Scottish Longitudinal Study
Development & Support Unit
Population mobility and its role in widening health inequalities in Scotland
Denise Brown (Medical Research Council)
Alastair Leyland (Medical Research Council)
Dermot O'Reilly (Queen's University)
Paul Boyle (University of St Andrews)
Sally Macintyre (Medical Research Council)
Approved on 07-12-2009
Despite recent improvements in survival, mortality rates in Scotland remain high (10.8 per 1000 in 2006) compared to the UK as a whole (9.7 per 1000 in 2005) and to the rest of Europe (9.1 per 1000 in 2005; GRO(S), 2007). Over the last two decades, inequalities in mortality rates in Scotland have not only persisted but have increased (Leyland et al., 2007). The explanation may, in part, relate to selective migration. Migration is selective in terms of a number of factors (e.g. age, education and socio-economic position) including health status (Champion et al., 1998). Given its possible contribution to the changing patterns of health, population mobility should be considered in all ecological studies that aim to make comparisons of area populations over time (O’Reilly et al., 2001). Movement of people between areas leads to problems, however, with comparisons of areas over time. We cannot compare like with like and therefore the monitoring of inequalities becomes difficult. If those in poor health are being left behind in the most deprived areas then the health status of those areas will reduce. This leads to inequalities appearing to increase over time when in fact there may be no change, or even potentially an improvement that would have been visible had everyone remained in the same place. We will use the Scottish Longitudinal Study to address a number of research questions. In particular we will examine the extent to which selective internal migration contributes to the widening health gap in Scotland, and whether this contribution varies for specific health measures.
The aim of this project is to investigate the relationship between population mobility, health and area level deprivation and the extent to which selective migration contributes to widening health inequalities in Scotland.
Champion, T., Fotheringham, S., Rees, P., Boyle, P. & Stillwell, J. (1998) The determinants of migration flows in England: a review of existing data and evidence.
Leyland, A.H., Dundas, R., McLoone, P. & Boddy, A. (2007) Inequalities in mortality in Scotland 1981-2001. Occasional Paper no. 16. Glasgow: MRC Social and Public Health Sciences Unit.
O'Reilly, D., Browne, S., Johnson, Z. & Kelly, A. (2001) Are cities becoming more unhealthy? An analysis of mortality rates in Belfast and Dublin between 1981 and 1991 to illustrate a methodological difficulty with ecological studies. Journal of Epidemiology and Community Health, 55, 354-355.