Why is this National Indicator important?
'We believe Scotland has a proud history and ethos of being a compassionate nation, with a strong sense of social justice and [a belief in] addressing the needs of the vulnerable' Taking forward the Government Economic Strategy: a discussion paper on tackling Poverty, Inequality and Deprivation in Scotland.
Deprived populations have considerably higher levels of mortality from coronary heart disease (CHD). This relationship is evident for all ages, but is strongest in the 0-64 age group, for whom death from CHD in the 10% most deprived areas is 1.9 times more likely than for Scotland overall. CHD also shares risk factors with the other 'big killers', so by targeting CHD, we can target these too.
What will influence this National Indicator?
Premature CHD is caused by factors such as personal vulnerabilities and lifestyles and health-related behaviours - specifically smoking, diet and physical activity. Early life circumstances lay the foundations for later health. Depression, closely associated with poor physical health, significantly increases the risks of CHD. As well as being more likely to develop CHD, deprived populations access health services less. They are affected by the inverse care law which states that 'the availability of good medical care tends to vary inversely with the need for the population served.'.
What is the Government's role?
The Ministerial Task Force on Health Inequalities will report in Summer 2008. Evidence presented has highlighted priority actions which include:
- Support particularly vulnerable children and families.
- Realign resources and effort in primary care.
- Extend anticipatory care approaches to preventing ill health.
- Reach and engage with the most vulnerable groups of people to improve their physical and mental health more effectively.
- Ensure that health is not a barrier to retaining or entering work.
- Improve the capacity of the Third Sector* to reduce inequalities in health.
*Note: The Third Sector includes charities, voluntary and volunteering organisations, faith organisations, co-operatives and mutual societies and social enterprises.
'Keep Well' is one specific example of resources being realigned in primary care to engage with the most vulnerable groups. It aims to reduce the incidence of coronary heart disease and diabetes. With Keep Well, individuals are offered a relevant health check followed by appropriate interventions and services. At the last count in May 2008, 35,000 of an eligible population of 88,000 have attended a Keep Well health check.
Based upon the principles of Keep Well, 'Well North' is being implemented in remote and rural areas in the North of Scotland. The aim of this programme is to widen the reach of health improvement interventions that deliver anticipatory care for those experiencing health inequalities in remote and rural areas.
How are we performing?
Between 1995 and 2006, there has been a consistent downward trend in the rate of premature mortality from coronary heart disease in Scotland. Although the rates are at a higher level among the most deprived areas in Scotland, the trend between 1995 and 2006 showed a very similar pattern. The latest figure of 112.4 deaths per 100,000 population in the most deprived areas in 2007 compares with 110.2 during 2006.
Sources: (1) General Register Office for Scotland (GRO(S)); (2) Analytical Services Division - Health (Scottish Government)
Note: Rates are European Age-Standardised Rates (EASR) per 100,000 population aged under 75 years.
Methodology
This evaluation is based on: any difference within +/- 2% of last year's rate suggests that the position is more likely to be maintaining than showing any change. A decrease in the rate of 2% or more suggests the position is improving; whereas an increase of 2% or more suggests the position is worsening.
For information on general methodological approach, please click here.
Further Information
2007 Spending Review Technical Note
Statistics Topic Page
Who are our partners?
NHS Scotland
Local Authorities
Related Strategic Objectives
Wealthier and Fairer
Smarter
Healthier
Safer and Stronger
Greener