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Audit Scotland - Resources need to be better targeted to help address Scotland’s long-standing health inequalities

There remain major differences in the health and life expectancy of different groups of people in Scotland. The problem is complex and addressing it requires a range of public bodies working together effectively; it is not just the responsibility of health services.

An Audit Scotland report published last week, Health inequalities in Scotland, says that while overall health has improved in the past 50 years, deep-seated inequalities remain. Deprivation is the key determinant, although age, gender and ethnicity are also factors. Men in the most deprived areas die 11 years earlier than those in the most affluent, and the gap is 7.5 years for women. People in deprived areas also have higher rates of heart disease, obesity, diabetes, drug and alcohol misuse, and mental health problems.

The report assesses how well public sector bodies are working together to target resources at health inequalities and monitor their collective performance, and reviews health services and initiatives aimed at reducing health inequalities.

The report says it is not clear how much money NHS boards and councils spend in this area or what it is spent on. The Scottish Government takes account of deprivation and other local needs in allocating funding to NHS boards and councils but it is not clear how boards and councils target their resources at local areas with the greatest needs.

Scotland has particular areas of significant deprivation and people living in these areas need more preventative services and healthcare. They tend to have poorer access to hospital services and worse outcomes, receive fewer treatments and are more likely to miss appointments. The distribution of primary care services across Scotland does not always reflect the higher levels of ill health in more deprived areas.

Auditor General for Scotland, Caroline Gardner, said: “Health inequalities are long-standing and entrenched in Scotland. Tackling this has been a priority for successive governments but most indicators show the problem remains substantial. On average, people in Scotland’s poorest neighbourhoods die earlier and children in the most deprived areas have significantly worse health.

“Across the country, there are particular areas of poverty where people have higher healthcare needs. Resources should be better targeted at those who require them most.” Chair of the Accounts Commission for Scotland, John Baillie, said: “Reducing health inequalities is challenging and requires effective partnership working across a range of organisations. Community Planning Partnerships have a key role to play and need to provide strong and supportive leadership for local organisations. They should also ensure all partners are clear about their roles and responsibilities, and improve their evaluation and reporting of progress in reducing health inequalities.”

For further information contact Simon Ebbett. Tel: 0131 625 1652 or sebbett@audit-scotland.gov.uk

Notes to Editors:

1. Due to the scale and complexity of health inequalities, the report does not cover areas such as education, employment and housing.

2. In addition to this report, Audit Scotland has published a range of accompanying documents on its website www.audit-scotland.gov.uk. These include: detailed analysis of health inequalities across a range of indicators; a report on focus group work with frontline staff and managers from Community Planning Partnerships (CPPs) and Community Health Partnerships (CHPs); a checklist for CPPs to help improve their approach to addressing health inequalities; and a checklist for councillors and health board non-executives to help address health inequalities in their local areas.

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