Health consistently worsens as deprivation increases, but the most deprived are faring particularly badly

For a wide range of health outcomes, health consistently worsens as deprivation increases. However, we see a particularly large drop-off across outcomes for those living in the most disadvantaged circumstances.

Key points:

  • People in more deprived areas experience disproportionately high levels of poor health, early death, and greater barriers to health services.
  • For example, drug deaths have increased exponentially since 2013, and especially in the most deprived fifth of areas. Half of all drug deaths now occur among people living in the most deprived fifth of areas. This is considerably more than we would expect even when we take into account the social gradient in health.
  • We see a similar, although less dramatic, patterns for avoidable mortality, deaths from alcohol, and outpatient appointments where the patient ‘Did Not Attend’.
  • There is also a large gap between the most deprived fifth of areas and all other areas in the proportion of babies born low birthweight. Similarly large gaps are evident in child development concerns and ‘delayed’ uptake of antenatal services.
  • Although we see these large gaps in health outcomes when we are investigating the levels of deprivation by area, this is unlikely to be solely an issue of geography. Area-level deprivation is the most consistently available measure of social circumstances, but social disadvantage is also experienced by people living outside Scotland’s most deprived areas.
  • Why do we think such a big gap exists? A number of possible factors are likely to be contributing, including:
  • People living in the most disadvantaged areas are exposed to multiple aspects of social disadvantage or social disadvantages which are more severe
  • People living in the most disadvantaged areas experience these throughout their lifetimes with ever increasing impacts on health.
  • The consequences of ill health can be worse for people living in disadvantaged areas, leading to worse social disadvantage (such as job loss), leading to a downward spiral of health.
  • Some of Scotland’s most disadvantaged areas have long histories of underinvestment, due to deindustrialisation for example.
  • These factors combined perpetuate and deepen health inequalities across people’s lives, and from one generation to the next.

 

Related Graphs

Drug deaths have increased exponentially since 2013 and those living in the most deprived areas are 20 times as likely to die


DNAs have fallen slightly over the past five years, but they remain far higher in the most deprived areas


Babies in the most deprived areas twice as likely to be born low birthweight, with few signs of improvement