Although mortality rates in Scotland have generally fallen more slowly than in the rest of the UK and elsewhere in Europe, the improvements are still considerable and the impact is demonstrated in the steadily rising expectation of life.
The expectation of life at birth is a commonly used measure of mortality which is particularly helpful in comparing the ‘health’ of a nation through time and for making comparisons with other countries as well as for areas within Scotland. Figure 4.1 shows that the expectation of life at birth in Scotland has improved greatly over the last 25 years or so, increasing from 69.1 years for men and 75.4 years for women born around 1981 to 75.3 years and 80.1 years respectively for those born around 2008. Figure 4.1 also illustrates that improvements in life expectancy at birth are projected to continue, rising to 80.7 years for men and 85.2 years for women by 2033.
Figure 4.1 Expectation of life at birth, Scotland, 1981-20331
1. Figures to 2008 are based on 3 years of data. For example 2008 figure uses data for 2007-2009.
Source: Figures to 2008 from Interim Life Tables, ONS. Figures after 2008 are projected single year life expectancies, ONS.
However, Figures 4.2a and 4.2b show that Scottish men and women have relatively low expectation of life at birth compared with much of the European Union. The countries with lower life expectancy than Scotland were most of the Eastern European states which joined the EU on 1 May 2004 as well as Romania and Bulgaria which joined in January 2007. For men, the expectation of life in Scotland is about 4 years lower than the countries with the highest expectation of life whilst for women it is almost 5 years lower.
Figure 4.2a Life expectancy at birth, 2007, selected countries, Males
Figure 4.2b Life expectancy at birth, 2007, selected countries, Females
Within Scotland, there are considerable differences in life expectancy at birth between different Council areas as illustrated in Figure 4.3. For men, the Council area with the lowest life expectancy was Glasgow City (70.7 years), and the Council area with the highest life expectancy was East Dunbartonshire (78.0 years), 7.3 years more than Glasgow City. For women, East Dunbartonshire also had the highest life expectancy (82.5 years), 5.3 years more than Glasgow City, the area with the lowest figure (77.2 years).
Figure 4.3 Life expectancy at birth, 95 per cent confidence intervals1 for Council areas, 2006-2008 (Males and Females)
1. Life expectancy at birth is an estimate which is subject to a margin of error. The accuracy of results can be indicated by calculating a confidence interval which provides a range within which the true value underlying life expectancy would lie (with 95 per cent probability).
Source: GROS life expectancy. Please note that the Scotland-level life expectancy estimate shown in this chart is for use only as a comparator for the corresponding sub-Scotland-level figures. The definitive Scotland-level life expectancy estimate (based on interim life tables) is published by the Office for National Statistics.
There are also differences between urban and rural areas as shown in Figure 4.4. Men in rural areas – remote and accessible – can expect to live around 3.5 years longer (77.2 and 77.5 years respectively) than men in large urban areas (73.7 years). Women in rural areas – remote and accessible – can expect to live around 2 years longer (81.4 and 81.2 years respectively) than women in large urban areas (79.3 years).
Figure 4.4 Life expectancy at birth, 95 per cent confidence intervals1 for Urban and Rural2 areas, 2006-2008 (Males and Females)
1. Life expectancy at birth is an estimate which is subject to a margin of error. The accuracy of results can be indicated by calculating a confidence interval which provides a range within which the true value underlying life expectancy would lie (with 95 per cent probability).
2. Scottish Government’s 6-fold Urban Rural Classification version 2007-2008. See Appendix 2 for more details.
Source: GROS life expectancy. Please note that the Scotland-level life expectancy estimate shown in this chart is for use only as a comparator for the corresponding sub-Scotland-level figures. The definitive Scotland-level life expectancy estimate (based on interim life tables) is published by the Office for National Statistics
A more detailed picture of the large geographical variations in life expectancy can be seen in the 40 Scottish Community Health Partnership (CHP) areas. There are currently 40 CHP organisations in Scotland. The principal aim of the CHPs, which link NHS and Council services, is to improve the long-term health and wellbeing of communities and enhance the quality of health and social care services. Life expectancy at birth in the 40 CHP areas is shown in Figure 4.5. Men in East Dunbartonshire CHP area can expect to live over 8 years longer than men in North and East Glasgow CHP areas (78.0 years compared with 69.4 and 69.6 years respectively). Women in East Dunbartonshire CHP area can expect to live around 6 years longer than women in North and East Glasgow CHP areas (82.5 years compared with 76.0 and 76.8 years respectively).
Figure 4.5 Life expectancy at birth, 95 per cent confidence intervals1 for Community Health Partnership Areas, 2006-2008 (Males and Females)
1. Life expectancy at birth is an estimate which is subject to a margin of error. The accuracy of results can be indicated by calculating a confidence interval which provides a range within which the true value underlying life expectancy would lie (with 95 per cent probability).
Source: GROS life expectancy. Please note that the Scotland-level life expectancy estimate shown in this chart is for use only as a comparator for the corresponding sub-Scotland-level figures. The definitive Scotland-level life expectancy estimate (based on interim life tables) is published by the Office for National Statistics.
The percentage change in life expectancy at birth in CHP areas over the 10 year period 1996-1998 to 2006-2008 is illustrated in Figures 4.6a and 4.6b (ordered from left to right by lowest to highest life expectancy in 1996-1998). The improvement at the national level over the 10 year period was 3.6 per cent for men (or 2.6 years) and 2.4 per cent for females (or 1.8 years) and is shown by the heavy horizontal lines across the charts.
In the 10 years since 1996-1998, life expectancy at birth has increased in every CHP area, although in 11 cases by a margin so small that it may be consequence of the volatile nature of life expectancy estimates in small areas. For men, the largest increase in life expectancy at birth was in West Lothian with 5.7 per cent (an improvement of 4.1 years) and for women in East Dunbartonshire with 3.8 per cent (an improvement of 3.0 years). The gap of 8.6 years between the area with the highest male life expectancy at birth and the area with the lowest has not changed over the 10 year period; for females it has increased by 0.7 years (from 5.8 years in 1996-1998 to 6.5 years in 2006-2008). The gap between male and female life expectancy narrowed in all but 6 of the CHP areas. The gap decreased most in North Highland (4.0 years in 2006-2008 compared with 6.2 years in 1996-1998).
Figure 4.6a Percentage change in life expectancy, 1996-1998 to 2006-2008, in Scotland and for each individual Community Health Partnership (CHP) Area, Males
Figure 4.6b Percentage change in life expectancy, 1996-1998 to 2006-2008, in Scotland and for each individual Community Health Partnership (CHP) Area, Females
In South West Glasgow, West Glasgow and Inverclyde CHPs (areas which had among the lowest life expectancy at birth in 1996-1998), male life expectancy improved by 4.5 per cent to 5.1 per cent (or 3.1 to 3.6 years) over the last 10 years which is around 1 to 1.5 percentage points more than the average improvement experienced by Scotland. In contrast, life expectancy at birth for men in North Glasgow and East Glasgow CHPs (the areas ranked lowest and second lowest respectively in 1996-1998) improved but to a lesser extent than the average rate of improvement for Scotland. In South East Glasgow CHP, life expectancy started out low 10 years ago and only improved marginally over the period.
The largest improvement in female life expectancy between 1996-1998 and 2006-2008 was in East Dunbartonshire CHP area (3.8 per cent or 3.0 years), which was also among the best performing in terms of life expectancy in 1996-1998. Female life expectancy in Edinburgh and Stirling CHP areas behaves in a similar way to East Dunbartonshire in that both CHP areas had a higher life expectancy than the national average in 1996-1998, and have improved at a much greater rate than the Scottish average. There are areas where female life expectations improved at a better rate than average for Scotland and had a very low life expectancy in 1996-1998 – for example Dundee, West Lothian and East Glasgow CHP areas. These areas have improved by 2.9 per cent to 3.3 per cent. But there does not seem to be a pattern whereby all of the best performing areas in 1996-1998 pull further ahead.
A useful extension of life expectancy estimates is information on Healthy Life Expectancy (HLE) which is published by the Information and Statistics Division of the NHS. HLE is defined as the number of years people can expect to live in good health. The difference between HLE and life expectancy indicates the length of time people can expect to spend in poor health. More information on HLE in Scotland is available on the website of the Scottish Public Health Observatory (ScotPHO): http://www.scotpho.org.uk
Life expectancy decreases as deprivation increases, as illustrated by Figure 4.7. Men in the 10 per cent least deprived areas of Scotland can expect to live around 13.5 years longer than those in the 10 per cent most deprived areas (80.8 years compared with 67.3 years). Women in the 10 per cent least deprived areas of Scotland can expect to live around 9 years longer than those in the 10 per cent most deprived areas (84.1 years compared with 75.1 years).
Figure 4.7 Life expectancy at birth, 95 per cent confidence intervals1 by level of deprivation2, 2006-2008 (Males and Females)
1. Life expectancy at birth is an estimate which is subject to a margin of error. The accuracy of results can be indicated by calculating a confidence interval which provides a range within which the true value underlying life expectancy would lie (with 95 per cent probability).
2. Scottish Index of Multiple Deprivation (SIMD) 2009. For more information see Appendix 2.
Source: GROS life expectancy. Please note that the Scotland-level life expectancy estimate shown in this chart is for use only as a comparator for the corresponding sub-Scotland-level figures. The definitive Scotland-level life expectancy estimate (based on interim life tables) is published by the Office for National Statistics.
Note: An error has been found in the income domain of SIMD 2009. This affects the SIMD 2009 income domain and overall SIMD 2009. The effect of this error is expected to be minimal and is unlikely to change the key messages. For further information on this error see: http://www.scotland.gov.uk/Topics/Statistics/SIMD/