Health inequalities in Scotland are significant. There are two key measures that demonstrate this – life expectancy, a measure of how long we can expect to live and healthy life expectancy, which tells us how many of those years are expected to be in good health.
The length of our lives
Scotland has the lowest life expectancy at birth of any nation in the UK. It is 76.8 years for men and 81.0 for women (2018-20). In Scotland as across the UK, life expectancy has decreased over the last year – primarily due to the Covid-19 pandemic.
But this is an average across the nation. Female life expectancy at birth in East Renfrewshire is 84 years, but in Glasgow City it is 78.3 – a gap of almost six years. Male life expectancy is highest in the Shetland Islands, at 80.6, and lowest also in Glasgow City, where it is 73.1. This seven and a half-year gap reflects a gap in quality of life.
Life expectancy varies hugely depending on how disadvantaged an area is. Disadvantage is measured by Indices of Multiple Deprivation (IMD). These are official measures of relative deprivation for small areas. The Scottish Indices of Multiple Deprivation ranks every part of Scotland into a relative measure, based upon income, employment, education, health, access to services, crime and housing.
In the most-disadvantaged ten percent of Scotland, men have a life expectancy of 68.9. In the least-disadvantaged, male life expectancy is 82.4 – a gap of 13.5 years of life.
For women, life expectancy in the most disadvantaged ten percent of neighbourhoods in Scotland is 75.4, but for the least disadvantaged it is 85.6. This, too, is a gap of more than ten years – and demonstrates the fact that good access to a decent income, better employment, a good education, better access to services and decent housing makes a serious difference to how long we live.
Life expectancy in Scotland
- In the most-disadvantaged ten percent of Scotland, men have a life expectancy of 68.9. In the least-disadvantaged, male life expectancy is 82.4 – a gap of 13.5 years of life.
- Women in the least disadvantaged parts of Scotland have a healthy life expectancy of 72.9. But in the most disadvantaged ten percent of Scotland, it is only 48.6. This is a difference of 24.3 years.
The quality of our health
It makes a difference to the quality of our health, too. Healthy Life Expectancy (HLE) is an estimate of the number of years we live in good or very good general health.
For women in the least disadvantaged parts of Scotland, their healthy life expectancy is 72.9. But in the most disadvantaged ten percent of Scotland, it is only 48.6. This is a difference of 24.3 years. Female healthy life expectancy in the least disadvantaged parts of Scotland is almost as long as the total life expectancy for women in the most disadvantaged neighbourhoods in Scotland.
The same is true for Scottish men. Healthy life expectancy for men born in the most disadvantaged neighbourhoods in Scotland is just 45.5 years, compared with 69.7 in the least. This is a gap of 24.2 years – almost a quarter of a century. It reinforces just how important these social and economic factors are in our lives.
National Records of Scotland, Healthy life expectancy in Scotland, 2018-2020 (2022).
Housing and Social Justice Directorate, Scottish government, Scottish Index of Multiple Deprivation 2020 (2020).