The Scottish Health Survey: Topic Report: The Glasgow Effect

The link between socio-economic circumstances and health is well known, and has been widely investigated, with deprivation found to be a key factor for a variety of health outcomes. One such health outcome is mortality. Scotland has the highest mortality rate in western Europe among the working age population, and has done since the late 1970s 1.

Carstairs and Morris 2 analysed data from 1980 – 1982 investigating whether social class and deprivation could explain the excess mortality experienced by Scotland compared to England and Wales. They found that standardising for social class had little effect, whereas standardising for relative affluence and deprivation greatly reduced the difference. However the impact of deprivation on the difference in mortality between Scotland and England and Wales has been found to have reduced since 1981; using census data from 1981, 1991 and 2001, Hanlon et al 3 found that whilst in 1981 deprivation explained over 60% of the excess mortality found in Scotland, in 1991 and 2001 deprivation explained less than half of the excess mortality. The excess mortality increased from 4.7% in 1981 to 8.2% in 2001 after adjusting for age, sex and deprivation. The largest excesses have been found in the most deprived areas of Scotland.