Around 22 people in Scotland die from alcohol misuse each week, according to a snapshot of the nation’s health which paints a stark picture of the challenges facing the NHS.
Alcohol abuse accounts for an average of 674 hospital admissions per week, according to the annual report by Scotland’s Chief Medical Officer Dr Catherine Calderwood.
The report “Realising Realistic Medicine” also identified rising levels of hospital infections, the continuing battle against HIV and a high rate of obesity.
A chapter titled “The Health of the Nation” noted Scotland continued to consume higher quantities of alcohol than elsewhere in the UK with sales 20 per cent higher north of the border than in England and Wales. Sales have also increased in Scotland over the last two years, after a fall between 2009 and 2013. In 2015 10.8 litres of pure alcohol was sold per Scottish adult. That was the equivalent of 20.8 units per adult per week – substantially more than the 14 units per week recommended safe limit.
In 2015, 74 per cent of alcoholic drinks were sold from supermarkets and off-licences – a record high.
“Levels of alcohol related harm remain unacceptably high in Scotland,” the report said. “Both deaths and admissions remain many times higher than in the 1980s.”
When it came to harmful infections, the report said there had been a 5.2 per cent year-on-year increase in E. Coli bacteraemia (bacteraemia is defined as when an infection gets into the blood stream) between 2011 and 2015.
There were 4,596 cases of E. Coli bacteraemia (ECB) in 2015, half of which were healthcare associated.
Health Protection Scotland is working with NHS Board infection control teams to improve ECB surveillance.
Increasing resistance of hospital bugs to drugs was described as a “major concern for public health and patient safety”.
Of particular concern has been the emergence of a type of bug – carbapenemase producing organisms (CPO) - which are resistant to hospital antibiotics known as carbapenems.
In 2015, a total of 66 CPOs were reported to Health Protection Scotland, an increase of 40 per cent from 2014. The rise is consistent with the increased use of carbapenems antibiotics in hospital in recent years.
According to the report, HIV remains a public health challenge. Transmission of the condition remains a challenge. During 2015/2016, one-third (34.8 per cent) of men who have sex with men newly diagnosed in Scotland had laboratory markers consistent with recent acquisition of infection.
An outbreak of HIV among people who inject drugs in Greater Glasgow & Clyde originally identified in 2015, continued in 2016.
Greater Glasgow typically records around 10 new diagnoses of HIV associated with injecting drug use each year. Forty-two 42 new cases were reported in 2015 and a further 18 by September 2016.
Across the adult population nearly two thirds (65 per cent) of adults are overweight, with almost one third (29 per cent) classed as obese. The report said there had been little change in the situation since the start of the millennium. Men and women in deprived communities were more likely to be obese.
Around 15 per cent of primary one pupils are overweight, obese or severely obese. And more than 18 per cent of primary one pupils in the most deprived communities categorised as overweight, obese or severely obese. In richer areas, the figure falls to 11 per cent.
More encouragingly, vaccine uptake continues to be high and life expectancy is improving.
Since the start of the century, life expectancy at birth for men has increased from just over 73 years to just over 77 years. For women, the increase has been from just under 79 years to just over 81.
The reduction in premature mortality has been 36% between 1994 and 2015. This fall has been down to the 28 per cent drop in premature deaths caused by cancer, the 71 per cent drop due to coronary heart disease, and the 68 per cent drop due to strokes.
Over the last decade the number of deaths due to cancer has continued to slowly rise – from just over 15,000 to closer to 16,000, with the number of males being slightly higher than females. However, once age has been accounted for, the mortality rates for males has fallen 10 per cent in the last decade, and seven per cent for females.
Dr Calderwood said: “Scotland has a difficult relationship with alcohol, with the most harm being caused by cheap, high strength alcohol. That’s why we remain totally committed to minimum unit pricing.
“We have already banned multi-buy discounts and will consider what further action to take to reduce alcohol related harm as part of the current work to refresh our Alcohol Framework.
“We are also taking action on the other points raised in this report. We’ve made significant progress in reducing cases of MRSA and C.Diff in our hospitals and healthcare settings, antibiotic prescribing rates have reduced, and £4.2 million is being invested in a five year research project – the biggest single investment for research into both antimicrobial resistance and infection rates in Scotland ever.
“We remain committed to tackling Scotland’s obesity problems and we will consult on our new diet and obesity strategy this year, building on our wide range of activity to make it easier for people to be more active, eat less, and eat better.”