How much of the difference in life expectancy between Scottish cities does deprivation explain?

Area of Science:

• Public Health
• Epidemiology
• Socioeconomic Determinants of Health

Background:

• Glasgow exhibits lower life expectancy and higher deprivation than comparable English cities.
• Comparisons within Scotland suggest deprivation may explain Glasgow's excess mortality.
• Life expectancy is an intuitive measure for quantifying between-city differences.

Purpose of the Study:

• To compare life expectancy in Glasgow with other Scottish cities using recent data.
• To evaluate the extent to which income deprivation accounts for life expectancy differences.
• To explore if age-specific mortality patterns explain Glasgow's lower life expectancy.

Main Methods:

• Calculated sex-specific life expectancy for Glasgow and combined Aberdeen, Dundee, and Edinburgh (2007-2011).
• Stratified life expectancy by national income deprivation deciles using the Scottish Index of Multiple Deprivation.
• Decomposed life expectancy differences by age using Arriaga's discrete method.

Main Results:

• Overall life expectancy in Glasgow was lower than the combined comparator cities.
• When stratified by deprivation deciles, Glasgow's life expectancy was not systematically lower; deprivation explained over 90% of the difference.
• Age distribution of mortality in Glasgow was not systematically different after accounting for deprivation.

Conclusions:

• Life expectancy in Glasgow is not systematically lower than comparator Scottish cities once deprivation is accounted for.
• Tackling deprivation in Glasgow is likely to reduce health inequalities between Scottish cities.
• Comparing socioeconomic deprivation between populations presents challenges, impacting the attribution of mortality inequalities to a 'place effect'.