Inequality & deprivation
Alcohol can harm anyone. In Scotland, though, the most serious alcohol-related health outcomes are far more common in deprived communities. The evidence does not show that this is simply because people there drink more.
Alcohol deaths 4.5× higher in the most deprived areas — 2024.
After adjusting for age, alcohol-specific mortality rates in Scotland's most deprived areas were 4.5 times as high as in the least deprived areas in 2024.
For comparison, mortality from all causes was around twice as high in the most deprived areas. The gap for alcohol-specific deaths is therefore considerably wider than the overall mortality gap.
National Records of Scotland — alcohol-specific deaths 2024↗Hospital admissions 7× higher in the most deprived areas — 2024/25.
In 2024/25, people in the most deprived areas were seven times more likely to be admitted to a general acute hospital for conditions wholly attributable to alcohol than those in the least deprived areas.
Public Health Scotland reported 782 patients per 100,000 population in the most deprived areas and 116 per 100,000 in the least deprived areas.
Public Health Scotland — hospital statistics 2024/25↗Drinking levels Hazardous or harmful drinking was reported more often in the least deprived areas.
In the 2024 Scottish Health Survey, 26% of adults in the least deprived areas reported hazardous or harmful drinking compared with 15% in the most deprived areas.
That is why the inequality in deaths and hospital admissions cannot be explained simply by saying that people in poorer areas drink more.
Scottish Health Survey 2024 — alcohol and deprivation↗The paradox More severe outcomes can occur even where reported drinking is lower.
This pattern is often described as the alcohol harm paradox: people in more deprived communities can experience substantially more alcohol-related illness and death even when population surveys do not show higher average drinking.
The statistics describe the pattern. They do not mean alcohol itself is more toxic in poorer people. Alcohol can damage anyone; the difference lies in the pattern of outcomes across populations.
Read the wider explanation of poverty and inequality→Local differences Some Scottish areas have persistently higher alcohol-specific mortality.
For the period 2020 to 2024, National Records of Scotland found alcohol-specific mortality rates above the Scottish average in Glasgow City, Inverclyde, North Lanarkshire, West Dunbartonshire and Dundee City.
Local rates should be read carefully because smaller populations can produce more statistical variation from year to year.
National Records of Scotland — local mortality data↗ Read about alcohol and Scottish communities→Urban and rural The pattern is not simply urban versus rural.
National Records of Scotland reports that the relationship between rurality and alcohol-specific mortality is less clear than the relationship with deprivation.
In 2024, the highest alcohol-specific mortality rate was in large urban areas at 24.5 deaths per 100,000 population. The lowest was in accessible rural areas at 11.0 per 100,000.
National Records of Scotland — urban and rural mortality↗What the figures mean Health inequality and drinking prevalence are different measures.
Survey figures tell us how people report drinking. Hospital and mortality statistics tell us about serious health outcomes. They should be compared carefully rather than treated as if they measure the same thing.
The important finding is consistent: Scotland has a large deprivation gap in alcohol-specific deaths and wholly attributable hospital admissions.
Back to Alcohol statistics in Scotland→ See the research library→