Dear Colleagues

The Chief Medical Officer in Scotland's annual report Health in Scotland 2002 is now available. The key theme this year is women and children.  It can be freely downloaded on line at

http://www.scotland.gov.uk/library5/health/his02-00.asp

I have attached a press release from the CMO as well; highlighting concern in particular over the health of women and children

Also available at

https://www.scotland.gov.uk/pages/news/2003/06/SEHD429.aspx

Best wishes

David McDaid
LSE Health and Social Care

Press Release
SEHD429/2003 05/06/2003 

CMO concerned over health of women and children 

Chief Medical Officer, Dr Mac Armstrong has taken the health of women and children as the key theme for his Annual Report for 2002 and his concerns about how seriously some women are taking their health and the health of their children.
As well as women and children the CMO's report, Health in Scotland 2002 <http://www.scotland.gov.uk/library5/health/his02-00.asp>, covers trends in Scotland's health, progress against health targets and the health priorities for the people of Scotland.
Dr Armstrong said: 
"The key theme for this report is women and children. The reason for this is simple. The children of Scotland are the future of Scotland and the health and well being of the women of Scotland is a key determinant of that future. 
"There are some areas of concern. The evidence is that women in Scotland and, in particular, young women need more incentive and support to take their own health and thus the health of their children seriously. Better women's health is both an individual and national asset and should not be an option or ambition beyond reach.
"Despite gradual improvements in life expectancy and the implementation of specific initiatives - such as cervical and breast cancer screening programmes which have led to earlier detection and treatment and improvements in survival - there are worrying trends in Scottish women's health.
"Comparing Scotland's health in an international context is very sobering particularly the comparison of trends in female mortality in Scotland with other Western European countries.
"While mortality rates from all causes among working-age Scottish women have declined over the last 50 years, the decrease in Scotland has been less marked and Scotland has been ranked with the highest mortality in this age group since 1958. In individual causes of death Scotland's position in a European context is, in fact, worsening.
"Action is needed across the board. I am encouraged by the measures being taken by the Executive, NHS and by partners in the voluntary sector and local authorities.
"I remain optimistic that Scotland can achieve the step change in health status through an Executive wide commitment to health improvement and encouraged that our approach is entirely in line with that advocated by the World Health Organisation."
Key features on women and children are:
Drinking
25 per cent of Scottish women say they binge drink. 15 per cent of adult women in 1998 exceeded the recommended weekly alcohol consumption limits - up from 13 per cent in 1995. 24 per cent of young women (16-24) were even more likely to exceed the weekly limits.
There have been sharp upward trends in alcohol-related illness and death - particularly alcoholic disease in women and this is being seen at younger ages. There is a well established link between alcohol and mental health problems. In 2002, a positive association between excessive alcohol consumption and breast cancer was found.
Smoking
The good news is that there has been a slight decrease in the proportion of women recorded smoking at the start of pregnancy falling from 29.7 in 1998 to 25.3 per cent in 2001.
However, the problems with smoking during pregnancy are closely related to health inequalities. The figures show 33 per cent of women in manual occupations smoked during pregnancy compared with 10 per cent in non-manual occupations. 78 per cent are in lower socio-economic groups and the smoking rate is highest among, lone mothers, over 60 per cent of whom begin their pregnancies as smokers.
Healthy Eating
The Health Behaviour in School Aged Children report (1990-1998) reveals a welcome 10 per cent increase in the proportion of 11-15 year olds consuming fresh fruit and a small increase in the number of children eating cooked vegetables on a daily basis.
However, the research also discloses that there has been increase in the number of 11-15 year olds consuming fizzy drinks and sweets daily. 
The good news is that the proportion of women eating fruit once a day has increased from 52 per cent in 1995 to 58 per cent in 1998. There was also an increase in the number who ate potatoes, pasta or rice - 59 per cent in 1995 to 68 per cent in 1998.
However, in comparison with England, women in Scotland were less likely to have eaten wholemeal bread (16 per cent to 22 per cent in 1998) and were less likely to have eaten high fibre cereals and more likely to have eaten fried food, chocolate, crisps and biscuits.
Health Effects on Babies
At present, about a quarter of Scottish babies are exposed to the toxins in cigarette smoke during pregnancy. Smoking is damaging to the baby and evidence is growing that maternal smoking during pregnancy can result in serious health and behavioural problems developing in later childhood. 
Given the known damaging effects of alcohol on the fetus, the increase in the amount of heavy drinking by young women is also worrying. With the increase over the past 20 years in drug misuse, especially heroin, tranquillisers and, more recently, cocaine, many fetuses are being exposed to these drugs and to drug injecting viruses.
The report also covers areas of health in Scotland, including mental health, communicable diseases, cancer, CHD/Stroke, oral healthcare for older people, anti-microbial resistance.