‘Leave no one behind’: New reseach shows significant health divide across Edinburgh and the Lothians

The Health Foundation’s review shows over 15% of children in West Lothian are living in relative poverty compared to 11.3% in Edinburgh

The state of health and health inequalities in Scotland

A comprehensive independent review of health and health inequalities in Scotland led by the Health Foundation shows that the health of Scots living in the most deprived 20% of local areas are being left behind the rest of society. 

Data shows that in West Lothian 15.5% of children are living in relative poverty compared to 11.3% in Edinburgh and 12.6% and 13.5% in East Lothian and Midlothian respectively.  The national average is 15.1%.

Furthermore, in East and Midlothian the least deprived 20% of men can expect to live between six and seven years longer than the 20% living in the most deprived areas. In Edinburgh the difference in life expectancy between the richest and the poorest is almost 12 years and in West Lothian the poorest 20% will live nine years less than those in the least deprived areas. 

The review found that trends in the socioeconomic factors that influence health provide little indication that health inequalities will improve in future, underlined by increasing rates of extreme poverty.*

The review consolidates research undertaken for the independent charity the Health Foundation by the MRC/CSO Social and Public Health Sciences Unit at University of Glasgow, the Fraser of Allander Institute at University of Strathclyde, Nesta in Scotland, and the Diffley Partnership.

The findings bring together evidence of trends in health inequalities and wider determinants of health over the past two decades since devolution and outline the consequences of worsening health in the most deprived areas. 

Overall, stalled improvements in health mean that nationally, since 2013, expectations of how long people are expected to live have reduced by 4.4 years, from 90.4  to 86 years.

The findings show that across a range of measures, there is a wide gap between the health of people living in the most and least deprived areas with people living in the most deprived areas increasingly left behind the rest. The report raises a number of areas of concern which need immediate action, in particular, improving the health of children in their early years and the health of young to middle aged men.

Young to middle aged men are the most likely to suffer from deaths related to drugs**, alcohol or suicide, with the exponential rise in drug deaths concentrated among men in their mid-30s to early-60s. This group engages less with health services and is the most likely not to attend hospital appointments.  Being younger, single, white and male is most strongly associated with experiencing severe multiple disadvantages, which are linked to greater risk of poor health.

Commenting on the findings, David Finch, Assistant Director of the Health Foundation, said: “Life expectancy varies greatly across Scotland. In the most deprived areas, men are dying over 13 years earlier than their peers in the least deprived areas– and women almost a decade earlier.

“A healthy community derives from a range of factors: stable jobs, good pay, quality housing and education. Poor health is almost inevitable when some or all of these factors are absent. Scotland’s wide and sustained health inequalities are being driven by the accumulation of severe multiple disadvantages, a lack of improvement in living standards and public service fragility due to the ongoing impact of austerity.

“Understanding the causes are not enough; a radical shift in approach is needed. The Scottish government, local authorities, businesses and the third sector must come together and collaborate closely with communities. Without action, Scotland’s most deprived communities are likely to continue suffering from poor quality of life and die younger.”

Chair of the Health Foundation’s  Expert Advisory Group, Chris Creegan added“This review is the most comprehensive study of health inequalities in Scotland since devolution, and while the findings are complex, what they clearly illustrate is that inequality in health is stubbornly high in Scotland.

“The public is receptive to longer term preventative interventions aimed at tackling the fundamental causes of health inequalities, rather than short term measures. They will support a bold, collective response.

“We need actors across economic, financial, social and health systems in Scotland to take note of these findings and use them to build on the strong policy intent we already have to reverse these trends and improve health outcomes for the future. But there is no need for a new strategy; over the last decade, several policy plans and strategies have focused on tackling health inequalities, most recently, 2018’s Public Health Priorities for Scotland. We have the policies, we now need action.”

The full report can be read here

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davepickering

Edinburgh reporter and photographer