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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

Comparison of teenage pregnancies in Scotland and England and Wales by age group at conception (1994–2012). Source: ISD Scotland, 2014 (Information Service Division Scotland, 2014).
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fig3: Comparison of teenage pregnancies in Scotland and England and Wales by age group at conception (1994–2012). Source: ISD Scotland, 2014 (Information Service Division Scotland, 2014).

Mentions: Current official publications of SEP gradients in early-life outcomes, using methods comparable across UK jurisdictions, are largely limited to time-trends in infant mortality rate (IMR). The longest comparable pair of time-series we could identify from Scotland, versus England and Wales, comes from the period 2001–2009 inclusive (Poverty, 2011; ONS, 2012). In England and Wales, IMR decreased in a linear fashion over this nine-year period, from approximately 6.5 to about 4.8/1000 live births (LBs) in the lower SEP groups, whereas the reduction in the higher SEP group was from a much lower 2001 rate of 4.2, to about 3.6/1000 live births by 2009 (Fig. 1). Thus, in England and Wales, the absolute IMR decline between these two calendar years' IMRs, in 2001 and 2009, was much greater in the lower-SEP grouping (1.7/1000 LBs) than in the higher-SEP grouping (0.6/1000 LBs). Despite a narrowing of the absolute gap between higher- and lower-SES IMR risks over this period, it must be noted that the gap was narrowing very slowly, with nine years of progress still leaving the lower-SEP infants with a substantially higher relative risk of death in 2009 compared to the higher-SEP infants that year, and – in the case of England and Wales – worse off than the higher-SEP infants were a decade earlier. Data from 2010 to 2011 are now available (after which ONS changed from using father's social class to highest household social class), showing similar patterns as seen in Fig. 3 (Supplementary Figs. 1 and 2).


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)

Comparison of teenage pregnancies in Scotland and England and Wales by age group at conception (1994–2012). Source: ISD Scotland, 2014 (Information Service Division Scotland, 2014).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig3: Comparison of teenage pregnancies in Scotland and England and Wales by age group at conception (1994–2012). Source: ISD Scotland, 2014 (Information Service Division Scotland, 2014).
Mentions: Current official publications of SEP gradients in early-life outcomes, using methods comparable across UK jurisdictions, are largely limited to time-trends in infant mortality rate (IMR). The longest comparable pair of time-series we could identify from Scotland, versus England and Wales, comes from the period 2001–2009 inclusive (Poverty, 2011; ONS, 2012). In England and Wales, IMR decreased in a linear fashion over this nine-year period, from approximately 6.5 to about 4.8/1000 live births (LBs) in the lower SEP groups, whereas the reduction in the higher SEP group was from a much lower 2001 rate of 4.2, to about 3.6/1000 live births by 2009 (Fig. 1). Thus, in England and Wales, the absolute IMR decline between these two calendar years' IMRs, in 2001 and 2009, was much greater in the lower-SEP grouping (1.7/1000 LBs) than in the higher-SEP grouping (0.6/1000 LBs). Despite a narrowing of the absolute gap between higher- and lower-SES IMR risks over this period, it must be noted that the gap was narrowing very slowly, with nine years of progress still leaving the lower-SEP infants with a substantially higher relative risk of death in 2009 compared to the higher-SEP infants that year, and – in the case of England and Wales – worse off than the higher-SEP infants were a decade earlier. Data from 2010 to 2011 are now available (after which ONS changed from using father's social class to highest household social class), showing similar patterns as seen in Fig. 3 (Supplementary Figs. 1 and 2).

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