How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

Ramsay, J., Minton, J. , Fischbacher, C., Fenton, L., Kaye-Bardgett, M., Wyper, G. M.A. , Richardson, E. and McCartney, G. (2020) How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017. BMJ Open, 10(10), e036529. (doi: 10.1136/bmjopen-2019-036529) (PMID:33033012) (PMCID:PMC7542937)

Abstract

Objective: Annual gains in life expectancy in Scotland were slower in recent years than in the previous two decades. This analysis investigates how deaths in different age groups and from different causes have contributed to annual average change in life expectancy across two time periods: 2000–2002 to 2012–2014 and 2012–2014 to 2015–2017. Setting Scotland. Methods: Life expectancy at birth was calculated from death and population counts, disaggregated by 5 year age group and by underlying cause of death. Arriaga’s method of life expectancy decomposition was applied to produce estimates of the contribution of different age groups and underlying causes to changes in life expectancy at birth for the two periods. Results: Annualised gains in life expectancy between 2012–2014 and 2015–2017 were markedly smaller than in the earlier period. Almost all age groups saw worsening mortality trends, which deteriorated for most cause of death groups between 2012–2014 and 2015–2017. In particular, the previously observed substantial life expectancy gains due to reductions in mortality from circulatory causes, which most benefited those aged 55–84 years, more than halved. Mortality rates for those aged 30–54 years and 90+ years worsened, due in large part to increases in drug-related deaths, and dementia and Alzheimer’s disease, respectively. Conclusion: Future research should seek to explain the changes in mortality trends for all age groups and causes. More investigation is required to establish to what extent shortcomings in the social security system and public services may be contributing to the adverse trends and preventing mitigation of the impact of other contributing factors, such as influenza outbreaks.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McCartney, Professor Gerard and Minton, Dr Jonathan and Wyper, Dr Grant
• Authors: Ramsay, J., Minton, J., Fischbacher, C., Fenton, L., Kaye-Bardgett, M., Wyper, G. M.A., Richardson, E., and McCartney, G.
• College/School: College of Social Sciences > School of Social and Political Sciences; College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 07 October 2020
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in BMJ Open 10(10): e036529
• Publisher Policy: Reproduced under a Creative Commons License