Long-term monitoring of health inequalities: January 2020 report
Annual update of the long-term monitoring of health inequalities headline indicators.
Headline indicator of Health Inequalities
Premature Mortality (under 75 years)
In 2018, the gap in premature mortality rates between the most and least deprived areas increased to its highest point since 2008, although the gap remains lower than at the start of the time series. Relative inequalities, however, have widened over the long term.
In 1997, premature mortality rates were 3 times higher in the most deprived areas compared to the least deprived; in 2018, rates were 4 times higher in the most deprived areas.
Trends in premature mortality
Just over 21,500 people in Scotland died before the age of 75 in 2018.
Over the long term there has been a reduction in the mortality rate among under-75s. The age-standardised mortality rate among under-75s in 2018 was 432.0 per 100,000 people, a reduction of 34 per cent since 1997 (651.9 per 100,000).
Table 1.1: Trends in premature mortality (under 75 years), 1997-2018
| Year | Number of deaths | Target population size | Rate per 100,000 (EASR) |
|---|---|---|---|
| 1997 | 26,081 | 4,740,269 | 651.9 |
| 1998 | 25,857 | 4,729,975 | 643.3 |
| 1999 | 25,491 | 4,721,298 | 632.5 |
| 2000 | 24,593 | 4,708,667 | 607.3 |
| 2001 | 24,168 | 4,703,661 | 593.1 |
| 2002 | 24,219 | 4,701,958 | 588.9 |
| 2003 | 23,789 | 4,702,431 | 573.4 |
| 2004 | 22,896 | 4,714,233 | 546.2 |
| 2005 | 22,441 | 4,735,320 | 530.3 |
| 2006 | 22,237 | 4,752,425 | 520.4 |
| 2007 | 22,359 | 4,783,452 | 516.8 |
| 2008 | 22,005 | 4,811,453 | 501.3 |
| 2009 | 21,229 | 4,835,007 | 477.0 |
| 2010 | 20,997 | 4,858,058 | 467.4 |
| 2011 | 20,685 | 4,888,316 | 456.1 |
| 2012 | 20,446 | 4,895,114 | 445.3 |
| 2013 | 20,344 | 4,903,074 | 437.5 |
| 2014 | 19,961 | 4,914,362 | 423.2 |
| 2015 | 20,988 | 4,935,283 | 440.5 |
| 2016 | 21,313 | 4,962,391 | 439.7 |
| 2017 | 20,992 | 4,976,829 | 425.2 |
| 2018 | 21,601 | 4,983,364 | 432.0 |
Inequalities in premature mortality, 2018
In 2018, the premature mortality rate in the most deprived areas was 820.0 per 100,000, four times higher than the rate in the least deprived areas (210.6 per 100,000).
Figure 1.1
All cause mortality amongst those aged <75y by Income Employment Index Scotland 2018 (European Age Standardised Rates per 100,000)
Trends in relative inequalities
Over the longer term, relative inequalities have increased. The RII for 2018 is the highest on record at 1.48, compared with 1.00 at the start of the time series in 1997.
Between 1997 and 2018, premature mortality rates declined by 45% in the least deprived areas, but by only 20% in the most deprived areas in Scotland.
Figure 1.2
Relative Index of Inequality (RII): All cause mortality <75y Scotland 1997-2018
In 1997, premature mortality rates were three times higher in the most deprived areas compared to the least deprived; in the last four years premature mortality rates have been four times higher in the most deprived areas.
Trends in absolute inequalities
Absolute inequalities in premature mortality reached a peak in 2002. Between 2002 and 2013 there was a general downward trend. Most notably, the absolute gap between the most and least deprived areas reduced every year between 2007 and 2013.
Since 2013 the gap has increased, and is currently at its highest point since 2008 at 609.4 per 100,000.
Figure 1.3
Absolute Gap: All cause mortality <75y, Scotland 1997-2018 (European Age Standardised Rates per 100,000)
Contact
Email: morag.shepherd@gov.scot
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