All-cause and cause-specific mortality in Scotland 1981-2011 by age, sex and deprivation: a population-based study

Brown, D. , Allik, M. , Dundas, R. and Leyland, A. H. (2019) All-cause and cause-specific mortality in Scotland 1981-2011 by age, sex and deprivation: a population-based study. European Journal of Public Health, 29(4), pp. 647-655. (doi: 10.1093/eurpub/ckz010) (PMID:31220246) (PMCID:PMC6660111)

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Background: Average life expectancy has stopped increasing for many countries. This has been attributed to causes such as influenza, austerity policies and deaths of despair (drugs, alcohol and suicide). Less is known on the inequality of life expectancy over time using reliable, whole population, data. This work examines all-cause and cause-specific mortality rates in Scotland to assess the patterning of relative and absolute inequalities across three decades. Methods: Using routinely collected Scottish mortality and population records we calculate directly age-standardised mortality rates by age group, sex, and deprivation fifths for all-cause and cause-specific deaths around each census 1981 to 2011. Results: All-cause mortality rates in the most deprived areas in 2011 (472 per 100,000 population) remained higher than in the least deprived in 1981 (422 per 100,000 population). For those aged 0-64, deaths from circulatory causes more than halved between 1981 and 2011 and cancer mortality decreased by a third (with greater relative declines in the least deprived areas). Over the same period, alcohol- and drug-related causes and male suicide increased (with greater absolute and relative increases in more deprived areas). There was also a significant increase in deaths from dementia and Alzheimer’s disease for those aged 75+. Conclusions: Despite reductions in mortality, relative (but not absolute) inequalities widened between 1981 and 2011 for all-cause mortality and for several causes of death. Reducing relative inequalities in Scotland requires faster mortality declines in deprived areas while countering increases in mortality from causes such as drug- and alcohol-related harm and male suicide.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Allik, Dr Mirjam and Brown, Dr Denise and Leyland, Professor Alastair and Dundas, Professor Ruth
Authors: Brown, D., Allik, M., Dundas, R., and Leyland, A. H.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:European Journal of Public Health
Publisher:Oxford University Press
ISSN (Online):1464-360X
Published Online:13 February 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in European Journal of Public Health 29(4): 647-655
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
Chief Scientist Office (CSO)SPHSU13