Scottish Longitudinal Study
Development & Support Unit
Trends in avoidable mortality in Scotland
Claire Boag (General Register Office for Scotland)
Gillian Raab (University of St Andrews)
Approved on 24-05-2010
In recent years there have been a number of different groupings of causes of death to identify those that are manipulable by treatment or public health measures. A recent ONS report (1) reviewed these for E&W and recommends the three fold classification described by Page Tobias and Glover (2) with minor modifications to make it more appropriate for the UK now. They found sharply declining trends in avoidable, and particularly amenable moratlity in E&W over the period 1993 – 2005.
There are several reasons why it may be interesting to repeat these analyses for Scotland. Scotland has a higher proportion of deaths before age 75 than E&W. In 2005 deaths under 75 for males were 50% (male) and 32% (female)of all deaths in Scotland compared to 43% (male) and 26% (female) in E&W. Recent trends in Scottish death rates for specific causes (3) suggest that we will expect to find similar downward trends in Scotland due to medical interventions in treatments of (E.g.) Ischaeimic Heart disease (4). However other research (eg ref 5) have found that improvements in life expectancy may actually be widening rather than narrowing the differences by socio-economic groups. This evidence has mainly come from area wide measures of deprivation (5). Using the SLS data will enable to estimate how the death rates vary by all the characteristics measures in the 1991 and 2001 censuses.
We plan to use a sample of SLS members traced at NHSCR and in the 1991 and/or the 2001 censuses. Linked mortality data will allow calculation of age and sex specific death rates using a person-years approach from 1991 to 2007 (or 2008 if available). These will be used to calculate standardised mortality by year relative to the European Standard Population. Trends in the different types of death can then be examined and compared by individual social characteristics.
- Wheller L, Baker A, Griffiths C & Rooney C (2007) Health Statistics Quarterly, vol Summer 2007, no 34
- Page A, Tobias M et al (2006) Australian and New Zealand atlas of avoidable mortality, University of Adelaide, Adelaide.
- Health of Scotland's population - Mortality Rates. Found at http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/TrendMortalityRates, accessed 27 September 2013.
- Capewell S, Morrison CE & McMurray JJ (1999) Contribution of modern cardiovascular treatment and risk factor changes to the decline in coronary heart disease mortality in Scotland between 1975 and 1994. Heart, 81(4): 380-386.
- Davies, CA, Dundas, R & Leyland, AH (2009) Increasing socioeconomic inequalities in first acute myocardial infarction in Scotland, 1990-92 and 2000-02, BMC Public Health, 9: 134.