Deprivation
Deprivation, as measured by the Scottish Index of Multiple Deprivation, is associated with higher rates of coronary heart disease (CHD) mortality. The relationship is stronger amongst the under 65s. ISD Scotland's Deprivation and Health in Scotland, published in 1998, discusses the impact of deprivation on CHD.
More recent figures on the effect of deprivation on mortality from CHD can be found in the health chapter of the Scottish Executive's Social Focus on Deprived Areas 2005.
The report of the ministerial taskforce on inequalities, "Equally Well', published in June 2008, contains a more general account of the effect of deprivation on health, including CHD and cerebrovascular disease.
Key Points:
- There has been a reduction in inequality in mortality rates over the decade 2001-2010. Mortality rates among all deprivation quintiles reduced but the reduction (34.1%) in the age-sex standardised CHD mortality rate among the most deprived category has been almost double the reduction observed in the least deprived category (18.1%) (see Table DC7
). - In the 15% most deprived areas in Scotland, the under 75 mortality rate from CHD (standardised by age) decreased slightly from 96.7 in 2009 to 95.5 per 100,000 in 2010. However the rate for males increased by 3.4% from 144.9 in 2009 to 149.8 per 100,000 in 2010 (see Table DC3 & Table DC4 ).Further information and data are available from the Scottish Government's web site "Scotland Performs" section.
- There is a strong positive relationship between deprivation and CHD mortality rates. This relationship is evident for all ages but is strongest in the 0-64 age group. The 0-64 SMR is approximately 4.5 times higher in the most deprived tenth, compared to the least deprived (see Table DC1 - last updated February 2011).
- The relationship between operation rates and deprivation in any age/sex group does not reflect the strong relationship between CHD mortality and deprivation. Table DC2 shows the ratio between the actual number of interventions performed and the number expected. The expected number is calculated using national procedure rates, taking into account the age and sex composition of the population, and the level of disease as measured by the relative level of CHD mortality in each deprivation decile. The figures show fewer interventions performed than expected for the more deprived areas - a finding first reported in the CHD and Stroke Task Force Report . Since there is no evidence that less deprived patients are having inappropriate interventions, the findings indicate inequity of access to, uptake of, or supply of interventions to more deprived populations (see Table DC2 - last updated February 2011).
| Analysis | New/Updated | Excel Available | Size | National Statistics |
| Table DC1 Coronary Heart Disease and Deprivation; mortality crude rates and standardised mortality ratios (SMR) by age group and SIMD decile; 2004-2008. |
22 Feb 2011 | |
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| Table DC2 Mortality Adjusted ratios for CABG, Angioplasties and CABG & Angioplasties for year ending 31st March 2009; by SIMD deprivation decile, age group and sex. |
22 Feb 2011 | |
171kb | |
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Table DC3 Trends (2001-2010) in mortality rate from coronary heart disease among the under 75s in the 15% most deprived SIMD areas. |
29 Nov 2011 | |
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Table DC4 Number of deaths and European age-standardised rates by NHS board; ages under 75; 15% most deprived SIMD areas. |
29 Nov 2011 | |
80kb | |
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Table DC5 Number of deaths from coronary heart disease and European age-standardised rates by community health partnership (CHP); ages under 75; 15% most deprived SIMD areas. |
29 Nov 2011 | |
73kb | |
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Table DC6 Number of deaths from coronary heart disease and European age-standardised rates by local authority/ council area; ages under 75; 15% most deprived SIMD areas. |
29 Nov 2011 | |
74kb | |
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Table DC7 Trend in coronary heart disease mortality, crude mortality rates and standardised mortality rates by SIMD deprivation quintile; 2001-2010. |
29 Nov 2011 | |
190kb | |
