Reactive Stats Summary, Life expectancy in Scotland, 2021-2023
One of the aims of the Scottish Health Equity Research Unit is to produce reactive statistical / research briefings that summarise relevant data releases. Designed to improve the accessibility and visibility of important statistical findings, these briefings provide concise, easy-to-understand round-ups that highlight key insights from recent publications. By demystifying complex statistics, methodologies, and data limitations, the unit aims to make this information more approachable for a wider audience.
This reactive stats briefing examines Scotland’s life expectancy data for 2021-2023, revealing persistent inequalities driven by socioeconomic factors and the lasting effects of COVID-19. The findings highlight a notable gap in life expectancy based on deprivation levels, emphasising the urgent need to address the underlying social determinants that contribute to health inequalities across Scotland.
A PDF of the briefing is available here
Scotland’s Life Expectancy: A Reflection of Deep-Rooted Socioeconomic Inequalities
Summary of Key Points
> Life Expectancy Trends: Scotland’s life expectancy for 2021-2023 remains lower than pre-pandemic levels, influenced by socioeconomic inequalities and the lingering effects of Covid-19.
> Covid-19 Impact: In 2021-2023, life expectancy in Scotland reached 80.9 years for females and 76.9 years for males, an improvement from the pandemic’s peak but still below pre-Covid levels, with ongoing health impacts evident.
> Deprivation Gap: There is a notable difference in life expectancy based on deprivation levels. Females in the most deprived areas live 10.5 years less than those in affluent areas; for males, the gap widens to 13.2 years.
> Geographical Inequalities: Life expectancy is higher in remote rural areas and lowest in urban areas like Glasgow, reflecting differences in pollution, access to green spaces, and social challenges.
> Health Inequality Drivers: Life expectancy data clearly shows that socioeconomic factors like income, location, and resource access drive health inequalities in Scotland.
Life Expectancy in Scotland, 2021 – 2023
Life expectancy is a key measure of a nation’s overall health, and in Scotland, it reveals deep-seated inequalities tied to socioeconomic factors. While modest improvements have been made since the peak of the COVID-19 pandemic, the latest figures on life expectancy in Scotland (2021-2023) from the National Records of Scotland (NRS) illustrate that health inequalities persist, particularly between the most and least deprived areas. Scotland’s life expectancy has historically lagged behind the rest of the UK, and the NRS report shows that, when compared with Eurostat data, Scotland has the lowest life expectancy in western Europe – a sobering pattern which has been highlighted many times before.
Life Expectancy Trends and Covid-19 Impact
These latest statistics show that life expectancy in Scotland was 80.9 years for females and 76.9 years for males in 2021-2023. The figures represent an increase by almost 7 weeks for females and 14 weeks for males since 2020-2022. This recent improvement in life expectancy is welcome, with 2021-2023 reflecting a period beyond peak pandemic-related mortality but one which remained affected by its lasting health impacts.
Between the early 1980s and early 2010s, life expectancy in Scotland was on an upward trajectory, with reductions in mortality from circulatory diseases a big factor. Since peaking in 2012-14, progress then started to stall, with NRS explaining that this coincided with rises in other causes of death, particularly drug-related deaths and deaths from dementia and Alzheimer’s disease. Since 2017-19, Covid-19 has had the largest negative impact on life expectancy for both females and males.
Deprivation and Health Inequalities
Deprivation, measured by factors such as income, education, employment, housing, and access to health services, is a powerful driver of health inequalities. Woman in the most deprived areas (decile 1) have a life expectancy that is 10.5 years lower than their counterparts in the least deprived areas (decile 10). For men, the equivalent gap is even wider, at 13.2 years. The stark difference in life expectancy between deprived and affluent areas is not just a statistic; it reflects a broader, systemic inequality that extends far beyond health, touching on almost every aspect of life.
Geographical Variations in Life Expectancy
There is also a notable geographical dimension to health inequalities in Scotland. Life expectancy is highest in remote rural areas and lowest in large urban areas. For woman, this urban-rural gap is 2.6 years, and for men, it stands at 3.4 years. Rural areas often benefit from lower pollution, a less stressful environment, and greater access to natural spaces that promote physical activity and mental well-being. However, urban areas, especially large cities like Glasgow (where life expectancy is lowest for both females and males), are often burdened by higher levels of deprivation, crowded living conditions, and more pronounced social challenges, which contribute to poorer health outcomes.
Socioeconomic Determinants of Health Inequalities
Evidence on Scotland’s health outcomes has illustrated the empirical experiences of social determinants. Health inequalities are driven by a complex range of factors such as rising levels of poverty, inequality in income and wealth, alongside access across to housing, health, social care and education services [2].
Focusing on differential access to housing includes areas such as: housing affordability, choice and quality as determinants of health inequality. At its core, a home that fails to meet people’s needs due to problems such as being unaffordable or insecure, cold and damp, overcrowded or ill equipped for the occupants needs, will in turn shape and have wide-ranging impacts on households physical and mental health, and longer-term health outcomes [3].
Research on families on a low-income shows the interconnections between housing costs alongside wider inequality drivers such as labour market experiences and income [4]. When analysing housing costs for families on Universal Credit or equivalent low-income legacy benefits (irrespective of their tenure), one in ten people are pulled into poverty due to their housing costs in Scotland. Furthermore, one in five people are in unaffordable housing, spending 30% or more of their income on housing costs [5]. Insecure incomes, and in particular persistent poverty, continue to generate adverse health impacts [6].
The relationship between housing affordability and health outcomes was illustrated in recent evidence commissioned by Scottish Government, which provides a snapshot of private rented and social tenant experiences in Scotland [7]. Respondents discussed challenges with food insecurity, and fuel poverty and general income adequacy, against a backdrop of rising costs, impacting on their physical and mental health outcomes [8].
“A decent standard of living is one where your mental health isn’t being affected by the cost of bills increasing, inflation and housing precarity.” (Private tenant).
“I like my house; I have to pay for the gas and electricity, so I compromise on the food.” (Social tenant)
Qualitative evidence from the Chance 2 Change Group (a group with lived experience of low income), shows people are all too aware of the way socio-economic factors shape health and of the resulting health inequalities [9]:
“It’s shocking that where you are born determines how long you can have a healthy life – accident of birth” (Chance 2 Change Expert)
The Bottom Line
Overall, the trends within these latest life expectancy statistics are a stark reminder of the profound impact of social determinants on health. Socioeconomic status, geographic location, access to resources, and environmental conditions all combine to create an uneven playing field where the most disadvantaged communities face significantly worse health outcomes and shorter lives. To close this gap, Scotland must confront the underlying social and economic determinants that create health inequalities, focusing on long-term, sustainable policies that promote well-being and equity across all regions and demographics.
Sources
[1] National Records of Scotland (2024) ‘Life Expectancy in Scotland 2021-23’ https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/life-expectancy/life-expectancy-in-scotland/2021-2023
[2] Smith, K. and Stewart, E. (2024) “Public-accounts-of-health-inequalities-and-the-social-determinants-of-health-in-Scotland,” Journal of Critical Public Health, (No 2), pp. 5–23. Available at: https://journalhosting.ucalgary.ca/index.php/jcph/article/view/77753 (Accessed: October 24, 2024).
[3] Ranmal, R., Tinson, A. and Marshall, L. (2021) “How do Health Inequalities Intersect with Housing and Homelessness?,” European Journal of Homelessness, (3), pp. 113–121. Available at: https://www.feantsaresearch.org/public/user/Observatory/2021/EJH_15-3/EJH_15-3_A8_v01.pdf
[4] Congreve Emma et al. (2022) Modelling packages to meet Scotland’s child poverty targets: Scenarios, benefits and trade-offs. Glasgow. Available at: https://fraserofallander.org/meeting-scotlands-child-poverty-targets/ (Accessed: October 24, 2024).
[5] Birt, C. et al. (2024) Poverty in Scotland 2024. Available at: https://www.jrf.org.uk/poverty-in-scotland-2024 (Accessed: October 24, 2024).
[6] Health Foundation (2024) Relationship between persistent poverty and health, https://www.health.org.uk/evidence-hub/money-and-resources/persistent-poverty/relationship-between-persistent-poverty-and-health (Accessed: October 24, 2024).
[7] the Lines Between (2024) Housing Affordability Study Findings report. Edinburgh. Available at: https://www.gov.scot/binaries/content/documents/govscot/publications/research-and-analysis/2024/03/housing-affordability-study-findings-report/documents/housing-affordability-study-findings-report/housing-affordability-study-findings-report/govscot%3Adocument/housing-affordability-study-findings-report.pdf (Accessed: October 24, 2024).
[8] ibid
[9] Scottish Government, T. (2022) A Chance to Change Scotland: Report of the Chance 2 Change Expert Reference Group with Lived Experience to the Primary Care Health Inequalities Short Life Working Group. Available at: https://www.gov.scot/binaries/content/documents/govscot/publications/independent-report/2022/03/chance-change-scotland-report-chance-2-change-expert-reference-group-lived-experience-primary-care-health-inequalities-short-life-working-group/documents/chance-change-scotland-report-chance-2-change-expert-reference-group-lived-experience-primary-care-health-inequalities-short-life-working-group/chance-change-scotland-report-chance-2-change-expert-reference-group-lived-experience-primary-care-health-inequalities-short-life-working-group/govscot%3Adocument/chance-change-scotland-report-chance-2-change-expert-reference-group-lived-experience-primary-care-health-inequalities-short-life-working-group.pdf
(Accessed: October 24, 2024).