Tag: health inequalities

Dentists urge action on ‘shameful’ oral health inequalities

The British Dental Association has urged all candidates contesting the Scottish election to pledge to commit to tackling the shameful inequalities in oral health set to go into overdrive as a result of the pandemic.

Unpublished data from Public Health Scotland has shown a dramatic reduction in NHS dentistry due to COVID, which is hitting those in most deprived communities the hardest. Between April and November 2020, the number of courses of treatment delivered was 83% lower than during the same period in 2019.  

Official figures show that primary school children from the most deprived communities experience more than four times the level of tooth decay compared to children in the least deprived areas. Latest data also shows that in 2020 children and adults from the most deprived areas were less likely to have seen their dentist within the last two years than those from the least deprived areas (73.5% compared to 85.7% of children and 55.9% compared to 67.1% of adults) and this gap has widened compared to the year before.   

The impact is now being felt in all corners of the service. The Public Dental Service– which treats specific patient groups including care home residents, children with additional needs and adults with disability – also faces a huge backlog, with many of its staff redeployed to urgent dental care centres. 2,500 children are now estimated by the BDA to be on waiting lists for dental extractions under general anaesthetic, which may take years to clear.   

High street practices continue to face wide-ranging restrictions, which have radically reduced patient numbers, including the need to maintain gaps between most routine procedures where surgeries are left ‘fallow’ to reduce risk of viral transmission.

Governments in Northern Ireland and Wales have already offered millions to help practices invest in new ventilation systems to cut down this time, and hence significantly expand patient volumes. The BDA is seeking commitments from Scotland’s parties to follow the same path.      

The BDA says prevention is now more essential than ever. The pioneering Childsmile programme, delivered via primary schools and nurseries, has secured record-breaking reductions in decay but has been suspended for much of the last year, with many core elements like supervised brushing yet to resume.

Restarting that programme, and providing additional support in high needs areas is at the centre of the BDA’s plan, alongside calls for Health Boards to be supported to conduct feasibility studies on water fluoridation. 

Dentistry challenges are now likely to be exacerbated by workforce problems. None of Scotland’s dental schools is on track to graduate classes at the usual time this year, which will have a domino effect on workforce planning for years to come. The BDA has called for a long-term strategy to ensure Scotland has the dentists it needs to meet this threat, and parallel challenges – including Brexit.   

Oral cancers kill three times more Scots than car accidents – and the country has one of the highest rates for the condition in Europe.

Residents in Scotland’s most deprived communities are more than twice as likely to develop and die from oral cancer as those in more affluent areas. The BDA is therefore seeking action on smoking cessation, and assurances that a rapid catch up programme will be in place to ensure school children are protected from the Human Papillomavirus via vaccination.

HPV is an important risk factor for oral cancer, and while steps were in place to extend the programme to boys in the last academic year, the programme continues to face massive disruption as a result of school closures.   

The Association is making direct contact with every candidate seeking election to Holyrood to ask them to commit to addressing oral health inequality.  

Robert Donald, Chair of the British Dental Association’s Scottish Council said: “A wealthy 21st century nation shouldn’t accept that a wholly preventable disease remains the number one reason its children are admitted to hospital. Sadly, COVID risks undermining hard-won progress, while leaving our dental service a shadow of its former self.  

“The result is that from decay to oral cancers, Scotland’s oral health gap is set to widen, and we need all parties to offer a plan. 

“In this campaign we need candidates to do more than talk about ‘prevention’. From helping practices boost capacity, through to expansion of the sugar levy, we have set out simple steps that can put that principle into action, addressing inequality, and restoring services to millions.”

The BDA Scotland manifesto: Bridging the Gap: Tackling Oral Health Inequalities (PDF)  

Scotland’s dental crisis: New data shows all parties need to act as inequalities widen

The British Dental Association Scotland has called on all political parties to set out an effective response to the crisis facing dentistry as new data reveals the collapse in attendance during the COVID pandemic.  

While registration rates remained high and broadly stable – owing to lifetime registration – data indicates the number of children seen between May and December 2020 was around a quarter of the 2018-19 average due to the pandemic.

Between September and November 2020, the number of adults seen was around a third of the 2018-19 average, before falling to 28% of the 2018-19 average in December 2020. 

The traditional measure of ‘participation’ – capturing attendance at an NHS dentist in the past 2 years – has less meaning in the context of COVID, as the full impact of the pandemic has yet to filter through.

Those in more deprived communities have traditionally experienced lower levels of participation. This data shows that in 2020, children and adults from the most deprived areas were less likely to have seen their dentist within the last two years than those from the least deprived areas (73.5% compared to 85.7% of children and 55.9% compared to 67.1% of adults). These inequalities in access between the most and least deprived areas have grown since 2019, particularly in children.

The BDA has warned lower levels of participation will inevitably translate into a higher disease burden. Early signs of decay and oral cancers are picked up at routine check-ups, and delays will mean both higher costs to the NHS and worse outcomes for patients. 

Dental care in Scotland is now facing crises on many fronts, with deep oral health inequalities expected to widen even further, given the cumulative impact of limited access to services, the suspension of public health programmes, and the impact of lockdown diets.  The pioneering Childsmile programme has not fully resumed, with many key elements, such as supervised brushing, delivered via schools and nurseries. 

Recent announcements by Scottish dental schools that many final year students will not graduate in 2021 and will also not be in a position to take on new undergraduates, are likely to have wide-ranging effects on the NHS workforce for years to come.   

While both the Welsh and Northern Irish governments have set aside ring-fenced investment to improve practice ventilation – and thereby increase patient numbers while meeting tight COVID restrictions – no commitments have yet been made by the Scottish Government and the BDA await clear guidance for practices.  

Robert Donald, Chair of the British Dental Association’s Scottish Council said: “These numbers underline the scale of the challenge ahead. Millions have missed out on dentistry. Problems that could have been caught early, from decay to oral cancer, have been missed.  

“Scotland’s huge oral health inequalities cannot be allowed to widen. Every party heading into May’s election now has a responsibility to set out how they will ensure families across Scotland can get the care they need.”  

Major health organisations urge government to keep £20 Universal Credit uplift

A coalition of major health organisations have joined forces in a joint letter to urge the government to keep the £20 uplift to universal credit and extend the same support to those on legacy benefits.

The group, which includes leading royal colleges and health bodies, says that without the £20 uplift, millions of families will be swept into poverty with the result being a reduction in the health, wellbeing, and life chances of children and young people for decades to come.

The letter stresses that we must view the investment in the social security system as an investment in the nation’s health, and cutting the uplift will result in deepening health inequalities, hitting the most vulnerable.

Read the full letter from the coalition

Commenting on the publication of the letter, Dr Hazel McLaughlin, President of the British Psychological Society, which coordinated the letter, said: “Today’s letter is the first time a coalition of health bodies and organisations have joined forces to urge the government to keep the £20 uplift to universal credit, a lifeline for so many families during this pandemic.

“As organisations working across health and care, we know the links between poverty and poor physical and mental health. Without investment in the health and wellbeing of our nation, particularly those on the lowest incomes, the pandemic threatens to entrench health inequalities for generations to come. 

“In this challenging time, together we call for the government to extend the uplift to bring security to the most vulnerable when they need it most.”

The letter reads:

Dear Prime Minister

Ahead of the Spring Budget we are writing to collective collectively to urge you to make the temporary £20/week increase to the standard allowance of Universal Credit and Working Tax Credit permanent from April, and address the inequality that currently exists by providing the same uplift to Employment and Support Allowance, Income Support and Jobseeker’s Allowance.

As organisations working across health and care, we see the irrefutable evidence that poverty has significant negative impacts on individuals, their families and society more widely. This uplift in Universal Credit has been a lifeline for many people in supporting them through the pandemic, it is crucial that this is maintained as the country seeks to recover from its impacts.

This investment in our social security system is also an investment in our nation’s health, ensuring many of those on the lowest incomes have access to essentials like food or heating. In a year marked by worry and uncertainty, the uplift has been a preventative lifeline keeping many afloat, protecting them from financial instability, debt and worsening mental health. 

By April 2021, if the uplift is discontinued, this good work risks being immediately undermined. Overnight, 6.2 million families will face a £1,040 a year cut to their income. Based on modelling by Joseph Rowntree Foundation, this will result in 700,000 more people being pulled into poverty, including 300,000 children. There is an established link between poverty and poor health, which is worsening in the face of Covid-19. The excess mortality rates in the most socioeconomically deprived areas due to the virus is proof of this. We are therefore urging you to make the uplift permanent and to continue to support a recovery that puts health and flourishing at its heart.

The Government’s commitment to invest in jobs, skills and infrastructure is a welcome and a necessary part of boosting opportunity. But without an equal emphasis on the health of those on the lowest incomes, this threatens to exacerbate and entrench health inequalities across the UK. Removing the £20 uplift will cut families adrift, forcing them to confront mounting bills and reducing participation in rebuilding their communities.

We cannot plan for the UK’s economic recovery only to face another escalating health crisis for those on the lowest incomes. The impact of millions of families being swept into poverty will be a reduction in the health, wellbeing, and life chances of children and young people for decades to come.  

Meanwhile, more than two million people on legacy benefits, most of whom are disabled people and people with long-term mental and physical health conditions, have not been offered the same lifeline. Many of these people are at greater risk from Covid-19, and are taking more extreme and prolonged measures, to protect themselves. This not only increases their living costs, but intensifies their mental and physical strain which in turn worsens health. We urge you to ensure that the full support of this lifeline is extended to those on legacy benefits.

We have recently welcomed what seems to be strong consensus against cutting this lifeline in the middle of a recession. However, we have been concerned of rumours of short-term extensions or one-off payments which would be insufficient and ineffective.  We believe making the uplift permanent would be a worthwhile and sensible investment, and strongly urge the Government to keep doing the right thing, keep families afloat and keep the lifeline.

Signed,

Association of Directors of Public Health

British Association of Social Workers

British Psychological Society

Faculty of Public Health

Institute of Health Equity

Mind

Royal College of General Practitioners 

Royal College of Nursing

Royal College of Paediatrics and Child Health

Royal College of Psychiatrists

Royal Society of Public Health

The Association of Mental Health Providers

The Mental Health Network of the NHS Confederation

“Unravelling”: Stalling life expectancy is a warning light for public health in Scotland

Two reports out today show that the increase in life expectancy that has shown steady progress in Scotland since the Second World War, has now stalled and that health inequalities have worsened.

In the past seven years, Scotland has seen the slowest growth in life expectancy, since at least the late 1970s and death rates have now begun to rise for people living in our poorest areas. Continue reading “Unravelling”: Stalling life expectancy is a warning light for public health in Scotland

GIC’s pioneering work celebrated at Holyrood

A reception to mark Granton Information Centre’s pioneering work in establishing advice provision in healthcare settings was held at the Scottish Parliament on Tuesday.  Continue reading GIC’s pioneering work celebrated at Holyrood

Twice as likely to die early or live with ill health if you live in Scotland’s poorest areas

We’ve known for some time that health inequalities exist, but a new report out today shows the scale of the problem. The NHS Health Scotland study (below) found that people living in the poorest areas have DOUBLE  the rate of illness or early death than people in our wealthiest areas.

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Nearly a third (32.9%) of early deaths and ill health in Scotland could be avoided if the whole population had the same life circumstances as the people who live in our wealthiest areas.

Our report also shows that early death and illnesses associated with the things that harm our health the most, like drugs, tobacco, poor diet, and alcohol, are more common in the poorest areas than in wealthiest areas.

Dr Diane Stockton, the study lead at NHS Health Scotland said: “The stark inequalities highlighted in our report represent thousands of deaths that didn’t need to happen. Illnesses that people didn’t have to endure, and tragedy for thousands of families in Scotland.

“It does not have to be this way. The fact that people in our wealthiest areas are in better health and that conditions that cause most of the ill health and early death result from things we can change – like illnesses associated with mental wellbeing, diet, drug use and alcohol dependency – shows that it is possible to create a fairer healthier Scotland.

“Our report highlights that to do this, we have to improve the life circumstances of people in our poorest areas and prevent their early death or avoidable ill health. This is about more than encouraging healthy choices. It’s easier to access the things that harm our health in these areas, and so no one type of behaviour change is going to solve this problem on its own. It’s about addressing the environment we live, rest, play, work and learn in so that it supports us to be mentally and physically well. And it’s complex. There is no silver bullet, but, with collective effort for a fairer healthier Scotland, we can help to ensure that everyone in Scotland can enjoy their right to the highest attainable standard of health.”

View the report on the ScotPHO website 

 

 

 

‘Shocking’: Johnstone calls for action on health inequality

Life expectancy gap between rich and poor continues to grow

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Lothian MSP and Scottish Greens’ spokesperson on Health and Wellbeing, Alison Johnstone has branded figures that show funding discrepancies between GPs in poorer and wealthier areas of Scotland as “shocking”.

The figures, published yesterday, were obtained by researchers at  the University of Glasgow and University of Dundee, and demonstrate there is a £7 per person per year funding gap between GP practices in the top 10% most affluent and the 10% most deprived areas.

Johnstone highlighted that health inequalities in her home region and around Scotland are rife, with a 7.3 year gap between Local Authorities in overall male life expectancy, and a 5.2 year difference between Local Authorities in overall female life expectancy.

Johnstone urged the Scottish Government to ensure that GPs in more deprived communities are able to deliver a high-quality health service, and called for resources to be distributed according to need, not wealth.

Alison Johnstone said: “These shocking figures highlight the challenges our NHS is facing trying to provide a decent service to all those who need it. It’s vitally important that help goes where it’s most needed, and the unequal distribution of funding means that doctors in deprived communities are unlikely to have the resources to meet their patients’ needs.

“In Lothian, a person living in one of the more affluent parts of the region can expect to live nearly two decades longer than those from the poorest.  If we don’t ensure that people in the poorest areas get the same quality service as wealthier communities, we have no chance of eradicating health inequalities.

“I urge the Scottish Government to take these figures very seriously and to reconsider how it distributes GP resources. It’s time to get back to basics – every single person from in Scotland deserves high quality healthcare, and we must make sure our NHS can deliver.”

Highest life expectancy for men in Scotland is in East Dumbartonshire at 80.7 years, with lowest in Glasgow City at 73.4 years. For females, highest life expectancy is in East Dunbartonshire at 83.9 years, and lowest at 78.7 years.

Figures available at: http://www.gro-scotland.gov.uk/news/2015/wide-variation-in-life-expectancy-between-areas-in-scotland

High-powered taskforce seeks ways to cut health gap

A new group of experts made up of health professionals and politicians is to seek ways to narrow the health gap between the richest and poorest people in Scotland. The Ministerial Taskforce on Health Inequalities meets for the first time today (Thursday) to examine evidence and to suggest new or better ways to reduce the difference in life expectancy and health among the whole population.

Chaired by Public Health Minister Michael Matheson, the Taskforce includes the Chief Medical Officer, clinicians, health experts, local government representative and other Ministers. The work will build on the Equally Well report of the last Ministerial taskforce in 2008.

Public Health Minister Michael Matheson said:

“While health in Scotland continues to improve and people live longer lives, health inequalities are still worse than in the rest of western Europe. Of all the challenges facing Scotland, the health gap between our richest and poorest communities is among the greatest. Inequality wastes human potential, while reducing inequalities will improve Scotland’s wellbeing, lead to higher productivity and less pressure on public finances.

”The challenge for the Taskforce is to review the effectiveness of current policy, to respond to new information and knowledge about what has worked to narrow inequalities and to hear to community views on the best way ahead.

“While Scotland is rightly seen as a world leader in public health legislation and policy, the main reasons for health inequality are income and power, so addressing these issues will be part of our overall approach. Delivering on this agenda takes leadership at all levels and I am determined to ensure the Scottish Government does what it can in the current political and economic circumstances to narrow the health gap.”

The Taskforce is expected to report in summer 2013.

Membership of the Ministerial Taskforce on Health Inequalities is:

Michael Matheson, Minister for Public Health (Chair)

Aileen Campbell, Minister for Children and Young People

Margaret Burgess, Minister for Housing and Welfare

Angela Constance, Minister for Youth Employment

Derek Mackay, Minister for Local Government and Planning

Roseanna Cunningham, Minister for Community Safety and Legal Affairs

Paul Wheelhouse, Minister for Environment and Climate Change

Sir Harry Burns, Chief Medical Officer for Scotland

Margaret Burns, Chair of NHS Health Scotland

Dr Charles Winstanley, Chair of NHS Chairs Scotland

Andrew Muirhead, Chief Executive, Inspiring Scotland

Professor Carol Tannahill, Director, Glasgow Centre for Population Health

Cllr Peter Johnston, COSLA Spokesperson for Health and Wellbeing