Long-term monitoring of health inequalities: December 2018 report

Methods

The report uses a combination of measures of health inequalities to give a fuller understanding of the different aspects of inequalities. These are:

• Scale: How big is the problem? This measure describes the underlying scale of the problem, puts it into context and presents past trends at Scotland level.
• Relative Index of Inequality (RII): How steep is the inequalities gradient? This describes the gradient of health observed across the deprivation scale, relative to the mean health of the whole population. Unless explicitly explained, the RII indicates the extent to which health outcomes are better in the least deprived areas, or worse in the most deprived areas, compared to the mean.
• Absolute range: How big is the gap? This measure describes the absolute difference between the extremes of deprivation.

Following recommendations from the expert group, an area-based index derived from the income and employment domains of the Scottish Index of Multiple Deprivation (SIMD) is used to define deprivation. This reflects the absence of individual-level data on socio-economic circumstance.

The index is referred to as the Income and Employment Index (IEI).

These indicators and measures were recommended for long-term monitoring of deprivation-related health inequalities at Scotland level. Monitoring health inequalities due to other factors, such as age, gender and ethnicity, and indicators at a local level, may require different indicators and measures. Further information on the methods is provided in Annex 1.

Changes to indicators

The most recent meeting of the Technical Advisory Group in July 2015 focused on a number of areas for development in the report, in the short and longer term, and reviewed the list of indicators. A full record of the recommendations which will be developed for future reports is provided on the Health Inequalities pages of the Scottish Government website.

The most recently incorporated changes were the inclusion of two new ‘morbidity indicators’ relating to self-assessed general health and long-term conditions. These indicators are included every second year and are included in this publication.