Increasing inequality in age of death at shared levels of life expectancy: A comparative study of Scotland and England and Wales

Seaman, R., Leyland, A. H. and Popham, F. (2016) Increasing inequality in age of death at shared levels of life expectancy: A comparative study of Scotland and England and Wales. SSM - Population Health, 2, pp. 724-731. (doi:10.1016/j.ssmph.2016.10.001) (PMID:28018961) (PMCID:PMC5165049)

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Abstract

There is a strong negative correlation between increasing life expectancy and decreasing lifespan variation, a measure of inequality. Previous research suggests that countries achieving a high level of life expectancy later in time generally do so with lower lifespan variation than forerunner countries. This may be because they are able to capitalise on lessons already learnt. However, a few countries achieve a high level of life expectancy later in time with higher inequality. Scotland appears to be such a country and presents an interesting case study because it previously experienced lower inequality when reaching the same level of life expectancy as its closest comparator England and Wales. We calculated life expectancy and lifespan variation for Scotland and England and Wales for the years 1950 to 2012, comparing Scotland to England and Wales when it reached the same level of life expectancy later on in time, and assessed the difference in the level of lifespan variation. The lifespan variation difference between the two countries was then decomposed into age-specific components. Analysis was carried out for males and females separately. Since the 1950s Scotland has achieved the same level of life expectancy at least ten years later in time than England and Wales. Initially it did so with lower lifespan variation. Following the 1980s Scotland has been achieving the same level of life expectancy later in time than England and Wales and with higher inequality, particularly for males. Decomposition revealed that higher inequality is partly explained by lower older age mortality rates but primarily by higher premature adult age mortality rates when life expectancy is the same. Existing studies suggest that premature adult mortality rates are strongly associated with the social determinants of health and may be amenable to social and economic policies. So addressing these policy areas may have benefits for both inequality and population health in Scotland.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Popham, Dr Timothy and Seaman, Rosie and Leyland, Professor Alastair
Authors: Seaman, R., Leyland, A. H., and Popham, F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Social Sciences
Journal Name:SSM - Population Health
Publisher:Elsevier
ISSN:1478-7954
ISSN (Online):2352-8273
Published Online:07 October 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in SSM - Population Health 2:724-731
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU