Health inequalities in Scotland are not inevitable

There was a period of health improvement and narrowing of absolute inequalities in the first decade of the 21st century in Scotland, but this has now stalled​.

Key points

  • Avoidable mortality, from causes of death like cancers, heart attacks, drugs and alcohol, was decreasing up until around 2014, but these improvements have slowed, with signs of increase, especially in the most deprived areas.
  • Deaths related to alcohol were also declining but this has stalled since 2013. At the same time, drug-related deaths have started to increase exponentially.
  • These trends are mainly seen for mortality, but not exclusively. Inequalities in MMR (mumps, measles, rubella) vaccination uptake had been almost eliminated by 2013, but these have started to widen again, mainly because the proportion of children not immunised with MMR is increasing in more deprived areas​.
  • Why have things started to get worse? Over this same period some important influences on people’s health have also been negatively affected. Austerity measures have led to increased poverty, housing costs have risen, and low-paid jobs have become more common. This is likely to have played an important part.

Related Graphs

Amenable mortality and absolute inequalities were falling in men, but these improvements have stalled

There were large declines in absolute inequalities in alcohol deaths in the first decade of the 21st century, but these have stalled and inequalities remain large

Children living in deprived areas are 2.6 times as likely to die before their first birthday as children in less deprived areas

Inequalities in MMR uptake (first dose, 2 years) have widened since ~2014 and the WHO target is only met in the least deprived 40% areas