Closing the gapHealth Inequalities in Highland

Dr. Margaret SomervilleDirector of Public Health

Why are we interested in health inequalities

Male life expectancy at birth  

Male life expectancy at birth  

All cause mortality for all ages and both sexes rates per 100,000 population  

All cause mortality for all ages and both sexes rates per 100,000 population  

What contributes to the gap in life expectancy?

All circulatory disease (CHD and stroke) and all cancers together account for 40-50% of the gap

The contribution from CHD has reduced slightly over time while the proportion of the gap due to cancer has increased

Other contributors include respiratory and digestive diseases and external causes

Diseases due to alcohol and smoking are major contributors to the gap

Coronary Heart Disease mortality for all ages and both sexes rates per 100,000 population

 

Coronary Heart Disease mortality for all ages and both sexes rates per 100,000 population

 

Cancer mortality for all ages and both sexes rates per 100,000 population  

Cancer mortality for all ages and both sexes rates per 100,000 population  

Lung Cancer mortality for all ages and both sexes rates per 100,000 population  

Lung Cancer mortality for all ages and both sexes rates per 100,000 population  

Areas within NHS Highland, that consistently appear among the most health deprived and the least health improved on multiple measures include: 

Local health inequalities in NHS Highland

Inverness MerkinchWick SouthHelensburgh EastOban SouthDunoonCampbeltownInverness MuirtownInverness Central and RaigmoreInvergordonFort William North

Insert pics – Merkinch? FW?Wick Pulteney Town?

What income do people need to achieve a socially acceptable standard of living in Grantown on Spey or Brora*?

Single One-earner couple + 2 children, no childcare

Two-earner couple + 2 children, with childcare

Lone parent, + 1 child, with childcare

Annual earnings required [urban*]

£19,820

[£16,383]

£39,091

[£34,881]

£47,146

[£36,728]

£29,452

[£23,861]Hourly wage requirement(each earner in household)[urban*]

£10.14

[£8.38]

£19.19

[£17.84]

£12.06

[£9.39]

£15.06

[£12.20]

[source: Joseph Rowntree Foundation, Minimum Income Standard for the UK http://www.jrf.org.uk/publications/MIS-2012 ]

* Minimum income standard for average urban and rural settlements

Fuel poverty in The Highland Council area 2009-11

% of households in The Highland Council spending more than 10% of income on fuel

35%

% of pensioner households in The Highland Council spending more than 10% of income on fuel

60%

% of households in The Highland Council spending more than 20% of income on fuel

9%

[source Scottish House Condition Survey, Local Authority Report 2009-11 http://www.scotland.gov.uk/Topics/Statistics/SHCS/LAReport2011 ]

The Highland Council Annual Survey of Performance & Attitudes: Social Capital

• 68% of respondents believe the area where they live provides them with a sense of belonging to a community

• 52% of respondents don’t feel involved in their local community

• People who tended to feel uninvolved in community life were: people who are unable to work and recent migrants to the area

[ Source: Highland Council’s Annual Survey of Performance and Attitudes 2012. UHI, 2012 http://www.highland.gov.uk/NR/rdonlyres/BC8A24B2-27C9-4BAE-8D1B-2BB263FBD1F7/0/THCAnnualPerformanceandAttitudesSurvey2012final300812.pdf Photo: Xmas at the Green Tree 2010 ]

Focussed community work to reduce inequalities

Keep Well health checks

Highland Council preventative spend

Assets-based approach

SummaryHealth Inequalities still widening across Highland

Many projects and targeted work in progress and presented here today

But vital that the work is sustained, embedded and coordinated

Enjoy the day!