Scots Death Rates ‘Vary Widely’

Death rates in Scotland are falling faster in more affluent areas than in poorer places, a study says. The Medical Research Council looked at census data and deaths over the last 20 years, and found the proportion of under-65s dying had fallen by a third.

Researchers put this down to healthier lifestyles and advances in medicine. But they said deprived areas across Scotland had much higher death rates than average, and more work was needed to improve health in these areas.

Mortality rates measure the number of deaths per 100,000 in a given year. The death rate in Glasgow was the highest seen in the study – 14% above the national average – across all social classes. In Clydeside, where around a third of the population live, the male mortality rate was 17% higher than the national average in 2001, compared to 9% higher in 1981.

In total, eight of the 32 council areas across Scotland had particularly high deprivation, and higher death rates. However, deprived areas were more concentrated in Glasgow and the west of Scotland. The researchers say this is not because whole areas are deprived, but because there are “pockets” of poverty which push mortality rates up.

Overall in Scotland, male mortality in under-65s was found to have declined by 32% following big falls in heart disease, while the drop of 33% seen in women under 65 was mainly attributed to falls in heart disease and breast cancer. But for men aged 15 to 44 and women aged 15 to 29 mortality rates have actually increased.

Researchers say this is down to deaths linked to suicide, drug and alcohol use and assault, which have been most pronounced in the more deprived parts of the country.

Scotland, as a whole, has higher mortality than other western European countries, with the exception of Portugal.

Report co-author Professor Alastair Leyland said: “Although it’s true to say that overall mortality rates in Scotland have fallen, the steady decline we’ve seen in more affluent areas hasn’t been matched in more deprived areas.

“The higher mortality rates in Glasgow at every level of social class may seem to support the theory of some sort of ‘Glasgow effect’ adversely affecting health in the city. However male mortality rates in the affluent parts of Glasgow are in line with those for the rest of Scotland and it is only in the more deprived areas that we see this effect.”

Professor Danny Dorling, an expert in health inequalities at the University of Sheffield, said: “This is actually quite surprising when you consider that there are areas in Scotland that are among the most affluent in Europe. It should be much easier for those areas with high mortality rates to see a fall. It seems we are at a point in history where the affluent are enjoying remarkable advantages – access to health care, being able to retire younger and so on.”