Deprivation and mortality in Scotland, 1981 and 1991

Area of Science:

• Public Health
• Socioeconomic Determinants of Health
• Epidemiology

Background:

• Socioeconomic status is a known determinant of health outcomes.
• Previous studies have indicated geographical variations in mortality rates.
• The Carstairs deprivation score is a validated measure for assessing socioeconomic status at a small area level.

Purpose of the Study:

• To compare mortality rates across Scottish postcode sectors using Carstairs deprivation scores.
• To analyze trends in mortality differences between affluent and deprived areas from 1981-2 to 1991-2.

Main Methods:

• Utilized census data from 1981 and 1991 to calculate Carstairs scores for Scottish postcode sectors.
• Grouped postcode sectors into seven deprivation categories.
• Analyzed death rates and standardized mortality ratios (SMRs) by deprivation category.

Main Results:

• Deprived postcode sectors in 1981 remained relatively deprived in 1991, with worsening mortality experiences.
• The gap in mortality between the most affluent and most deprived categories increased by 162% between 1991-2.
• While overall mortality declined, deprived areas experienced smaller reductions, particularly in younger age groups (suicide) and for conditions like ischemic heart disease and lung cancer.

Conclusions:

• Mortality differences linked to relative poverty significantly increased between 1981 and 1991 in Scotland.
• Despite overall improvements in mortality, a growing divide exists between the health experiences of the majority and a substantial minority.
• The concentration of deprived areas, such as in Glasgow, contributes to observed regional mortality disparities.