Publication - Statistics

Long-term monitoring of health inequalities: January 2020 report

Published: 28 Jan 2020

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

61 page PDF

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61 page PDF

4.5 MB

Supporting files

Contents
Long-term monitoring of health inequalities: January 2020 report
Inequalities in morbidity and mortality indicators

61 page PDF

4.5 MB

Supporting files

Inequalities in morbidity and mortality indicators

The relative index of inequality (RII) indicates the extent to which health outcomes are worse in the most deprived areas compared to the average throughout Scotland. While comparisons of RII between indicators are possible, they should be made with some caution, in particular where absolute values are significantly higher or lower in the compared indicators or where the measurement scale differs.

The following charts group indicators in this report into broadly comparable categories: the first shows hospital admissions and incidence of conditions for people belonging to the under 75 age group; while the second shows mortality rates in the 45-74 age group for three causes of death.

Although relative inequalities in heart attack hospital admissions have increased in recent years, inequalities have remained highest in alcohol-related admissions throughout the period covered by this report. Inequalities in cancer incidence have remained relatively stable.

Figure 2.1

Relative Index of Inequality (RII) Selected morbidity indicators (ages <75 years) Scotland 1997-2018

Figure 2.1

Relative inequalities in CHD mortality among adults aged 45-74 have increased over the long term. Relative inequalities for alcohol-specific deaths have shown more year on year fluctuation over the same period and are currently the lowest in the time series at 1.79.

Although RII in cancer mortality has increased slightly over the longer term, inequalities remain highest in alcohol-specific and coronary heart disease deaths .

Figure 2.2

Relative Index of Inequality (RII) Mortality indicators (ages 45 74 years) Scotland 1997-2018

Figure 2.2

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

Trends in heart attack hospital admissions

In 2018, around 4,200 new cases of heart attack (for those aged under 75 years) were recorded in Scottish hospitals.

The rate of admissions is currently 42% lower than in 1997. Whilst there were increases in the rate of hospital admissions between 2007 and 2012, (rising from 80.4 per 100,000 to 100.8 per 100,000), in 2018 the rate of hospital admissions was the third lowest on record (83.9 per 100,000).

Table 3.1: Trends in heart attack hospital admissions (aged <75), 1997-2018

Total admissions Population Rate per 100,000 (EASR)
1997 5,764 4,740,269 145.1
1998 5,676 4,729,975 141.5
1999 5,101 4,721,298 126.6
2000 4,812 4,708,667 118.4
2001 4,776 4,703,661 116.9
2002 4,833 4,701,958 116.6
2003 4,569 4,702,431 109.0
2004 4,413 4,714,233 103.9
2005 4,047 4,735,320 94.2
2006 3,750 4,752,425 86.4
2007 3,549 4,783,452 80.4
2008 3,655 4,811,453 81.7
2009 3,851 4,835,007 84.9
2010 4,377 4,858,058 95.4
2011 4,537 4,888,316 97.7
2012 4,747 4,895,114 100.8
2013 4,697 4,903,074 98.8
2014 4,503 4,914,362 93.4
2015 4,521 4,935,283 92.8
2016 4,521 4,962,391 91.5
2017 4,738 4,976,829 94.8
2018 4,233 4,983,364 83.9

Inequalities in hospital heart attack hospital admissions, 2018

In 2018, the admission rate in Scotland's most deprived areas was more than twice that of those living in the least deprived (132.4 cases per 100,000 compared to 55.1 per 100,000).

Figure 3.1

Hospital admissions for heart attack among those aged <75y by Income Employment Index, Scotland 2018 (European Age Standardised Rates per 100,000)

Figure 3.1

Trends in relative inequalities

Relative inequality levels for heart attack hospital admissions have fluctuated over time, ranging from 0.69-1.01. The RII for 2018 (0.95) is higher than that at the start of the time series (0.82).

Figure 3.2

Relative Index of Inequality (RII): Hospital admissions for heart attack <75y Scotland 1997 2018

Figure 3.2

Heart attack hospital admission rates (aged <75) have been 2-3 times higher in the most deprived areas compared to the least deprived areas across the time series. (European Age Standardised Rates per 100,000)

Trends in absolute inequalities

The absolute gap in hospital admissions between those living in the most and least deprived areas was 77.3 per 100,000 in 2018, lower than at the start of the times series in 1997 when the gap was at its largest (114.6 per 100,000).

However, absolute inequalities have fluctuated over that time, with the gap at its narrowest between 2006 and 2008.

Figure 3.3

Absolute Gap: Hospital admissions for heart attack <75y Scotland 1997-2018 (European Age Standardised Rates per 100,000)

Figure 3.3

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

Trends in CHD deaths

In 2018, around 2,400 deaths amongst those aged 45-74 years were attributed to CHD.

Since 1997, there has been a considerable decrease in CHD mortality amongst the population aged 45-74 years. In 2018, the death rate for this age group was 117.6 per 100,000, less than one third what it was in 1997 and the lowest figure on record.

Table 4.1: Trends in coronary heart disease deaths (aged 45-74), 1997-2018

  Number of deaths Target population size Rate per 100,000 (EASR)
1997 5,887 1,635,590 372.5
1998 5,675 1,646,711 357.9
1999 5,389 1,658,124 338.9
2000 4,858 1,670,660 303.9
2001 4,483 1,687,422 279.3
2002 4,310 1,706,141 265.9
2003 4,197 1,727,112 256.3
2004 3,840 1,751,037 232.3
2005 3,721 1,774,865 222.3
2006 3,393 1,799,382 200.8
2007 3,374 1,827,320 196.6
2008 3,155 1,856,874 180.9
2009 2,857 1,885,693 160.7
2010 2,811 1,914,226 156.6
2011 2,592 1,941,253 142.6
2012 2,584 1,964,203 139.7
2013 2,515 1,986,202 133.7
2014 2,358 2,007,988 123.1
2015 2,463 2,026,210 127.4
2016 2,467 2,047,858 124.7
2017 2,476 2,064,612 122.2
2018 2,416 2,073,318 117.6

Inequalities in CHD deaths, 2018

In 2018, the CHD mortality rate was more than four times greater in Scotland's most deprived areas compared to the least deprived (219.8 compared to 54.0 deaths per 100,000 population).

Figure 4.1

CHD mortality amongst those aged 45-74y by Income Employment Index, Scotland 2018 (European Age Standardised Rates per 100,000)

Figure 4.1

Trends in relative inequalities

Relative inequalities in CHD mortality have increased over the longer term. The RII figures for the last four years have been the highest in the time series, ranging from 1.54-1.60.

Figure 4.2

Relative Index of Inequality (RII): CHD mortality 45-74y Scotland 1997-2018

Figure 4.2

In the last ten years, CHD mortality rates have typically been 4-5 times higher in the most deprived areas compared to the least deprived areas. This is higher than at the start of the times series when CHD mortality rates were typically 3-4 times higher.

Trends in absolute inequalities

In contrast to relative inequality, absolute inequality between those living in the most deprived areas and those living in the least deprived areas has reduced over the longer term from a high of 390.1 per 100,000 in 1998. The current gap is the lowest across the series and less than half what it was in 1998 (165.8 per 100,000 in 2018).

Figure 4.3

Absolute Gap: CHD mortality 45-74 years, Scotland 1997 2018 (European Age Standardised Rates per 100,000)

Figure 4.3

Cancer incidence rate aged under 75 years

Trends in cancer incidence

In 2017, there were around 21,200 new cases of cancer among people aged under 75. Figures for 2018 are not currently available and will be included in the next report.

Cancer incidence among people aged under 75 has fluctuated over the time series. It showed a general decrease from a high of 452.7 per 100,000 in 1996 to 417.5 per 100,000 in 1999, before showing an overall increase until 2009 (446.6 per 100,000). Since then cancer incidence has decreased overall and was 426.5 per 100,000 in 2017.

Table 5.1: Trends in cancer incidence (aged < 75), 1996-2017

Number of new cases Target population size Rate per 100,000 (EASR)
1996 18,128 4,754,906 452.7
1997 17,167 4,740,269 427.4
1998 17,109 4,729,975 424.3
1999 16,914 4,721,298 417.5
2000 17,138 4,708,667 420.6
2001 17,147 4,703,661 418.9
2002 17,530 4,701,958 423.6
2003 17,574 4,702,431 420.8
2004 18,159 4,714,233 430.3
2005 17,987 4,735,320 421.9
2006 18,167 4,752,425 423.3
2007 18,775 4,783,452 430.8
2008 19,449 4,811,453 439.7
2009 19,999 4,835,007 446.6
2010 20,015 4,858,058 441.9
2011 20,208 4,888,316 441.3
2012 20,296 4,895,114 436.8
2013 20,598 4,903,074 437.7
2014 21,064 4,914,362 442.4
2015 20,888 4,935,283 433.5
2016 20,980 4,962,391 429.2
2017 21,187 4,976,829 426.5

Inequalities in cancer incidence, 2017

In 2017, there were 524.5 cases of cancer per 100,000 people in the most deprived areas, compared to 373.6 cases per 100,000 in the least deprived areas.

Figure 5.1

Cancer incidence amongst those aged <75y by Income Employment Index,Scotland 2017 (European Age Standardised Rates per 100,000)

Figure 5.1

Cancer incidence is more common in the most deprived areas of Scotland. However, this is not the case for all types of cancer[1]. This is driven in part by variations in screening uptake, leading to socially patterned rises in cancer incidence and, in turn, cancer survival for some types of cancer in the least deprived areas.

As has been the case in previous years, of the most common types of cancer, the absolute gap between most and least deprived areas was largest for cancer of the trachea, bronchus and lung (2017 rates were 129.6 and 26.3 per 100,000 population in the most and least deprived areas respectively).

Trends in relative inequalities

Changes in the relative index of inequality over time have been minimal and show no clear pattern, with the rate fluctuating between 0.29 and 0.40.

Figure 5.2

Relative Index of Inequality (RII): Cancer incidence <75y Scotland 1996-2018

Relative Index of Inequality (RII): Cancer incidence <75y Scotland 1996-2018

Incidence rates have typically been 30-50% higher in the most deprived areas in Scotland compared to the least deprived (40% in 2017).

Trends in absolute inequalities

Absolute inequality levels in cancer incidence have fluctuated over time, with a gap ranging from 122.1 to 178.2 per 100,000 population. Rates in both the least and most deprived areas of Scotland have shown no clear pattern.

Figure 5.3

Absolute Gap: Cancer incidence <75y, Scotland 1996-2017 (European Age Standardised Rates per 100,000)

Figure 5.3

The gap was widest in 2004 (rates of 551.1 per 100,000 and 372.9 per 100,000 in the most and least deprived areas, respectively) but the adjacent years of 2003 and 2005 displayed relatively narrow gaps. The gap was lower in 2017 (150.9 per 100,000) than at the start of the time series (167.7 per 100,000).

Cancer deaths aged 45-74 years

Trends in cancer deaths

The cancer mortality rate amongst those aged 45-74 years has fallen by 31% since 1996 (from 529.8 to 367.0 per 100,000 population in 2018). The number of deaths each year has also reduced in this period, from around 8,400 to 7,500.

Table 6.1: Trends in cancer mortality (aged 45-74), 1996-2018

Number of deaths Target population size Rate per 100,000 (EASR)
1996 8,402 1,631,224 529.8
1997 8,068 1,635,590 509.1
1998 7,995 1,646,711 501.9
1999 7,904 1,658,124 494.4
2000 7,776 1,670,660 484.8
2001 7,903 1,687,422 489.2
2002 7,850 1,706,141 481.2
2003 7,706 1,727,112 467.4
2004 7,678 1,751,037 460.9
2005 7,606 1,774,865 451.8
2006 7,486 1,799,382 441.3
2007 7,569 1,827,320 439.5
2008 7,536 1,856,874 431.0
2009 7,481 1,885,693 421.2
2010 7,394 1,914,226 411.1
2011 7,428 1,941,253 408.5
2012 7,514 1,964,203 406.2
2013 7,520 1,986,202 399.8
2014 7,445 2,007,988 389.6
2015 7,621 2,026,210 392.9
2016 7,385 2,047,858 373.5
2017 7,342 2,064,612 363.6
2018 7,531 2,073,318 367.0

Inequalities in cancer deaths, 2018

Of people in the 45-74 year age group, those in Scotland's most deprived areas are more than twice as likely to die of cancer than those in the least deprived areas (556.2 deaths per 100,000 population compared to 235.3 per 100,000 population, in 2018).

Figure 6.1

Cancer mortality amongst those aged 45-74y by Income Employment Index, Scotland 2018 (European Age Standardised Rates per 100,000)

Figure 6.1

As is the case for cancer incidence, inequality levels vary when examining deaths by cancer type[2]. As described in the previous section, variations in screening uptake may lead to socially patterned rises in cancer incidence and, in turn, cancer survival (therefore having a possible effect on mortality) for some types of cancer.

The largest differences between rates in the most and least deprived areas are again observed for cancer of the trachea, bronchus and lung (191.6 compared to 41.4 per 100,000 population in 2018).

Trends in relative inequalities

Relative inequalities for this indicator have increased over time and the RII in 2018 (0.98) was the highest recorded across the time series. This compares with a range of 0.68-0.81 seen in the years between 1996 and 2006.

Figure 6.2

Relative Index of Inequality (RII): Cancer mortality 45-75y Scotland 1996-2018

Figure 6.2

Cancer mortality rates (aged 45-74) have consistently been twice as high in the most deprived areas compared to least deprived areas over the time series.

Trends in absolute inequalities

Levels of absolute inequality for cancer deaths have fluctuated since 1996, with a absolute gap between the most and least deprived areas ranging from 304.8 to 395.3 per 100,000 population. In 2018 the gap was 320.9 per 100,000.

Figure 6.3

Absolute Gap: Cancer mortality 45-74y, Scotland 1996-2018 (European Age Standardised Rates per 100,000)

Figure 6.3

Alcohol-related hospital admissions aged under 75 years

Trends in alcohol-related admissions

The hospital admission rate for alcohol-related conditions amongst those aged under 75 years has fallen over time, with a 25% decrease between 1996 and 2018 (289.8 and 217.5 cases per 100,000 respectively).

Table 7.1: Trends in alcohol-related hospital admissions (aged < 75), 1996-2018

Number of admissions Target population size Rate per 100,000 (EASR)
1996 12,787 4,754,906 289.8
1997 12,918 4,740,269 292.6
1998 13,316 4,729,975 300.7
1999 13,217 4,721,298 298.2
2000 12,786 4,708,667 286.6
2001 13,469 4,703,661 300.3
2002 13,492 4,701,958 299.9
2003 12,996 4,702,431 290.0
2004 14,084 4,714,233 312.5
2005 13,346 4,735,320 293.8
2006 13,595 4,752,425 295.3
2007 14,641 4,783,452 313.5
2008 14,222 4,811,453 302.3
2009 12,891 4,835,007 272.9
2010 12,307 4,858,058 258.7
2011 12,264 4,888,316 256.2
2012 11,556 4,895,114 240.9
2013 11,225 4,903,074 236.8
2014 10,776 4,914,362 223.6
2015 10,467 4,935,283 216.2
2016 10,767 4,962,391 219.4
2017 10,644 4,976,829 218.0
2018 10,656 4,983,364 217.5

Inequalities in alcohol-related hospital admissions, 2018

In 2018, alcohol-related admissions were 4 times higher in the most deprived areas of Scotland compared to the least (426.8 compared to 98.6 cases per 100,000).

Figure 7.1

Alcohol related hospital admissions amongst those aged <75y by Income Employment Index, Scotland 2018 (European Age Standardised Rates per 100,000)

Figure 7.1

Trends in relative inequalities

There has been a general downward trend observed in relative inequalities for alcohol-related hospital admissions since 1996. However, there has been some fluctuation including an increase in 2016 when the RII was 1.85, the highest rate since 2003. The figure for 2018 is the lowest in the series at 1.62.

Figure 7.2

Relative Index of Inequality (RII): Alcohol-related hospital admissions <75y Scotland 1996-2018

Figure 7.2

In 1996, alcohol-related admission rates were 7 times higher in the most deprived areas compared to the least deprived. These rates have ranged between 5 and 6 times higher since 2003 and declined to 4 times higher for the first time in 2018.

Trends in absolute inequalities

Absolute inequality in alcohol-related admissions has generally reduced over time, due to a reduction in admissions in the most deprived areas. The gap was widest at the start of the time series in 1996 (613.0 per 100,000) and is currently at its lowest level (328.3 per 100,000 in 2018).

Figure 7.3

Absolute Gap: Alcohol-related hospital admissions <75y Scotland 1996-2018 (European Age-Standardised Rates per 100,000)

Figure 7.3

Alcohol-specific deaths aged 45-74 years

Trends in alcohol-specific deaths

The alcohol-specific death rate among those aged 45-74 years has fluctuated over the time series. There was an overall increase between 1997 and 2006 (increasing from 38.5 per 100,000 to 61.3 per 100,000) followed by a general downward trend until 2011 (38.2 per 100,000) when the rate was similar to the start of the time series. Since 2011, the alcohol-specific mortality rate has increased slightly, ranging from 38.6-44.0 per 100,000. The rate in 2018 was 43.2 per 100,000, 12.2% higher than at the start of the time series in 1997.

Table 8.1: Trends in alcohol-specific deaths (aged 45-74), 1997-2018

Number of deaths Target population size Rate per 100,000 (EASR)
1997 636 1,635,590 38.5
1998 695 1,646,711 41.9
1999 761 1,658,124 45.2
2000 873 1,670,660 52.1
2001 957 1,687,422 56.7
2002 1,049 1,706,141 61.3
2003 1,053 1,727,112 60.9
2004 1,015 1,751,037 57.6
2005 1,056 1,774,865 59.3
2006 1,105 1,799,382 61.3
2007 1,002 1,827,320 54.6
2008 1,019 1,856,874 54.8
2009 905 1,885,693 47.9
2010 927 1,914,226 48.3
2011 871 1,941,253 45.1
2012 752 1,964,203 38.2
2013 769 1,986,202 38.6
2014 808 2,007,988 40.2
2015 840 2,026,210 41.4
2016 898 2,047,858 43.7
2017 910 2,064,612 44.0
2018 898 2,073,318 43.2

Inequalities in alcohol-specific deaths, 2018

The alcohol-specific death rate (for those aged 45-74 years) in Scotland's most deprived areas is 5 times higher than that observed in the least deprived areas (93.1 compared to 18.6 per 100,000 population).

Figure 8.1

Alcohol specific mortality amongst those aged 45-74y by Income Employment Index,Scotland 2018 (European Age Standardised Rates per 100,000)

Figure 8.1

Trends in relative inequalities

Relative inequalities in alcohol-specific deaths have fluctuated since the start of the series in 1997. The RII in 2018 is the lowest in the series (1.79).

Figure 8.2

Relative Index of Inequality (RII): Alcohol-specific mortality 45-74y Scotland 1997-2018

Figure 8.2

Over time the relative range between the most and least deprived areas has fluctuated, peaking in 2002 when death rates were fourteen times higher in the most deprived areas. In 2018, death rates were five times higher in the most deprived areas, the lowest in the time series.

Trends in absolute inequalities

Although the rate of alcohol-specific deaths in the least deprived areas has remained reasonably static since 1997, there has been considerable change in the rate in the most deprived areas. This has largely driven changes in the absolute gap.

Following an increase from 104.4 to 198.8 per 100,000 between 1997 and 2002, there was a general decrease in the alcohol-specific mortality rate in the most deprived areas until 2013 (83.2 per 100,000). Since then, the rate has fluctuated between 93.1 and 114.7 per 100,000, with the rate for 2018 (93.1 per 100,000) being the second lowest in the time series.

Figure 8.3

Absolute Gap: Alcohol-specific mortality 45-74y Scotland 1997-2018 (European Age-Standardised Rates per 100,000)

Figure 8.3

All-cause mortality aged 15-44 years

Trends in all-cause mortality aged 15-44

There were a total of 2,220 deaths of people aged 15-44 in Scotland in 2018.

There was an overall decrease in the mortality rate from the start of the time series to 2014, when rates reached a low of 96.8 per 100,000. Since then, the mortality rate of those aged 15-44 has risen and in 2018 it was similar to the rate in 1997 (114.5 per 100,000 and 116.3 per 100,000 respectively).

Table 9.1: Trends in all-cause mortality (aged 15-44), 1997-2018

Number of all-causes deaths Target population size Rate per 100,000 (EASR)
1997 2,440 2,158,030 116.3
1998 2,507 2,142,787 119.4
1999 2,507 2,129,794 119.0
2000 2,501 2,118,568 118.7
2001 2,509 2,111,242 119.0
2002 2,566 2,102,670 122.0
2003 2,461 2,094,408 116.9
2004 2,409 2,088,563 114.7
2005 2,305 2,091,415 109.3
2006 2,482 2,091,581 118.3
2007 2,461 2,097,902 117.5
2008 2,443 2,096,495 117.5
2009 2,389 2,092,065 115.1
2010 2,229 2,087,635 108.6
2011 2,262 2,092,311 110.8
2012 2,071 2,077,902 102.8
2013 1,990 2,064,867 100.1
2014 1,904 2,053,897 96.8
2015 1,976 2,053,401 101.2
2016 2,194 2,054,055 112.5
2017 2,068 2,048,063 107.1
2018 2,220 2,044,305 114.5

The 2,220 deaths of those age 15-44 in 2018 included: 370 probable suicides, 28 deaths from assault and 723 drug-related deaths. While the rates of probable suicide in this age group had generally been declining in recent years there was an increase in 2018 to 18.28 per 100,000, the highest figure since 2012 (18.34 per 100,000). Rates of death from assault have increased slightly from a low of 1.04 per 100,000 in 2014, but have generally been lower in the last decade that at the start of the series. Drug-related deaths have shown large increases since the beginning of the time series in 1997. In 2018, the drug-related death rate was 37.33 per 100,000, this compares with 8.91 per 100,000 in 1997.

Table 9.2: Trends in deaths from assault, drugs and suicide (aged 15-44), 1997-2018

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 8.9 518 23.9
1998 65 3.0 227 10.6 526 24.4
1999 86 4.0 274 12.9 529 24.7
2000 60 2.9 268 12.7 541 25.6
2001 63 3.0 289 13.8 531 25.3
2002 76 3.6 345 16.7 539 25.7
2003 71 3.4 282 13.6 456 21.8
2004 78 3.8 311 15.2 475 22.7
2005 50 2.4 277 13.4 436 21.0
2006 83 4.0 350 17.1 435 20.9
2007 54 2.6 392 19.1 453 21.8
2008 53 2.5 477 23.3 480 23.4
2009 47 2.3 436 21.3 432 20.8
2010 54 2.6 384 18.9 423 20.5
2011 53 2.6 454 22.5 420 20.5
2012 37 1.9 416 20.8 375 18.3
2013 35 1.7 354 17.9 356 17.7
2014 22 1.0 416 21.1 309 15.4
2015 28 1.4 442 22.8 306 15.3
2016 34 1.7 568 29.2 329 16.2
2017 40 2.0 581 30.1 305 15.1
2018 28 2.0 723 37.3 370 18.3

Inequalities in all-cause mortality aged 15-44, 2018

The mortality rate amongst people aged 15-44 years is 8 times higher in the most deprived areas (273.3 per 100,000) compared to the least deprived (36.3 per 100,000).

Figure 9.1

Mortality amongst those aged 15-44 years by Income-Employment Index, Scotland 2018 (European Age-Standardised Rates per 100,000)

Figure 9.1

Trends in relative inequalities

There has been an overall increase in relative inequalities over time and they are currently at their highest point in the time series (1.97).

Figure 9.2

Relative index of inequality (RII): mortality aged 15-44y Scotland 1997-2018

Figure 9.2

Between 1997 and 2017, death rates ranged from 4-7 times higher in the most deprived areas compared to the least deprived. In 2018 deaths for those aged 15-44 years were 8 times higher in the most deprived areas compared to the least deprived areas.

Trends in absolute inequalities

The absolute gap between the most and least deprived areas in all-cause mortality between ages 15 and 44 reached its lowest level in 2013 (a gap of 159.6 per 100,000). In each year since 2013, the mortality rate between ages 15 and 44 in the most deprived areas increased and the gap between the most and least deprived areas widened to 237 per 100,000 in 2018.

Figure 9.3

Absolute Gap: Mortality 15-44y, Scotland 1997-2018 (European Age-Standardised Rates per 100,000)

Figure 9.3

Low Birthweight

Trends in low birthweight

Almost 2,700 low birthweight babies were born in Scotland in 2018.

The percentage of babies born with a low birthweight has fluctuated slightly since 1996. Between 1996 and 2007 the percentage of babies born with a low birthweight ranged between 5.5% and 6.0%. Since 2008 the figures have generally been lower, ranging from 5.0% to 5.6%.

Table 10.1: Trends in low birthweight, 1996-2018

  Number of low birthweight babies Target population size % of live singleton births
1996 3,057 55,683 5.5
1997 3,132 56,787 5.5
1998 3,087 54,987 5.6
1999 3,083 52,591 5.9
2000 2,888 50,911 5.7
2001 2,832 49,625 5.7
2002 2,894 48,798 5.9
2003 3,006 49,925 6.0
2004 3,016 51,709 5.8
2005 3,049 51,309 5.9
2006 2,919 52,298 5.6
2007 3,079 55,131 5.6
2008 3,124 56,793 5.5
2009 2,878 55,854 5.2
2010 2,798 55,914 5.0
2011 2,926 55,808 5.2
2012 2,765 55,124 5.0
2013 2,676 53,042 5.0
2014 2,766 54,265 5.1
2015 2,807 52,703 5.3
2016 2,755 52,307 5.3
2017 2,820 50,625 5.6
2018 2,666 49,049 5.4

Inequalities in low birthweight 2018

In 2018, 8.1% of live singleton births in the most deprived areas were recorded as low birthweight. This is more than double the percentage in the least deprived areas (3.9%).

Figure 10.1

Low birthweight babies in Scotland by Income-Employment index 2018 (as percentage of live singleton births)

Figure 10.1

Trends in relative inequalities

Relative inequalities in low birthweight were higher in 2018 than those observed at the start of the time series (0.99 and 0.84 respectively). The RII values between 1997 and 2006 tended to be higher than those observed in the last decade, however, the RII in 2018 was the highest since 2006.

Figure 10.2

Relative index of inequality (RII): Low birthweight babies in Scotland 1996-2018

Figure 10.2

Trends in absolute inequalities

Overall, the absolute gap between the most and least deprived areas has reduced from its widest point in 2004 (5.7 percentage points). However, the gap has fluctuated in recent years, ranging from 3.1-4.3 percentage points over the last 10 years.

The narrowing and widening of the gap has tended to be driven by changes in the most deprived decile, as the least deprived decile has remained broadly stable since the beginning of the time series.

Figure 10.3

Absolute Gap:Low birthweight babies in Scotland 1996-2018 (as percentage of live singleton births)

Figure 10.3

Healthy Birthweight

Trends in healthy birthweight babies

In each year of the time series, either 89% or 90% of babies have been of healthy birthweight. For the past seven years the value has been 90%.

Table 11.1: Trends in healthy birthweight, 1996-2018

Number appropriate for gestational age1 Target population size1 % of live singleton births
1996 49,829 55,581 89.7
1997 50,941 56,701 89.8
1998 49,163 54,910 89.5
1999 46,930 52,521 89.4
2000 45,162 50,833 88.8
2001 44,256 49,547 89.3
2002 43,438 48,703 89.2
2003 44,411 49,812 89.2
2004 45,757 51,596 88.7
2005 45,472 51,176 88.9
2006 46,530 52,162 89.2
2007 48,930 54,942 89.1
2008 50,540 56,602 89.3
2009 49,654 55,656 89.2
2010 50,038 55,818 89.6
2011 49,788 55,730 89.3
2012 49,235 55,004 89.5
2013 47,488 52,857 89.8
2014 48,554 53,913 90.1
2015 47,158 52,387 90.0
2016 46,587 51,754 90.0
2017 45,041 50,048 90.0
2018 44,123 48,803 90.4

1. Excludes records that could not be assigned an income employment decile

Inequalities in healthy birthweight babies 2018

In 2018, there was a marginal difference between the least and the most deprived areas in terms of the proportion of healthy births (90.3% versus 90.4% respectively)

Figure 11.1

Babies appropriate for gestational age in Scotland by Income-Employment index 2018 (as percentage of live singleton births)

Figure 11.1

Trends in relative inequalities

Relative inequalities have been consistently low over the times series. The RII for 2018 is at 0.00, suggesting that there is no relative inequality for this indicator.

Figure 11.2

Relative index of inequality (RII): Babies appropriate for gestational age in Scotland 1996-2018

Figure 11.2

Trends in absolute inequalities

The absolute gap between the percentage of healthy birthweight babies in the most and least deprived deciles has been consistently low across the full time series.

Figure 11.3

Absolute Gap: Babies appropriate for gestational age in Scotland 1996-2018 (as percentage of live singleton births)

Figure 11.3

Drug-related hospital admissions aged under 75 years

Trends in drug-related hospital admissions

In 2017/18, 9,270 individuals under the age of 75 were admitted to hospital for drug-related issues.

The rate of drug-related hospital admissions, which is based on the number of patients admitted to general acute and psychiatric specialties for drug misuse in each financial year, has shown a general upward trend since 1996/97 and is currently over three times higher than at the start of the time series.

Table 12.1: Trends in drug-related hospital admissions (aged <75), 1996/97-2017/18

Number of patients admitted1 Population Rate per 100,000 (EASR)
1996/97 3,366 4,754,906 64.0
1997/98 3,801 4,740,269 73.6
1998/99 4,395 4,729,975 86.2
1999/00 4,734 4,721,298 94.1
2000/01 4,851 4,708,667 97.6
2001/02 5,205 4,703,661 105.7
2002/03 5,415 4,701,958 110.7
2003/04 5,124 4,702,431 106.0
2004/05 5,292 4,714,233 109.7
2005/06 5,019 4,735,320 104.0
2006/07 5,262 4,752,425 108.8
2007/08 5,790 4,783,452 119.3
2008/09 6,120 4,811,453 125.9
2009/10 6,009 4,835,007 124.0
2010/11 6,435 4,858,058 132.6
2011/12 6,384 4,888,316 131.1
2012/13 6,033 4,895,114 124.5
2013/14 6,624 4,903,074 137.5
2014/15 6,984 4,914,362 144.8
2015/16 7,839 4,935,283 162.4
2016/17 8,616 4,962,391 178.6
2017/18 9,270 4,976,829 192.2

1. Patients who have been admitted to hospital for drug misuse multiple times in the same

financial year will only be counted once per year.

Inequalities in drug-related hospital admissions, 2017/18

In 2017/18, the admission rate in Scotland's most deprived areas was 21 times greater than that of the least deprived (624.5 cases per 100,000 compared to 29.2 per 100,000).

Figure 12.1

Drug-related hospital admissions <75y by Income-Employment Index, Scotland 2017/18 (European Age-Standardised Rates per 100,000)

Figure 12.1

Trends in relative inequalities

Relative inequality levels for patients with drug-related hospital admissions have fluctuated over time. Although they have decreased from a high of 3.05 in 1998/99 they have increased every year for the last five years and the RII for 2017/18 (2.90) is higher than at the start of the time series (2.77).

Figure 12.2

Relative Index of Inequality (RII): Drug-related hospital admissions <75y Scotland 1996/97-2017/18

Figure 12.2

Since 1996/97 admission rates (aged <75) have ranged from 15-28 times higher in the most deprived areas compared to the least deprived areas.

Trends in absolute inequalities

The absolute gap in rates between those living in the most deprived areas and the least deprived areas has increased overall since the start of the time series. After an initial increase between 1996/97 and 1998/99 the absolute gap remained relatively stable, ranging from 309.6 - 385.2 per 100,000 between 1999/00 and 2012/13 before increasing in each of the past five years. In 2017/18 the absolute gap was at its highest level at 595.3 per 100,000. These fluctuations have mainly been driven by changes in drug-related hospital admissions in the most deprived areas, with drug-related hospital admissions in the least deprived areas remaining fairly static over time.

Figure 12.3

Absolute Gap: Drug-related hospital admissions <75y Scotland 1996/97-2017/18 (European Age-Standardised Rates per 100,000)

Figure 12.3


Contact

Email: morag.shepherd@gov.scot