title: Dying younger in Scotland: Trends in mortality and deprivation relative to England and Wales, 1981-2011.
abstract: Given previous evidence that not all Scotland's higher mortality compared to England & Wales (E&W) can be explained by deprivation, the aim was to enhance understanding of this excess by analysing changes in deprivation and mortality in Scotland and E&W between 1981 and 2011. Mortality was compared by means of direct standardisation and log-linear Poisson regression models, adjusting for age, sex and deprivation. Different measures of deprivation were employed, calculated at different spatial scales. Results show that Scotland became less deprived compared to E&W between 1981 and 2011. However, the Scottish excess (the difference in mortality rates relative to E&W after adjustment for deprivation) increased from 4% higher (c.1981) to 10% higher in 2010-12. The latter figure equates to c. 5000 extra deaths per year. The increase was driven by higher mortality from cancer, suicide, alcohol related causes and drugs-related poisonings. The size and increase in Scottish excess mortality are major concerns. Investigations into its underlying causes continue, the findings of which will be relevant to other populations, given that similar excesses have been observed elsewhere in Britain.
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland, UK.
authors.forename: Lauren
authors.initials: L
authors.lastname: Schofield
authors.affiliation: Glasgow Centre for Population Health, Olympia Building, 2-16 Orr Street, Bridgeton Cross, Glasgow G40 2QH, Scotland, UK. Electronic address: David.Walsh.2@glasgow.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Walsh
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland, UK.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Munoz-Arroyo
authors.affiliation: Public Health Observatory Team, NHS Health Scotland, Glasgow, Scotland, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: McCartney
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Buchanan
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Lawder
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB Scotland, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Armstrong
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, Scotland, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Dundas
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow G2 3QB, Scotland, UK.
authors.forename: Alastair H
authors.initials: AH
authors.lastname: Leyland
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011204:Poverty Areas; D012111:Residence Characteristics; D017678:Sex Distribution; D012959:Socioeconomic Factors; D006113:United Kingdom
keywords: Deprivation; Excess mortality; Mortality; Scottish effect