Transcript Power Point Presentation

Why is mortality higher in
Scotland than in England
and Wales?
An update of the 'Scottish Effect'
work using 2011 Census data
Rosalia Munoz-Arroyo
Lauren Schofield
Bespoke Specialist Services
(BSS)
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Example of recently completed
work
An update of the 'Scottish Effect' work
Overview
• Results of new national analyses for
2011 (update of previous paper 1981 –
2001)
• ‘Scottish effect’
– By deprivation decile
– By sex and age group
– Specific causes
Excess mortality
• Higher mortality observed in Scotland
(compared to elsewhere in the UK) over and
above that explained by differences in socioeconomic deprivation
• Also referred to as the ‘Scottish Effect’
Methods
• Directly standardised mortality rates (by age,
sex and deprivation decile) for census years
1981 - 2011
• Carstairs deprivation (ward/pc sector)
-four standardised census variables
• Male unemployment, lack of car
ownership, low social class and
overcrowding
• Deprivation scores used to categorise
into deprivation deciles by population
Specific causes
• Respiratory Disease
• Cerebrovascular Disease
• Ischaemic Heart Disease
• Malignant Neoplasms
• Lung Cancer
• Intentional self-harm and events of undetermined intent
Additional causes
• External causes
• Alcohol related deaths
• Drug poisoning
Conclusions
• Excess increasing over time
• Affects all levels of deprivation, but highest among
comparisons of most deprived, increasing over time
• Seen for many different causes of death
• Additional work – alternative measures of
deprivation, new smaller, more comparable
geography
• David Walsh (GCPH) and Gerry McCartney (Health
Scotland) large piece of work synthesise
explanations of ‘Scottish Effect’