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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Abstract
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. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Bouttell, Dr Janet and McCartney, Professor Gerard and Lewsey, Professor Jim and Minton, Dr Jonathan |
| Authors: | Parkinson, J., Minton, J., Lewsey, J., Bouttell, J., and McCartney, G. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Social Sciences > School of Social and Political Sciences > Urban Studies College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences |
| Journal Name: | BMC Public Health |
| Publisher: | BioMed Central |
| ISSN: | 1471-2458 |
| 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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