Michael Simmons
Scotland is getting sicker
For Scotland to stay at its current levels of health in 20 years’ time it would have to entirely eradicate cancer. That’s according to the Burden of Disease study published this morning by Public Health Scotland.
The report found that although the country’s population is projected to fall in the next two decades, its annual ‘disease burden’ – the impact of morbidity and mortality on population health – is forecast to increase by some 21 per cent. ‘In order to achieve a similar level of disease burden as 2019’, they say it would need to be reduced by 17 per cent by 2043 – ‘which is equivalent to eradicating the entire disease burden of cancer in 2019.’
Most of the future disease burden will affect 65- to 84-year-olds, a demographic which is expected to grow as an overall share of Scotland’s population, despite the nation’s headcount shrinking. There was better news for younger age groups, where disease was forecast to be 10 per cent lower in children and young people between the ages of 16 to 24. The burden will be slightly higher for men than women.
The study works by estimating ‘disability-adjusted life years’ (DALYs). They combine years lived with a disability and years of life lost due to the same causes. This quantifies the impact disease and injury have in preventing Scots from living long and healthy lives.
These estimates are based on modelling, so of course contain uncertainties. Though the researchers think things might be even worse than what they’ve forecast: ‘there is already evidence that the pandemic has exacerbated progress in tackling disease and risk factors, meaning the forecasts… may underestimate the future disease burden.’ They point to childhood obesity as an example – which rose during the pandemic unexpectedly – leading to underestimates in future diseases caused by obesity.
The five leading causes of disease and injury in Scotland (cancer, heart disease, neurological diseases, mental health and bone and joint disorders) are expected to be the same in 2043 as they were in 2019. The largest absolute increases will be in heart diseases, cancers and neurological conditions. These three groups account for some 68 per cent of the total increase in the disease burden forecast. There will also be relative increases in infectious diseases, accidental injuries, diabetes and kidney issues and chronic respiratory diseases.
Lockdown’s unintended consequences are highlighted by Public Health Scotland too: ‘Public health protective measures put in place have already indirectly caused delays’. The researchers add that ‘many of these factors are likely to increase health inequalities in the short, medium and long term’. It is possible to prevent things getting as bad as this though. The report’s authors also say ‘considerations over interventions and efforts to mitigate and prevent the underlying causes of these diseases are required to prevent forecasts disease burdens becoming a reality’