
371 |
35 |
9.4% |
3.6% |
24 |
6.5% |
2.5% |
Aberdeen City Community Health Partnership |
267 |
43 |
16.1% |
4.4% |
44 |
16.5% |
4.5% |
Aberdeenshire Community Health Partnership |
301 |
5 |
1.7% |
0.5% |
3 |
1.0% |
0.3% |
Moray Community Health & Social Care Partnership |
116 |
1 |
0.9% |
0.1% |
1 |
0.9% |
0.1% |
Grampian |
684 |
49 |
7.2% |
5.0% |
48 |
7.0% |
4.9% |
East Dunbartonshire Community Health Partnership |
127 |
3 |
2.4% |
0.3% |
5 |
3.9% |
0.5% |
East Glasgow Community Health & Care Partnership |
157 |
105 |
66.9% |
10.8% |
101 |
64.3% |
10.3% |
East Renfrewshire Community Health & Care Partnership * |
117 |
7 |
6.0% |
0.7% |
7 |
6.0% |
0.7% |
Inverclyde Community Health Partnership |
110 |
43 |
39.1% |
4.4% |
46 |
41.8% |
4.7% |
North Glasgow Community Health & Care Partnership |
119 |
80 |
67.2% |
8.2% |
70 |
58.8% |
7.2% |
Renfrewshire Community Health Partnership |
214 |
44 |
20.6% |
4.5% |
50 |
23.4% |
5.1% |
South East Glasgow Community Health & Care Partnership |
124 |
42 |
33.9% |
4.3% |
37 |
29.8% |
3.8% |
South West Glasgow Community Health & Care Partnership |
134 |
62 |
46.3% |
6.4% |
65 |
48.5% |
6.7% |
West Dunbartonshire Community Health Partnership |
118 |
21 |
17.8% |
2.2% |
25 |
21.2% |
2.6% |
West Glasgow Community Health & Care Partnership |
160 |
51 |
31.9% |
5.2% |
48 |
30.0% |
4.9% |
North Lanarkshire Community Health Partnership * |
22 |
1 |
4.5% |
0.1% |
0 |
0.0% |
0.0% |
South Lanarkshire Community Health Partnership * |
71 |
26 |
36.6% |
2.7% |
25 |
35.2% |
2.6% |
Greater Glasgow & Clyde |
1473 |
485 |
32.9% |
49.7% |
479 |
32.5% |
49.1% |
Argyll & Bute Community Health Partnership |
122 |
8 |
6.6% |
0.8% |
9 |
7.4% |
0.9% |
Mid Highland Community Health Partnership |
122 |
6 |
4.9% |
0.6% |
7 |
5.7% |
0.7% |
North Highland Community Health Partnership |
57 |
4 |
7.0% |
0.4% |
5 |
8.8% |
0.5% |
South East Highland Community Health Partnership |
113 |
8 |
7.1% |
0.8% |
10 |
8.8% |
1.0% |
Highland |
414 |
26 |
6.3% |
2.7% |
31 |
7.5% |
3.2% |
East Renfrewshire Community Health & Care Partnership * |
3 |
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
North Lanarkshire Community Health Partnership * |
396 |
95 |
24.0% |
9.7% |
96 |
24.2% |
9.8% |
South Lanarkshire Community Health Partnership * |
327 |
39 |
11.9% |
4.0% |
25 |
7.6% |
2.6% |
Lanarkshire |
726 |
134 |
18.5% |
13.7% |
121 |
16.7% |
12.4% |
East Lothian Community Health Partnership |
120 |
1 |
0.8% |
0.1% |
1 |
0.8% |
0.1% |
Midlothian Community Health Partnership |
112 |
7 |
6.3% |
0.7% |
6 |
5.4% |
0.6% |
West Lothian Community Health & Care Partnership |
211 |
19 |
9.0% |
1.9% |
35 |
16.6% |
3.6% |
Edinburgh Community Health Partnership |
549 |
59 |
10.7% |
6.0% |
54 |
9.8% |
5.5% |
Lothian |
992 |
86 |
8.7% |
8.8% |
96 |
9.7% |
9.8% |
Orkney Community Health Partnership |
27 |
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
Orkney |
27 |
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
Shetland Community Health Partnership |
30 |
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
Shetland |
30 |
0 |
0.0% |
0.0% |
0 |
0.0% |
0.0% |
Angus Community Health Partnership |
142 |
2 |
1.4% |
0.2% |
1 |
0.7% |
0.1% |
Dundee Community Health Partnership |
179 |
43 |
24.0% |
4.4% |
38 |
21.2% |
3.9% |
Perth & Kinross Community Health Partnership |
175 |
8 |
4.6% |
0.8% |
6 |
3.4% |
0.6% |
Tayside |
496 |
53 |
10.7% |
5.4% |
45 |
9.1% |
4.6% |
Western Isles Community Health Partnership |
36 |
2 |
5.6% |
0.2% |
0 |
0.0% |
0.0% |
Western Isles |
36 |
2 |
5.6% |
0.2% |
0 |
0.0% |
0.0% |
Scotland |
6505 |
976 |
15.0% |
100.0% |
976 |
15.0% |
100.0% |
* These Community Health Partnerships are split across two health boards. Data zones have been counted in the Health Board in which they fall. Totals and percentages for these CHPs are: |
|||||||
East Renfrewshire Community Health & Care Partnership |
120 |
7 |
5.8% |
0.7% |
7 |
5.8% |
0.7% |
North Lanarkshire Community Health Partnership |
418 |
96 |
23.0% |
9.8% |
96 |
23.0% |
9.8% |
South Lanarkshire Community Health Partnership |
398 |
65 |
16.3% |
6.7% |
50 |
12.6% |
5.1% |
6.11. Of the datazones in the 15% most deprived in the Health domain on SIMD 2009 in Scotland, over 70% have been in the 15% most deprived in each of the three versions of the domain (Chart 6.2). Greater Glasgow & Clyde Health Board has the highest percentage (87%) of datazones remaining in the 15% most deprived over all three versions of the domain. Borders and Fife Health Boards have the highest proportion of new datazones in the 15% most deprived. These Health Boards have seen increases in the number of datazones in the 15% most health deprived in SIMD 2009 which explains this.
Chart 6.2: Datazones in the 15% most deprived (Health Domain) in SIMD 2009 showing the numbers of versions of the index for which they've been in the 15% most deprived*
* Number in brackets shows the number of datazones in each Health Board in the 15% most deprived on the Health domain of SIMD 2009
6.12. Analysis of the data behind the health domain can show whether there has been an absolute improvement in those datazones that have moved out of the 15% most deprived. Five of the seven indicators in the health domain have not changed since SIMD 2006 so an improvement or worsening in these indicators will show whether things are getting better.
6.13. Of the 139 datazones that moved out of the 15% most deprived, 97 (70%) experienced an improvement in 3 or more of the indicators. 89 datazones (64% of those moving out) experienced an improvement in both the Comparative Illness Factor and the Emergency Admissions indicator (which together make up 60% of the domain). 138 datazones (99% of those moving out) experienced an improvement in at least one of the indicators.
6.14. Of the datazones moving into the 15% most deprived, 91% saw a worsening on three or more of the indicators. 63% saw a worsening on Comparative Illness Factor and Emergency admissions with 99% seeing a worsening on at least one. This shows that absolute changes were at least part of the driver for datazones moving in or out of the 15% most deprived on the health domain.
6.15. Of the datazones that have moved out of the 15% most deprived, 60% have moved to the 15-20% most deprived band and another quarter to the 10-25% most deprived band. Of the datazones moving in, two-thirds have moved from the 15-20% most deprived band and another quarter have moved from the 20-25% most deprived band.
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