Scotland's poorest 15.3 times more likely to die from drug misuse

Opposition parties described the findings in the document as "damning."

The wide-ranging report - published by National Records of Scotland - also projects that Scots will have significantly fewer babies over the next two decades, and reveals the declining popularity of the Kirk and the Catholic Church. 

On deaths, it reveals that alcohol-specific fatalities were 5.6 times as likely to occur in the most deprived areas. While that has decreased from a high of 8.7 in 2002, it has spiked again in the last few years. 

The report also touches on the impact of Covid. Older people and the disabled were more likely to die from the virus, with about 72 out of every 100 people dying from Covid -19 being 75 or older.

More generally, people whose daily activities were limited a little were almost twice as likely to die after contracting coronavirus.

Covid-19 accounted for 8% of all deaths during the pandemic so far.

However, in 2020 and 2021 there were more deaths than usual from cancer, heart disease, digestive system diseases and external causes, such as drug-related deaths.

There were fewer deaths than usual from respiratory diseases such as asthma and COPD. NRS says it is likely that many people who died with Covid-19 had pre-existing respiratory diseases.

While life expectancy has improved over the last 40 years, those improvements have stalled over the last decade, and, worryingly, have started to reverse. 

NRS says the recent fall was mainly due to Covid-19, but that the initial stall was caused by a slowing down in progress in tackling heart disease deaths, an increase in the number of drug-related deaths, and a spike in the number of deaths from dementia and Alzheimer’s.

Julie Ramsay, head of vital events for NRS, said: “Mortality rates are about twice as high in the most deprived areas compared with the least deprived.

“But for some specific causes of death, we see much larger inequalities.

“For example, people in the most deprived areas of Scotland are more than 15 times as likely to die from drug misuse as those in the least deprived areas.

“That ratio has increased over the past two decades.

“In the early 2000s, those in the most deprived areas were around 10 times as likely to have a drug misuse death as those in the least deprived areas. In the last year, the gap has narrowed slightly.”

On births, NRS warns that for the first time in a number of years, the number of people living here will fall significantly from the end of the decade. 

This will in part be because growth from migration will no longer offset the growing gap between births and deaths. 

NRS forecast the population to peak in 2028 at 5.48 million before falling by 1.8% to 5.39 million by 2045. 

This they say is partly because people are not having babies. They project that there will be 22% fewer children and 21% more people of pensionable age.

It will be council areas in the west and southwest of Scotland which see the biggest loss of population. 

The report says: “They tend to be local authorities with a higher percentage of more deprived areas or a higher percentage of rural areas.

"Their populations are generally projected to decline due to more deaths than births, without enough migration to compensate.”

In contrast, most of the central belt and other urban areas are projected to grow in population, most of which will come from migration.

The dire forecast comes just a day after the Scottish Fiscal Commission warned of “particularly acute" challenges for economic growth because of worrying demographics.

Meanwhile, on marriages, more than 4 in 5 civil partnerships were of mixed-sex couples last year, despite the widening of who could apply for the legal recognition only coming into force last June. 

More than 1 in 30 marriages in 2021 were of same-sex couples.

Humanist ceremonies now account for about 1 in 4 marriages, NRS says, while the number conducted by the Church of Scotland and the Roman Catholic Church has declined. In 2021 they represented less than 1 in 10 of all marriages.

Scottish Labour health spokesperson Jackie Baillie said: “This shocking report once more lays bare Scotland’s outrageous and unacceptable levels of health inequality.

“Scotland’s life expectancy has been stalling for years but it is a national shame that those from the most deprived backgrounds have a considerably shorter life expectancy than those from wealthier backgrounds.

“Nobody’s health and future should be determined by a postcode lottery.

“It is clear from the report that the pandemic has exacerbated many of these issues, but they pre-date covid.

“After a decade and a half in power, the SNP government has completely failed to tackle our underlying health inequalities and the disarray in our NHS risks to fan the flames of this inequality.

“We know already that our life expectancy is lower than the rest of the UK and many of our neighbours across western Europe.

“This damning report must be a clarion call for Scotland’s do-nothing health minister and to this government which puts constitutional obsessions before saving lives.”

Conservative MSP Sue Webber said: “This damning report is further confirmation that it’s those from the most deprived areas of Scotland who suffer most under the SNP Government.

“Scotland’s drugs death epidemic has spiralled out of control on the SNP’s watch and the country’s fatality rate is now the worst in Europe by a huge margin.

“What is more, the NRS make clear that those from the poorest parts of the country are making up a higher proportion of drug-related deaths than they did when the SNP took power.

“They must belatedly give their backing to the Scottish Conservatives’ Right to Recovery Bill if they’re ever to get a grip on this national emergency.”

Scottish Liberal Democrat leader Alex Cole-Hamilton said: “These shocking figures speak to how shabbily this SNP government have treated some of Scotland’s most deprived communities.

“On drugs deaths we need to see radical action to establish heroin assisted treatment and safe consumption spaces, and the establishment of new specialist Family Drug and Alcohol Commissions to help provide wraparound services close to communities.”