Drug-related deaths in Scotland 1979-2013: evidence of a vulnerable cohort of young men living in deprived areas

Parkinson, J., Minton, J. , Lewsey, J. , Bouttell, J. and McCartney, G. (2018) Drug-related deaths in Scotland 1979-2013: evidence of a vulnerable cohort of young men living in deprived areas. BMC Public Health, 18, 357. (doi: 10.1186/s12889-018-5267-2) (PMID:29580222) (PMCID:PMC5870372)

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Background: Even after accounting for deprivation, mortality rates are higher in Scotland relative to the rest of Western Europe. Higher mortality from alcohol- and drug-related deaths (DRDs), violence and suicide (particularly in young adults) contribute to this ‘excess’ mortality. Age-period and cohort effects help explain the trends in alcohol-related deaths and suicide, respectively. This study investigated whether age, period or cohort effects might explain recent trends in DRDs in Scotland and relate to exposure to the changing political context from the 1980s. Methods: We analysed data on DRDs from 1979 to 2013 by sex and deprivation using shaded contour plots and intrinsic estimator regression modelling to identify and quantify relative age, period and cohort effects. Results: The peak age for DRDs fell around 1990, especially for males as rates increased for those aged 18 to 45 years. There was evidence of a cohort effect, especially among males living in the most deprived areas; those born between 1960 and 1980 had an increased risk of DRD, highest for those born 1970 to 1975. The cohort effect started around a decade earlier in the most deprived areas compared to the rest of the population. Conclusion: Age-standardised rates for DRDs among young adults rose during the 1990s in Scotland due to an increased risk of DRD for the cohort born between 1960 and 1980, especially for males living in the most deprived areas. This cohort effect is consistent with the hypothesis that exposure to the changing social, economic and political contexts of the 1980s created a delayed negative health impact.

Item Type:Articles
Keywords:Age-period-cohort effects, drug-related deaths, excess mortality, intrinsic estimator, Scotland, Scottish effect, shaded contour plots.
Glasgow Author(s) Enlighten ID:Minton, Dr Jonathan and McCartney, Gerard and Bouttell, Mrs Janet and Lewsey, Professor Jim
Authors: Parkinson, J., Minton, J., Lewsey, J., Bouttell, J., and McCartney, G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN (Online):1471-2458
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in BMC Public Health 18(1):357
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
589501Applied Quantitative Methods Network: Phase II (AQMeN 2)Nick BaileyEconomic and Social Research Council (ESRC)ES/K006460/1SPS - URBAN STUDIES