Publication - Statistics

Long-term monitoring of health inequalities: December 2018 report

Published: 11 Dec 2018

Annual update of the long-term monitoring of health inequalities headline indicators.

Long-term monitoring of health inequalities: December 2018 report
Headline indicators of Health Inequalities

Headline indicators of Health Inequalities

Premature Mortality (under 75 years)

In 2017, the gap in premature mortality rates between the most and least deprived areas reduced for the first time in three years and is lower than at the start of the time series in 1997. Relative inequalities, however, have widened over the long term.

In 1997, premature mortality rates were 3 times higher in the most deprived areas compared to the least deprived; in 2017, rates were 4 times higher in the most deprived areas.

Trends in premature mortality

Around 21,000 people in Scotland died before the age of 75 in 2017.

Over the long term there has been a reduction in the mortality rate among under-75s. The age-standardised mortality rate among under-75s in 2017 was 425.2 per 100,000 people, a reduction of 35 per cent since 1997 (651.9 per 100,000).

Inequalities in premature mortality, 2017

In 2017, the premature mortality rate in the most deprived areas was 812.1 per 100,000, 4 times higher than the rate in the least deprived areas (218.9 per 100,000).

Figure 1.1

Figure 1.1

Trends in relative inequalities

Over the longer term, relative inequalities have increased. The RII for 2017 is the highest on record at 1.44, compared with 1.00 at the start of the time series in 1997.

Between 1997 and 2017, premature mortality rates declined by 43% in the least deprived areas, but by only 21% in the most deprived areas in Scotland.

In 1997, premature mortality rates were 3 times higher in the most deprived areas compared to the least deprived; in the last three years premature mortality rates have been 4 times higher in the most deprived areas.

Figure 1.2

Figure 1.2

Trends in absolute inequalities

Absolute inequalities in premature mortality reached a peak in 2002. Between 2002 and 2013 there was a general downward trend. Most notably, the absolute gap between the most and least deprived areas reduced every year between 2007 and 2013.

Since 2013 the gap has increased, although it is currently lower than at any point prior to 2010.

Figure 1.3

Figure 1.3

Table 1.1: Trends in premature mortality (under 75 years), 1997-2017

Year Number of deaths Target population size Rate per 100,000 (EASR)
1997 26,081 4,740,269 651.9
1998 25,857 4,729,975 643.3
1999 25,491 4,721,298 632.5
2000 24,593 4,708,667 607.3
2001 24,168 4,703,661 593.1
2002 24,219 4,701,958 588.9
2003 23,789 4,702,431 573.4
2004 22,896 4,714,233 546.2
2005 22,441 4,735,320 530.3
2006 22,237 4,752,425 520.4
2007 22,359 4,783,452 516.8
2008 22,005 4,811,453 501.3
2009 21,229 4,835,007 477.0
2010 20,997 4,858,058 467.4
2011 20,685 4,888,316 456.1
2012 20,446 4,895,114 445.3
2013 20,344 4,903,074 437.5
2014 19,961 4,914,362 423.2
2015 20,988 4,935,283 440.5
2016 21,313 4,962,391 439.7
2017 20,992 4,976,829 425.2

Mental Wellbeing – adults aged 16+

The gap in mental wellbeing amongst adults living in the most deprived and least deprived areas has decreased over the last two time periods from 20.9 percentage points in 2012/2013 to 17.2 percentage points in 2016/2017, however, it remains higher than at the start of the time series (15.5 percentage points in 2008/2009).

Adults in the most deprived areas were three times more likely to have below average wellbeing than adults in the least deprived areas at all time periods except 2012/2013, when they were five time more likely to have below average wellbeing.

Trends in mental wellbeing

The mean score on the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) was fairly static between 2008/09 and 2016/17 ranging from 49.8-49.9.

‘Below average’ wellbeing has been defined as WEMWBS scores of at least one standard deviation below the mean, equivalent to scores of 41 or lower in all years. The proportion of adults in Scotland who have a below average WEMWBS score has remained at 15% since 2008/2009.

Inequalities in mental wellbeing, 2016/17

In 2016/17, 24% of adults in the most deprived areas had below average wellbeing, indicated by a WEMWBS score of 41 or lower. This compared to 7% of adults in the least deprived areas.

Figure 2.1

Figure 2.1

Trends in relative inequalities

The relative index of inequality (RII) in below average wellbeing increased slightly between 2014/2015 and 2016/2017 (from 1.13 to 1.16) but remained below the 2008/2009 figure of 1.18.

Adults in the most deprived areas were approximately 3 times more likely to have below average wellbeing compared to those in the least deprived areas at all time periods except 2012/2013, when they were 5 times more likely to have below average wellbeing.

Figure 2.2

Figure 2.2

Trends in absolute inequalities

The gap in prevalence of below average wellbeing between those in the most and least deprived areas increased until 2012/2013 before decreasing over the last two time periods. However, the gap in 2016/2017 (17.2 percentage points) is higher than at the start of the time series (15.5 percentage points in 2008/2009).

Figure 2.3

Figure 2.3

Table 2.1: Trends in mental wellbeing, 2008/2009-2016/2017

Year Mean WEMWBS Below average wellbeing
(
indicated by a WEMWBS score of 41 or lower)
Mean WEMWBS score Lower 95% confidence limit Upper 95% confidence limit Proportion of adults with below average wellbeing (%) Lower 95% confidence limit (%) Upper 95% confidence limit (%)
2008/2009 49.8 49.6 50.0 14.8 14.1 15.6
2010/2011 49.9 49.7 50.1 15.0 14.2 15.8
2012/2013 49.9 49.7 50.2 14.9 13.9 15.8
2014/2015 49.9 49.7 50.2 14.7 13.7 15.7
2016/2017 49.8 49.6 50.1 15.1 14.1 16.2

Contact

Email: Morag Shepherd