Life expectancy is perhaps the surest sign of a country’s welfare, which makes it all the more worrying that Scotland’s is going down. Figures out today show that when it comes to life expectancy, Scotland is no longer near the bottom range of western European countries and has instead joined the ranks of the post-Soviet states. Given Scotland’s level of state spending (amongst the highest in the world) this presents a conundrum. What’s going wrong?
A boy born in Scotland today will live to 76.6 years on average, a girl just under 81. That’s a fall of some 11 weeks for men and almost 8 for women since last year. It’s the second year in a row the figure has fallen, bucking international trends. Scotland continues to have the lowest life expectancy in the UK and the gap with the other nations is widening.
This is mainly a sign of deprivation, and what has been called the most expensive poverty in the world because of the cost of the country’s welfare state. In Glasgow, where parts of my family are from, life expectancy is just 73 – on a par with the Gaza Strip and Syria. And that’s an average which includes the city’s lush West End: go east and you can find places where life expectancy is in the 60s.
There’s a 14-year gap for male life expectancy between the poorest and the richest Scots. It’s 11 years for women. That gap is widening too. Dundee, having become the violent crime capital of Scotland and drugs death capital of Europe, may soon have the worst life expectancy in Britain too.
The point about eastern and western Europe is made by the National Records of Scotland who produced today’s report. They point out that Scotland’s figures are the worst in western Europe and now some eastern European countries are overtaking us too. Scotland’s political leaders aspire to be like the rich nations of Europe: Ireland, Norway, Sweden. But healthwise, we’d be doing well to emulate Slovenia.
Even before the pandemic, life expectancy was stalling. It hasn’t significantly improved in Scotland for the past eight years. When I worked for the National Records of Scotland, who produce the life expectancy statistics, some of my colleagues were put on ‘working groups’ to get to the bottom of life expectancy figures that were flatlining. But then the pandemic came along and provided an easy solution: blame it all on Covid.
It’s certainly true the pandemic has dragged life expectancy down. Covid has been mentioned on some 15,555 death certificates in Scotland since March 2020 – and NRS say it accounts for nearly 32 weeks of the life expectancy fall. But it’s not just the virus that has struck people down – and dragged the stats with them. Lockdowns, and their consequences, are having an impact now too.
Another release from the National Records of Scotland, published on Tuesday, found deaths in the second quarter of the year were some 10 per cent higher than average for that time of year. In other words, 1,322 more Scots died than we might have expected. Cancer deaths are 0.6 per cent above average, heart disease is killing 3 per cent more people than expected, dementia is some 7 per cent higher than what’s gone before and yet respiratory diseases are more than 7 per cent lower. It can’t all be blamed on Covid.
Handily, the life expectancy statistics are split out by contributing causes. As the below graph shows, even if you removed Covid – which contributed to 32 weeks of the fall – the change would still be a negative one. Drugs, circulatory diseases and ‘external factors’ brought down life expectancy by some 14 weeks while improved outcomes in cancer, dementia and other respiratory diseases only improved the length someone might expect to live by 12.7 weeks.
Scotland is bucking an international trend too. Whilst people in most developed countries are living longer, that is not the case in Scotland. And even before the pandemic it was levelling off. Another country where this is happening, perhaps surprisingly, is the US. Could this give us some answers?
There are myriad drivers of life chances and life length, but something both Scotland and America have is huge problems with drug deaths. In Scotland 1,330 died from drug-related causes last year – over twice as many as died a decade ago. In America 107,622 died in 2021, again more than twice the number ten years ago. The drug death rate in Scotland is 245 per million, four times worse than any European country. America’s rate is 283 per million, higher than their neighbours too.
Before life expectancy began to stall (in 2012 to 2014) reductions in ‘circulatory disease’ deaths were driving most of Scotland’s improvement. Since then drug deaths and deaths from dementia and Alzheimer’s began to increase sharply.
The government is keen to point to the massive impact of Covid on Scotland’s death statistics. The front page of their press release draws your attention to it. But life expectancy has been stalling since 2012, and as these figures today show, it would still be falling even without Covid deaths. Pre-pandemic, Scotland spent £125 more per head on health than England.
There comes a point where policymakers have to ask if money really is the answer – or whether the fault lies with factors that require deeper diagnosis.
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