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ANNEX: CELEBRATING SUCCESS - PROGRESS ON IMPROVING SCOTLAND'S HEALTH
Introduction
This annex provides some hard facts and figures to show the real progress we are making in Scotland. Most of the data reproduced here is updated annually, and we have included the latest available information. More detailed information on the state of the nation's health is available in the Chief Medical Officer's Annual Report - Health in Scotland 2005 - and from the Scottish Public Health Observatory website 29.
The Executive set targets for improving Scotland's health in its 2004 spending review, published in Building a Better Scotland30 - and we continue to make major and significant progress in relation to coronary heart disease, cancer and stroke. We need to do more to close the health inequalities gap, but good progress has also been made on the six inequalities indicators which are being used to track progress and are given below.
Setting Scotland in the International Context
Coronary Heart Disease and International Comparisons
We aspire for Scotland to be the best small country in the world. This chart shows how we are doing on CHD (also known as Ischaemic Heart Disease) in relation to other European countries - both large and small.
CHD (<75) MORTALITY RATES (STANDARDISED TO EUROPEAN POPULATION
SDR, ischaemic heart disease, all ages per 100,000 male
The Scotland and European Health for All database 31 ( WHO & ScotPho) holds internationally comparable data on various indicators of health, including mortality rates from Coronary Heart Disease ( CHD). Comparable figures for Scotland have been calculated by ScotPho for the late 1970s onwards. The chart above shows that in the 1970s the CHD mortality rate
for males in Scotland was higher than almost all the other European countries displayed. However, by the early part of the twenty first century the rate had decreased and was similar to other small northern European countries such as Finland and Ireland. Male mortality rates from CHD in Scotland do however, remain above average compared with most other European countries.
The Three Big Killers
Considerable progress has been made and is illustrated below.
CANCER MORTALITY (UNDER 75)
Cancer (<75)MortalityRates(Standardised to European Population)
(2010Target X=133.8; Target trend from1995 = - - - -)
Our Cancer (under 75) Mortality Rate Target is to achieve a 20% reduction from 167.3 in 1995 to 133.8 per 100,000 population in 2010 (standardised to the European population).
There has been a 14.8% reduction in the rate from 167.3 in 1995 to 140.9 in 2005. If this trend continues (dotted line on chart), the rate will have reduced by 21.8% by 2010 and therefore the target will be met.
CHD MORTALITY (UNDER 75)
CHD (<75) Mortality Rates (Standardised to European Population)
(2010Target X=49.8;Target trend from1995 = - - - -)
Our CHD (under 75) Mortality Rate Target is to achieve a 60% reduction from 124.6 in 1995 to 49.8 per 100,000 population in 2010 (standardised to the European population).
There has been a 45.8% reduction in the rate from 124.6 in 1995 to 67.5 in 2005. If this trend continues (dotted line on chart), the rate will have reduced by 61.4% by 2010 and therefore the target will be met, but only just.
STROKE MORTALITY (UNDER 75)
Stroke (<75)MortalityRates(Standardised to European Population)
(2010Target X=18.8;Target trendline from1995 = ----)
Our Stroke (under 75) Mortality Rate Target is to achieve a 50% reduction from 37.5 in 1995 to 18.8 per 100,000 population in 2010 (standardised to the European population).
There has been a 45.1% reduction in the rate from 37.5 in 1995 to 20.6 in 2005. If this trend continues (dotted line on chart), the rate will have reduced by 53.7% by 2010 and therefore the target will be met.
HEALTH INEQUALITIES TARGETS
Tackling health inequalities and closing the health gap is a key priority for the Executive. We identified suitable indicators on which to measure our progress and these were used to set targets as part of the spending review process in 2004, and published in Building a Better Scotland. Information on our six health inequalities targets is given below.
SMOKING DURING PREGNANCY
Smoking during pregnancy
Our SR2004 Target is to reduce smoking during pregnancy in the most deprived areas by 10.0% from 35.8% in 2003 to 32.2% in 2008.
An average annual reduction of -2.1% is required to meet this target.
During the first two years of the target period the rate has decreased by 11.1% (from 35.8% in 2003 to 31.8% in 2005). If this trend continues the 2008 target will be met. Rates of smoking in the most affluent areas have however decreased more than those in the most deprived areas, increasing the inequality ratio and therefore widening the inequality gap.
ADULT SMOKING
Adultsmoking (16+ year olds)
Our SR2004 Target is to reduce adult (16+) smoking rates in the most deprived areas by 10.9% from 37.3% in 2004 to 33.2% in 2008 (rebased in December 2005 from the previous target to reduce adult, 16-64, smoking rates in the most deprived areas by 10.9% between 2003 and 2008).
An average annual reduction of 2.8% is required to meet this target.
During the first year of the target period the rate has decreased by 7.7% (from 37.3% in 2004 to 34.4% in 2005). If this trend continues the 2008 target will be met. During the same period, rates of smoking in the most affluent areas increased, decreasing the inequality ratio and therefore narrowing the inequality gap.
CANCER MORTALITY (UNDER 75)
Cancer mortality (under75s)
Our SR2004 Target is to reduce the under 75 cancer mortality rate (per 100,000) in the most deprived areas by 10.1% from 186.4 in 2003 to 167.6 in 2008 (standardised to the European population).
An average annual reduction of -2.1% is required to meet this target.
During the first two years of the target period the rate has decreased by 7.4% (from 186.4 in 2003 to 172.6 in 2005). If this trend continues the 2008 target will be met. A larger decrease in the mortality rates in the most affluent areas during the first year of the target period widened the inequality gap, but this levelled out in the second year.
CHD Mortality (Under 75)
Our SR2004 Target is to reduce the under 75 coronary heart disease mortality rate (per 100,000) in the most deprived areas by 27.1% from 112.0 in 2003 to 81.7 in 2008 (standardised to the European population).
An average annual reduction of -6.1% is required to meet this target.
During the first two years of the target period the rate has decreased by 12.7% (from 112.0 in 2003 to 97.8 in 2005). If this trend continues the 2008 target will be met. Mortality rates in the most affluent areas also fell, but not as much as in the most deprived areas. The inequality ratio therefore decreased and so the inequality gap narrowed.
TEENAGE PREGNANCY
Teenage pregnancies (13-15 yearolds)
Our SR2004 Target is to reduce the teenage pregnancy rate (per 1,000 population) of 13-15 years olds in the most deprived areas from 12.6 in 2000/2 to 8.4 in 2007/9.
An average annual reduction of -5.6% is required to meet this target.
Between 2000/2 and 2002/4, the rate has decreased by 0.8% (from 12.6 in 2000/1 to 12.5 in 2002/4). To be on track to achieve the target, the rate in 2002/4 should have been 11.2 or less per 1,000. During the same period, the rate in the least deprived areas has decreased by 11.1%. The inequality gap has therefore widened.
SUICIDE IN YOUNG PEOPLE
Suicide rateyoungpeople (aged10-24)
Our SR2004 Target is to reduce the suicide rate (per 100,000 population) for young people aged 10-24 years olds in the most deprived areas by 15.0% from 10.7 in 2001/3 to 8.6 in 2007/9.
An average annual reduction of -2.7% is required to meet this target.
Between 2001/3 and 2003/5, the rate has decreased by 16.4% (from 10.1 in 2001/3 to 8.4 in 2003/5). This actually exceeds the 2007/9 target, but the rate may rise again before the end of the target period because the small numbers involved cause fluctuations in these data. During the same period, the rate in the least deprived areas actually increased by 7.8%. The inequality gap has therefore narrowed.
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