Information

Long-term Monitoring of Health Inequalities - Headline Indicators - October 2010

This publication is an update of headline indicators from the long term monitoring of health inequalities report, last published in September 2009.

This document is part of a collection


Results

Healthy Life Expectancy ( HLE) - at birth

Summary

  • Inequalities are stable in both absolute and relative terms

The HLE indicator is based on two years of data to ensure large enough sample sizes. Between 1999/2000 and 2007/2008, HLE has increased by 3 years (4.5%) for males and 2.3 years (3.5%) for females. Over the same period, the difference between HLE and total life expectancy (that is, the number of years that could be expected to be spent in poor health) has fallen by 0.6 years (7%) for males and 0.8 years (8%) for females. In 2007/2008, HLE at Scotland level for males was 68.0 years (7.2 years less than total life expectancy) and HLE for females was 70.5 years (9.4 years less than total life expectancy). HLE in deprived areas is lower for both males and females than HLE in areas of low deprivation. In 2007/2008, HLE of those living in the most deprived decile was 18.8 years lower for males and 17.1 years lower for females than HLE of those living in the least deprived decile. The difference between HLE and total life expectancy (expected years spent in poor health) is also notably greater in more deprived areas: for males - 10.3 years in poor health in the most deprived decile compared with 5.5 years in the least deprived decile; and for females - 14.4 years in poor health in the most deprived decile compared with 6.0 years in the least deprived decile. Between 1999/2000 and 2007/2008, increases in HLE have been observed across the population, with no discernible difference between deprivation groups. Inequalities have been stable in both absolute and relative terms (as demonstrated by the absolute range and RII respectively).

Inequalities gradient in the most recent year available

Chart 1

rt 2

(Note: the red bars for each column indicate the uncertainties in each estimate of HLE).

Relative Index of Inequality ( RII) over time

rt 3

rt 4

Absolute range over time

rt 5

rt 6

(Note: the red bars for each column indicate the uncertainties in each estimate of absolute difference in HLE).

Scale / context

Male HLE in years

95% LL

95% UL

Male LE in years

95% LL

95% UL

Estimated years spent in poor health

1999/2000

Scotland

65.0

64.7

65.4

73.0

72.8

73.1

7.8

Most deprived decile

53.7

52.5

54.9

65.8

65.4

66.3

11.7

Least deprived decile

75.0

73.9

76.0

78.6

78.3

79.0

3.3

2001/2002

Scotland

65.9

65.6

66.2

73.4

73.3

73.5

7.4

Most deprived decile

55.0

53.8

56.2

65.8

65.4

66.3

10.4

Least deprived decile

75.7

74.7

76.6

79.5

79.1

79.9

3.4

2003/2004

Scotland

74.0

73.9

74.1

-

Most deprived decile

66.3

65.9

66.8

-

Least deprived decile

79.7

79.3

80.0

-

2005/2006

Scotland

67.4

67.1

67.7

74.8

74.7

74.9

7.3

Most deprived decile

57.0

55.9

58.1

67.5

67.1

67.9

10.1

Least deprived decile

76.8

75.8

77.8

80.7

80.4

81.1

3.6

2007/2008

Scotland

68.0

67.6

68.3

75.1

75.2

75.0

7.2

Most deprived decile

56.9

55.7

58.1

67.6

67.2

68.0

10.3

Least deprived decile

75.7

74.6

76.8

80.9

81.2

80.5

5.5

Female HLE in years

95% LL

95% UL

Female LE in years

95% LL

95% UL

Estimated years spent in poor health

1999/2000

Scotland

68.2

67.8

68.5

78.4

78.3

78.5

10.2

Most deprived decile

59.8

58.6

61.0

74.2

73.9

74.6

14.1

Least deprived decile

77.1

76.2

78.0

81.8

81.5

82.1

4.4

2001/2002

Scotland

69.2

68.9

69.6

78.9

78.8

79.0

9.5

Most deprived decile

60.0

58.8

61.2

74.6

74.2

74.9

14.2

Least deprived decile

76.8

75.7

77.9

82.4

82.1

82.8

5.3

2003/2004

Scotland

79.1

79.0

79.2

-

Most deprived decile

74.8

74.4

75.2

-

Least deprived decile

83.0

82.6

83.3

-

2005/2006

Scotland

69.6

69.3

70.0

79.7

79.6

79.8

10.0

Most deprived decile

59.9

58.7

61.1

75.1

74.7

75.5

14.9

Least deprived decile

78.1

76.9

79.2

84.2

83.9

84.6

5.8

2007/2008

Scotland

70.5

70.1

70.9

80.0

79.8

80.1

9.4

Most deprived decile

60.8

59.5

62.1

75.6

75.2

75.9

14.4

Least deprived decile

77.9

76.7

79.1

84.2

83.9

84.5

6.0

Premature Mortality - from all causes, aged under 75 years

Summary

  • Inequalities are stable in absolute terms but are widening in relative terms

Between 1997 and 2008, deaths amongst those aged under 75 years have decreased by 21.2%. Despite these decreases, around 22,000 people aged under 75 still die each year. Deaths in this age group are more common in deprived areas than in areas of low deprivation. In 2008, the rate in the most deprived decile was 698 compared to a rate of 205 in the least deprived decile - a difference of 493 premature deaths per 100,000 population. Recent reductions in premature mortality have been observed across the population. Whilst inequalities have been stable in absolute terms (as demonstrated by the absolute range), improvements observed in deprived areas have not been as great as those observed elsewhere in Scotland resulting in a widening of inequalities in relative terms (as demonstrated by RII).

Inequalities gradient in the most recent year available

rt 7

Relative Index of Inequality ( RII) over time

rt 8

Absolute range over time

rt 9

Scale / context

Number of deaths

Target population size

Rate per 100,000 ( EASR)

1997

26,081

4,740,269

485.5

1998

25,857

4,729,975

479.8

1999

25,491

4,721,298

471.6

2000

24,593

4,708,667

454.1

2001

24,168

4,703,661

446.2

2002

24,219

4,690,508

443.8

2003

23,789

4,690,603

431.4

2004

22,896

4,706,922

411.6

2005

22,441

4,718,403

401.0

2006

22,237

4,734,676

395.8

2007r

22,359

4,755,963

393.4

2008

22,005

4,775,321

382.8

Mental Wellbeing ( WEMWBS) - adults aged 16 years and over

Summary

  • Inequalities are stable in both absolute and relative terms but more data required to identify a trend

There is a clear difference in mean WEMWBS scores in terms of deprivation. Those in the most deprived decile reported a lower mean score (indicating lower mental wellbeing) than those in the highest decile (a difference of 3.9 between the lowest and highest deciles). Both absolute and relative inequalities have remained stable although with only two data points available more information is required over time to identify a trend.

Inequalities Gradient in the most recent year available

rt 10

Relative Index of Inequality ( RII) over time

rt 11

Absolute range over time

rt 12

Scale / context

SIMD decile

Mean WEMWBS

score 2008

Mean WEMWBS

score 2009

most deprived

47.4

47.5

2

47.8

47.7

3

48.9

49.1

4

49.6

49.2

5

49.8

49.4

6

50.5

49.9

7

50.7

50.7

8

51.3

50.8

9

51.6

51.3

least deprived

51.7

51.4

Total

50.0

49.8


Low Birthweight

Summary

  • Inequalities are narrowing in both absolute and relative terms

Between 1998 and 2008, the number and percentage of low birthweight babies has been relatively stable. Around 3,000 low birthweight babies are born each year (around 6% of total live, singleton births in Scotland). As found previously, low birthweight babies are more common in deprived areas than in areas of low deprivation. In 2008, the percentage in the most deprived decile was 7.6 compared to 3.9 in the least deprived decile - a difference of 3.7 percentage points. However, inequalities have narrowed in both absolute (as demonstrated by the absolute range) and relative terms (as demonstrated by the RII). This is mainly due to a reduction in the most deprived deciles as the percentage of low birthweight babies in the least deprived decile has remained fairly stable in recent years.

Inequalities gradient in the most recent year available

rt 13

Relative Index of Inequality ( RII) over time

rt 14

Absolute range over time

rt 15

Scale / context

Number of low BW babies

Target population size (live singleton births)

Percentage

1998

3108

55,152

5.6

1999

3098

52,726

5.9

2000

2906

51,082

5.7

2001

2848

49,752

5.7

2002

2910

48,952

5.9

2003

3026

50,071

6.0

2004

3030

51,852

5.8

2005

3056

51,372

5.9

2006

2928

52,286

5.6

2007r

3083

54,863

5.6

2008

3104

56,305

5.5

Coronary Heart Disease - first ever hospital admission for heart attack aged under 75 years

Summary

  • Inequalities have decreased in both absolute and relative terms in recent years

Around 3,800 new cases (aged under 75 years) were admitted to hospital for heart attack in 2008. However between 1997 and 2008, there has been a considerable decrease (40%) in the annual rates. Despite this downward trend, in 2008 the rate of admission for people living in the most deprived decile was 96.1 per 100,000 population compared to a rate of 43.1 in the least deprived decile - a difference of 53.0. Although both absolute and relative measures reflect higher rate of hospital admissions in deprived areas, the extent of these inequalities has been decreasing since 2003, mainly due to a reduction in the most deprived areas.

Inequalities gradient in the most recent year available

rt 16

Relative Index of Inequality ( RII) over time

rt 17

Absolute range over time

rt 18

Scale / context

Number of new cases*

Target population size*

Rate per 100,000 ( EASR)*

1997

5,814

4,740,269

111.8

1998

5,735

4,729,975

109.3

1999

5,155

4,721,298

97.9

2000

4,886

4,708,667

92.0

2001

4,852

4,703,661

90.9

2002

4,877

4,690,508

90.4

2003

4,634

4,690,603

85.1

2004

4,468

4,706,922

81.4

2005

4,117

4,718,403

74.3

2006

3,883

4,734,676

69.8

2007

3,681

4,755,963

65.5

2008

3,802

4,775,321

66.9

*Please note that trend data for this indicator have been revised from last year's report.

Coronary Heart Disease ( CHD) - deaths aged 45-74 years

Summary

  • Inequalities have narrowed in absolute terms but are widening in relative terms

Between 1997 and 2008, there has been a considerable decrease in CHD mortality amongst the population aged 45-74 years as a whole - rates fell by 51%. However, CHD remains one of Scotland's biggest causes of premature mortality, with around 3,100 deaths occurring in the latest year. Premature mortality from CHD is more prevalent in deprived areas than in areas of low deprivation. In 2008, there were 299 deaths per 100,000 population in the most deprived decile compared to 63 deaths per 100,000 population in the least deprived decile. The absolute range indicates that inequalities have narrowed in absolute terms, however improvements observed in deprived areas have not been as great as those observed in Scotland overall, resulting in a widening of inequalities in relative terms (as demonstrated by the RII).

Inequalities gradient in the most recent year available

rt 19

Relative Index of Inequality ( RII) over time

rt 20

Absolute range over time

rt 21

Scale / context

Number of deaths

Target population size

Rate per 100,000 ( EASR)

1997

5,887

1,635,590

320.0

1998

5,676

1,646,711

306.1

1999

5,389

1,658,124

289.8

2000

4,858

1,670,660

261.1

2001

4,483

1,687,422

238.9

2002

4,309

1,703,819

227.9

2003

4,197

1,724,940

219.5

2004

3,840

1,750,293

198.8

2005

3,721

1,771,454

191.2

2006

3,394

1,793,423

174.5

2007

3,374

1,818,202

171.4

2008

3,153

1,843,609

157.8

Cancer - incidence rate aged under 75 years

Summary

  • Inequalities are stable in both absolute and relative terms

There were around 18,500 new cases of cancer diagnosed in 2007. Rates have decreased by 5% since 1996 but fluctuated year on year with not clear trend since 1997. In 2007, the rate in the most deprived decile was 414 per 100,000 population compared to a rate of 288 in the least deprived decile - a difference of 126. Inequality measures (both absolute range and RII) have remained stable, albeit with some fluctuations from one year to the next.

Inequalities gradient in the most recent year available

rt 22

Relative Index of Inequality ( RII) over time

rt 23

Absolute range over time

rt 24

Scale / context

Number of new cases

Target population size

Rate per 100,000 ( EASR)

1996

18,136

4,754,906

345.1

1997

17,160

4,740,269

326.7

1998

17,144

4,729,975

323.6

1999

16,915

4,721,298

318.4

2000

17,122

4,708,667

321.2

2001

17,097

4,703,661

318.8

2002

17,465

4,690,508

323.3

2003

17,453

4,690,603

319.2

2004

18,002

4,706,922

326.5

2005

17,800

4,718,403

319.3

2006

17,873

4,734,676

318.5

2007

18,577

4,755,963

328.1

Cancer - deaths aged 45-74 years

Summary

  • Inequalities have generally increased in absolute and relative terms over time but there has been a slight reduction in the latest year.

Between 1997 and 2008, there has been a 15.4% decrease in rates of death from cancer amongst those aged 45-74 years as a whole. In 2008, around 7,500 people aged 45-74 died from cancer. Cancer deaths in this age group are more common in deprived areas (588 per 100,000 population) than in areas of low deprivation (273 per 100,000 population) - a difference of 315. Previous data up to 2007 suggested an increase in inequalities in both absolute and relative terms. However, data for 2008 shows a slight decrease in both measures.

Inequalities gradient in the most recent year available

rt 25

Relative Index of Inequality ( RII) over time

rt 26

Absolute range over time

rt 27

Scale / context

Number of deaths

Target population size

Rate per 100,000 ( EASR)

1997

8,068

1,635,590

446.9

1998

7,995

1,646,711

440.0

1999

7,904

1,658,124

433.8

2000

7,776

1,670,660

422.8

2001

7,903

1,687,422

430.1

2002

7,850

1,703,819

422.4

2003

7,706

1,724,940

409.3

2004

7,678

1,750,293

402.0

2005

7,606

1,771,454

396.7

2006

7,486

1,793,423

386.6

2007

7,569

1,818,202

385.4

2008

7,503

1,843,609

377.9

Alcohol - first ever hospital admission aged under 75 years

Summary

  • Inequalities have fluctuated with no clear trend in absolute and relative terms

There has been a 19% increase in rates of new hospital admissions for alcohol related conditions amongst those aged under 75 years between 1997 and 2008. In 2008 there were around 15,000 new cases. These types of admissions are more common in deprived areas - 661 per 100,000 population compared to 145 per 100,000 population in areas of low deprivation, absolute range is 516. Both absolute and relative inequalities have remained stable, albeit with some fluctuation from one year to the next. There was a slight decrease in inequality in the latest year, mainly cause by an increase in the admission rate in the least deprived decile from 134 to 145 per 100,000 population.

Inequalities gradient in the most recent year available

rt 28

Relative Index of Inequality ( RII) over time

rt 29

Absolute range over time

rt 30

Scale / context

Number of admissions

Target pop

EASR

1997

12,310

4,740,269

254.1

1998

12,900

4,729,975

265.7

1999

12,871

4,721,298

265.8

2000

12,695

4,708,667

262.6

2001

13,474

4,703,661

276.9

2002

13,656

4,690,508

280.3

2003

13,249

4,690,603

269.6

2004

14,482

4,706,922

291.6

2005

13,911

4,718,403

278.8

2006

14,353

4,734,676

286.7

2007r

15,344

4,755,963

307.0

2008

15,185

4,775,321

302.0

Alcohol - deaths aged 45-74 years

Summary

  • Inequalities have fluctuated in absolute and relative terms over time but there has been a slight reduction in the latest year.

Between 1998 and 2008, there has been a 13% increase in the rates of alcohol related deaths amongst those aged under 45-74 years as a whole. Numbers have risen to around 1,800 deaths per year in this age group dying from alcohol related conditions. There are more alcohol related deaths amongst those aged 45-74 years in deprived areas than in areas of low deprivation. In 2008, the rate in the most deprived decile was 259 per 100,000 population compared to a rate of 28 per 100,000 population in the least deprived decile - a difference of 231 deaths. Increases in alcohol related deaths amongst those aged 45-74 years have been particularly observed in deprived areas. Both absolute and relative inequalities have shown some fluctuation from one year to the next. There was a slight decrease in inequality in the latest year, mainly cause by a decrease in the alcohol related death rate for the most deprived decile from 303 to 258 per 100,000 population.

Inequalities gradient in the most recent year available

rt 31

Relative Index of Inequality ( RII) over time

rt 32

Absolute range over time

rt 33

Scale / context

Number of deaths

Target population size

Rate per 100,000 ( EASR)*

1998

1,415

1,646,711

85.6

1999

1,508

1,658,124

91.0

2000

1,489

1,670,660

89.1

2001

1,565

1,687,422

92.8

2002

1,753

1,703,819

102.9

2003

1,749

1,724,940

101.4

2004

1,764

1,750,293

100.8

2005

1,790

1,771,454

101.1

2006

1,899

1,793,423

105.9

2007

1,801

1,818,202

99.1

2008

1,782

1,843,609

96.7

*Please note that all data have been revised due to an error in the standardisation calculations.

All-cause mortality aged 15-44 years

Summary

  • Inequalities have remained stable in absolute terms but are widening in relative terms

Between 1997 and 2008, rates of death have been stable amongst those aged 15-44 years as a whole. Within this age group, rates of drug related deaths have more than doubled over the same period (to around 470 deaths per year), rates of death from assault have stayed the same (around 50 deaths per year) and rates of death from suicide have dropped by 3% (to around 480 deaths per year). However, note that the relatively small numbers involved mean that comparison of numbers for single years should be interpreted with caution as there will be natural fluctuation from one year to the next. Deaths amongst those aged 15-44 years are more common in deprived areas than in areas of low deprivation. In 2008, the all-cause mortality rate for adults aged 15-44 years in the most deprived decile was 248 compared to a rate of 52 in the least deprived decile - a difference of 196 deaths. Whilst inequalities has remained fairly stable in absolute term over this period, it has increased in relative terms (as demonstrated by the RII, albeit with some fluctuation from one year to the next).

Inequalities gradient in the most recent year available

rt 34

Relative Index of Inequality ( RII) over time

rt 35

Absolute range over time

rt 36

Scale / context

Number of all-causes deaths

Target population size

Rate per 100,000 ( EASR)*

1997

2,436

2,158,030

112.0

1998

2,498

2,142,787

115.1

1999

2,507

2,129,794

115.6

2000

2,501

2,118,568

114.8

2001

2,509

2,111,242

114.9

2002

2,566

2,096,447

118.5

2003

2,461

2,087,978

113.3

2004

2,409

2,084,722

110.9

2005

2,305

2,081,858

105.5

2006

2,482

2,085,170

114.5

2007

2,461

2,086,427

114.2

2008

2,443

2,081,506

114.5

*Please note that all data have been revised due to an error in the standardisation calculations.

Deaths from assault

Drug related deaths

Suicides

Number

EASR per 100,000

Number

EASR per 100,000

Number

EASR per 100,000

1997

56

2.6

196

9.1

518

23.7

1998

65

3.1

227

10.8

526

24.2

1999

86

4.0

274

13.2

529

24.6

2000

60

2.9

268

12.8

541

25.5

2001

63

3.0

288

13.8

531

24.9

2002

76

3.6

345

17.0

539

25.6

2003

71

3.4

281

13.7

456

21.5

2004

78

3.8

311

15.4

475

22.1

2005

50

2.4

277

13.2

436

20.7

2006

83

4.0

351

17.0

435

20.6

2007

54

2.6

392

18.9

453

21.6

2008

53

2.6

477

23.1

480

23.1

Back to top