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Seven key investments for health equity across the lifecourse: Scotland versus the rest of the UK.

Frank J, Bromley C, Doi L, Estrade M, Jepson R, McAteer J, Robertson T, Treanor M, Williams A - Soc Sci Med (2015)

Bottom Line: We present hard-to-find comparable analyses of routinely collected data to gauge the relative extent to which these investments have been pursued and achieved expected goals in Scotland, as compared with England and Wales, in recent decades.Despite Scotland's longstanding explicit goal of reducing health inequalities, it has recently been doing slightly better than England and Wales on only one broad indicator of health-equity-related investments: childhood poverty.Although Scotland did not choose independence on September 18th, 2014, it could still (under the planned increased devolution of powers from Westminster) choose to increase investments in the underperforming categories of interventions for health equity listed above.

View Article: PubMed Central - PubMed

Affiliation: Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK. Electronic address: john.frank@ed.ac.uk.

No MeSH data available.


Related in: MedlinePlus

Scotland infant mortality rates by SEP (1999–2009). Source: Poverty UK, 2012 (Poverty, 2011).
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fig2: Scotland infant mortality rates by SEP (1999–2009). Source: Poverty UK, 2012 (Poverty, 2011).

Mentions: Comparable statistics from Scotland show more statistical instability over time (Fig. 2), due to the much smaller number of infant deaths in a population less than one tenth of the size of the UK as a whole (Poverty, 2011). Nonetheless, both jurisdictions show a remarkably similar overall pattern – a more rapid absolute decline in IMR, in the years leading up to 2009, for lower-SEP infants than for higher-SEP infants. However, that pattern of decline left the most recent IMRs much more discrepant – in terms of absolute health inequality gap – across the two social class groupings in Scotland than in England: 5.6 versus 2.9/1000 LBs (almost double) in 2009 within Scotland. Thus, while the overall IMR for all of England and Wales was either comparable to or slightly higher than the overall Scottish IMR for most years since 1995, the IMR gap between the two SEP groupings depicted in Figs. 1 and 2 was consistently larger in Scotland, throughout the nine years (3.5/1000 LBs in 2000–2001 to about 2.8/1000 LBs in 2008–9 – whereas the gap in England and Wales fell from 2.0 to 1.1/1000 LBs over the same period). Data for 2010–2012 now use the Scottish Index of Multiple Deprivation, SIMD, although similar time-trends continue (Supplementary Fig. 3). As with virtually every other routinely collected health outcome analysed annually in recent years by the Scottish Government (Frank and Haw, 2011, 2013), Scottish socioeconomic inequalities in health remain large, generally the largest in Western Europe (Popham and Boyle, 2010).


Seven key investments for health equity across the lifecourse: Scotland versus the rest of the UK.

Frank J, Bromley C, Doi L, Estrade M, Jepson R, McAteer J, Robertson T, Treanor M, Williams A - Soc Sci Med (2015)

Scotland infant mortality rates by SEP (1999–2009). Source: Poverty UK, 2012 (Poverty, 2011).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4539344&req=5

fig2: Scotland infant mortality rates by SEP (1999–2009). Source: Poverty UK, 2012 (Poverty, 2011).
Mentions: Comparable statistics from Scotland show more statistical instability over time (Fig. 2), due to the much smaller number of infant deaths in a population less than one tenth of the size of the UK as a whole (Poverty, 2011). Nonetheless, both jurisdictions show a remarkably similar overall pattern – a more rapid absolute decline in IMR, in the years leading up to 2009, for lower-SEP infants than for higher-SEP infants. However, that pattern of decline left the most recent IMRs much more discrepant – in terms of absolute health inequality gap – across the two social class groupings in Scotland than in England: 5.6 versus 2.9/1000 LBs (almost double) in 2009 within Scotland. Thus, while the overall IMR for all of England and Wales was either comparable to or slightly higher than the overall Scottish IMR for most years since 1995, the IMR gap between the two SEP groupings depicted in Figs. 1 and 2 was consistently larger in Scotland, throughout the nine years (3.5/1000 LBs in 2000–2001 to about 2.8/1000 LBs in 2008–9 – whereas the gap in England and Wales fell from 2.0 to 1.1/1000 LBs over the same period). Data for 2010–2012 now use the Scottish Index of Multiple Deprivation, SIMD, although similar time-trends continue (Supplementary Fig. 3). As with virtually every other routinely collected health outcome analysed annually in recent years by the Scottish Government (Frank and Haw, 2011, 2013), Scottish socioeconomic inequalities in health remain large, generally the largest in Western Europe (Popham and Boyle, 2010).

Bottom Line: We present hard-to-find comparable analyses of routinely collected data to gauge the relative extent to which these investments have been pursued and achieved expected goals in Scotland, as compared with England and Wales, in recent decades.Despite Scotland's longstanding explicit goal of reducing health inequalities, it has recently been doing slightly better than England and Wales on only one broad indicator of health-equity-related investments: childhood poverty.Although Scotland did not choose independence on September 18th, 2014, it could still (under the planned increased devolution of powers from Westminster) choose to increase investments in the underperforming categories of interventions for health equity listed above.

View Article: PubMed Central - PubMed

Affiliation: Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, EH8 9DX, UK. Electronic address: john.frank@ed.ac.uk.

No MeSH data available.


Related in: MedlinePlus