Scots are living more of their lifetime in poor health – is it time for radical change?

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The number of years people in Scotland can expect to live in good health has fallen again, according to new figures. The Healthy Life Expectancy 2018 -2020 report shows those in our poorest communities now spend up to a third of their life on average in ill health.  In this guest article writer and campaigner Kenneth Murray argues such inequality is a form of violence affecting our most vulnerable communities. 

As a child in school I learned how the average life expectancy has improved over generations. History lessons painted a picture of a population that didn’t wash, understand the power of bacteria and hadn’t discovered penicillin. Therefore it made sense that our ancestors wouldn’t enjoy as long, or healthy, a life as modern men and women. 

In 1861 the National Records of Scotland shows the average life expectancy, as low as 40 for men and 43 for women. To put that into context, the American Civil War began that same year. 

Over the last 160 years or so we have seen life expectancy even for our most deprived communities, improve thanks to the power of science and social reform. However, the trend for several years now has been going in the wrong direction with healthy life expectancy falling for Scottish males and females. 

The latest figures show the average male healthy life expectancy is now 60.9 and for women it’s 61.8. However if you’re a woman living in North Ayrshire that figure falls to just 54. Indeed those living in our countries most deprived communities spend on average 24 years fewer in good health than those living in the least deprived areas. 

It’s easy to get lost in statistics and people will undoubtedly navel gaze about the meaning of the data and information without being able to break that into individual cases. However, if these statistics do anything it’s give an indication as to what’s happening for people across Scotland when it comes to health, wellbeing and ultimately death. 

People are dying well before they should and the headlines are becoming a bit of a self-fulfilling prophecy. We’re also becoming more and more, numb to them. In the deprived areas of Scotland people are too busy trying to get on, to maintain their sense of community and survive. In well-meaning conversations across the country people debate about how to describe people and their poverty. Is it ‘lived experience’? Is it ‘person with ACES’? Or does ‘vulnerable’ cover it? 

I’ve been on both sides of that discussion. I’ve been caught up in the shame and stigma of language that rightfully has changed, but I’ve also picked through my pockets trying to make up enough change for the bus home from those same discussions.

Meanwhile, in the boardrooms and the glass offices, there’s money to be made. Whether it’s gambling, alcohol or fast food. Corporate social responsibility strategies are springing up all around us. We’re told that a portion of the profits these businesses make are going back into the communities they profit most from. If we search deep within ourselves we’d know we’re being hoodwinked, at best. 

I’m not saying we shouldn’t have strong industries and I’m not suggesting that people who live in deprived communities shouldn’t be able to have a flutter on the horses, have a wine or a burger. It’s just convenient that these communities are better served by off-sales, fast food outlets and bookies than any other.

I had a conversation with someone recently about the early deaths of care experienced people and those in deprived areas, it descended into an academic discussion about how we have to look at all the factors, life choices and even freak accidents! I’m not quite sure how that marries up with the rise of crowdfunded funerals I’ve experienced in the last five years. It isn’t a new phenomenon either. I remember people coming to my family’s door in Easterhouse with a jar and a story about some unfortunate soul who had died before their time. The only difference is the mechanism is different and because of the power of the internet, these same stories can be heard in middle and upper class homes. It’s a fuel for guilt and naivety that unfortunately don’t always get to the root of the problem.

When we think about violence in Scotland it’s easy to go straight to gang violence. The stories of the young teams and knives. However, with the help of the SVRU, we understand the issue of gang violence differently. We take a whole environment approach and it feels like, with a few small stumbles, things are beginning to change. 

The same can’t be said about healthy life expectancy. In not radically changing our approach to the delivery of services to those in the most deprived areas we’re creating an environment where their lives end prematurely and according to the latest statistics from the National Records of Scotland, even if you do make it past 60, the chances are you’re doing so in ill health. If that isn’t violence, I don’t know what else you’d call it.

Scotland is leading the way in so many ways. We’re using ground breaking co-design methods of delivering work into communities. More and more people who’ve experienced the circumstances we’re attempting to improve are being consulted as the experts they are, but it still isn’t enough.

If Covid has taught us anything, community has power. It was vital in understanding and putting us on the road to a solution for gang violence. Perhaps it too can play a powerful part in the solution for the violence of ignorance of poverty and its true costs. 

Kenneth Murray writer and campaigner.

The views expressed in this article are those of the author and do not necessarily represent the views of the Scottish Violence Reduction Unit. The SVRU is not responsible for the content of external sites.  

Niven Rennie

Director

Telephone: 01786 896785          Email: violence.reduction@scotland.pnn.police.uk

Niven has more than 30 years of operational policing experience in the United Kingdom. He joined Strathclyde Police in 1985 serving throughout the west of Scotland in a variety of ranks and positions before progressing to the rank of Chief Superintendent. Niven previously held the role of President of the Association of Scottish Police Superintendents where he represented the interests of the operational leaders of policing in Scotland.

On leaving Police Scotland in 2016 Niven took up the position of Chief Executive Officer of South Ayrshire Escape from Homelessness (SeAscape).

Niven was appointed director of the Scottish Violence Reduction Unit in July 2018.