20 December 2004
The health of children is suffering due to social deprivation, a major new report from NHS Quality Improvement Scotland (NHS QIS) today (Monday) confirmed.
The Health Indicators Report - A Focus on Children reveals deprivation as a factor impacting on a range of health issues, such as teenage pregnancy and the number of children admitted to hospital for unintentional injury, asthma, and diabetes.
The health of children is suffering due to social deprivation, a major new report from NHS Quality Improvement Scotland (NHS QIS) today (Monday) confirmed.
The Health Indicators Report - A Focus on Children (PDF, 760K, 3.21 mins) reveals deprivation as a factor impacting on a range of health issues, such as teenage pregnancy and the number of children admitted to hospital for unintentional injury, asthma, and diabetes.
For example, the report presents health indicators showing:
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Stillbirth and neonatal death is highest for mothers from areas of social deprivation
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The teenage pregnancy rate has fallen - however teenage girls from areas of social deprivation are most likely to become pregnant, and to continue with their pregnancy through to delivery
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Emergency admissions to hospital for asthma, diabetes and unintended injury are all higher for children from areas of social deprivation.
This is the tenth in a series of reports presenting such indicators for Scotland, and is part of a process of information collection and publication designed to aid the delivery of high quality care in the health service. This year's report concentrates on children, with some indicators on the health of mothers. Commenting on the report, NHS QIS Chairman Lord Naren Patel said:
"Scotland has led the way in delivering robust, clear information on how the Health Service is performing. NHS QIS is committed to building on the experience gained in Scotland over the past decade, and making available data that can contribute towards quality improvement in the health service in Scotland.
"The health of our children defines the health of our nation in years to come. One of the most important and striking patterns we can see this year is the continuing impact of social deprivation on everything from stillbirth through to teenage pregnancy, asthma and diabetes.
"This reinforces the need to take a broad view of health that goes beyond simply seeing the NHS as an illness service and instead views health as everyone's responsibility."
Commenting on the report, Dr Dorothy Moir, Chairman of the Clinical Outcomes Group, said:
"This is the tenth year that health indicators have been published and it is an enormous strength of the NHSScotland that people are willing to learn from this type of information.
"This year, the indicators report focuses on children's health. This was identified as a priority by the Scottish Executive Health Department in 2000.
"While this report does not attempt to offer an exhaustive guide to children's health, it does cover a wide spectrum of topics under this general heading. Some of these have been included in previous indicator reports, for example, obesity in children, while others, including unintentional injury, are covered for the first time. The report also includes some information on the health of mothers.
"There is good news, with falls in the emergency admission rate for asthma and for unintended injury, but the report also draws attention to issues the Health Service will want to look into further.
"It highlights issues that need to be addressed and asks questions that need to be answered. We expect NHSScotland and policy makers generally to treat these indicators as a roadmap to the issues they need to address."
Among the findings of the report are new figures on prescribing for attention deficit hyperactivity disorder (ADHD) in children. This shows an increase in the prescribing rate for Scotland, together with increasing regional variations in the prescribing rate.
An increase in the clinical recognition of ADHD may have contributed to the increase in the prescribing rate for Scotland - which remains below that of Switzerland, Netherlands and Iceland, and is around a third of that in Canada and the United States.
It is unclear whether the current prescribing rates are above or below the expected level, or why there are regional variations. For that reason, NHS QIS will fund an audit - based upon the Scottish Intercollegiate Guidelines Network (SIGN) guideline - of the care and treatment provided for Scottish children with ADHD. Commenting, NHS QIS Chief Executive Dr David Steel said:
"The increase in the prescribing rate for ADHD drug Methylphenidate - commonly known as Ritalin - raises the important issue of what constitutes the appropriate level of prescribing in Scotland.
"We can see significant regional variations, but until we have a robust, evidence-based assessment of what the appropriate level might be, no-one can say whether this is the result of under-prescribing, over-prescribing, demographic and social variations, or some complex mix of all these issues.
"That's why NHS QIS will now fund an audit of the care and treatment of children with ADHD. It will seek to answer some of the questions highlighted by this report."
Main Findings:
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Social deprivation is a major factor in the health of Scotland's children, with notable differences seen between levels of social deprivation for many of the indicators.
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Emergency hospital admissions for asthma for children under 15 years of age reduced by half between 1993 and 2003. They fell from 49.2 to 22.3 per 10,000 of the population.
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For young people aged 10-19 years, emergency hospital admissions for diabetes rose from 7.8 to 9.6 per 10,000 between 1993 and 2003.
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The death rate from unintentional injury remained fairly constant. The rate of hospital admission for unintentional injury decreased in recent years. Both rates were higher for boys than for girls.
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The stillbirth and neonatal death rate for mothers from areas of least social deprivation was 3.4 deaths per 1,000 births. The rate for mothers from areas of greatest social deprivation was 5.3 deaths per 1,000 births.
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The pregnancy rate among 13 -15 year olds fell between 1995 and 2003, from 8.9 to 7.4 per 1,000 of the population. This is approaching the target of 6.9 by 2010.
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Women who had recently given birth were more likely to experience depression or anxiety (27 percent) than those who had not (19 percent).
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Between 1993 and 2002, the percentage of 4-6 and 13-15 year olds who were overweight increased. By the school year ending June 2002, 30 percent of 13-15 year olds were estimated to be overweight.
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Prescribing of methylphenidate for ADHD rose between 1996 and 2003, from 69 to 603 prescriptions per 10,000 of the population aged 6-14 years.
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The proportion of antibiotics prescribed for children that were sugar-free increased steadily, from 29% in 1996 to 51% in 2003.
Click here to download a summary of the report.
Editors Note:
Copies of the full report and copies of a short summary guide detailing the main findings are available from the press office.
Press Office: Colin McAllister on 07813 095 930; Patrick Maitland-Cullen on 0131 623 4297