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!