Coronary Heart Disease

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:

• In the 15% most deprived areas in Scotland, the under 75 mortality rate from CHD (standardised by age) decreased slightly from 112.4 in 2007 to 103.5 per 100,000 in 2008. This rate has shown a general decline over from the period 2000 to 2008, although there was a minor rise between 2006 and 2007 (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 4.5 times higher  in the most deprived tenth, compared to the least deprived (see Table DC1 ).
• 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 ).

Analysis	New/Updated	Excel Available	CSV Available	Size (Excel/CSV)	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.	24 November 2009		N/A	86 KB/- KB	√
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.	24 November 2009		N/A	179 KB/- KB	√
Table DC3 Trends (2000-2008) in mortality rate from coronary heart disease among the under 75s in the 15% most deprived SIMD2006 areas.	24 November 2009		N/A	48 KB/- KB	√
Table DC4 Number of deaths and European age sex standardised rates by NHS board; ages under 75; 15% most deprived SIMD2006.	24 November 2009		N/A	51 KB/- KB	√

Main contact: Adam Redpath

 Printer friendly version