Trends and inequalities in the burden of mortality in Scotland 2000–2015

Mesalles-Naranjo, O., Grant, I., Wyper, G. M.A. , Stockton, D., Dobbie, R., McFadden, M., Tod, E., Craig, N., Fischbacher, C. M. and McCartney, G. (2018) Trends and inequalities in the burden of mortality in Scotland 2000–2015. PLoS ONE, 13(8), e0196906. (doi: 10.1371/journal.pone.0196906) (PMID:30067740) (PMCID:PMC6070167)

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Background: Cause-specific mortality trends are routinely reported for Scotland. However, ill-defined deaths are not routinely redistributed to more precise and internationally comparable categories nor is the mortality reported in terms of years of life lost to facilitate the calculation of the burden of disease. This study describes trends in Years of Life Lost (YLL) for specific causes of death in Scotland from 2000 to 2015. Methods: We obtained records of all deaths in Scotland by age, sex, area and underlying cause of death between 2000 and 2015. We redistributed Ill-Defined Deaths (IDDs) to more exact and meaningful causes using internationally accepted methods. Years of Life Lost (YLL) using remaining life expectancy by sex and single year of age from the 2013 Scottish life table were calculated for each death. These data were then used to calculate the crude and age-standardised trends in YLL by age, sex, cause, health board area, and area deprivation decile. Results: Between 2000 and 2015, the annual percentage of deaths that were ill-defined varied between 10% and 12%. The proportion of deaths that were IDDs increased over time and were more common: in women; amongst those aged 1–4 years, 25–34 years and >80 years; in more deprived areas; and in the island health boards. The total YLL fell from around 17,800 years per 100,000 population in 2000 to around 13,500 years by 2015. The largest individual contributors to YLL were Ischaemic Heart Disease (IHD), respiratory cancers, Chronic Obstructive Pulmonary Disease (COPD), cerebrovascular disease and Alzheimer’s/dementia. The proportion of total YLL due to IHD and stroke declined over time, but increased for Alzheimer’s/dementia and drug use disorders. There were marked absolute inequalities in YLL by area deprivation, with a mean Slope Index of Inequality (SII) for all causes of 15,344 YLL between 2001 and 2015, with IHD and COPD the greatest contributors. The Relative Index of Inequality (RII) for YLL was highest for self-harm and lower respiratory infections. Conclusion: The total YLL per 100,000 population in Scotland has declined over time. The YLL in Scotland is predominantly due to a wide range of chronic diseases, substance misuse, self-harm and increasingly Alzheimer’s disease and dementia. Inequalities in YLL, in both relative and absolute terms, are stark.

Item Type:Articles
Additional Information:Funding was received from the Scottish Government’s Chief Scientist Office (Grant CZH/4/756) of £223,075 for this study.
Glasgow Author(s) Enlighten ID:McCartney, Professor Gerard and Wyper, Dr Grant
Creator Roles:
McCartney, G.Conceptualization, Methodology, Writing – original draft, Writing – review and editing
Authors: Mesalles-Naranjo, O., Grant, I., Wyper, G. M.A., Stockton, D., Dobbie, R., McFadden, M., Tod, E., Craig, N., Fischbacher, C. M., and McCartney, G.
College/School: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:PLoS ONE
Publisher:Public Library of Science
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2018 Mesalles-Naranjo et al.
First Published:First published in PLoS ONE 13(8): e0196906
Publisher Policy:Reproduced under a Creative Commons License

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