Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect'...
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![Page 1: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/1.jpg)
Why is mortality higher in Scotland
than in England and Wales?
An update of the 'Scottish Effect' work using 2011 Census data
Rosalia Munoz-ArroyoLauren Schofield
![Page 2: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/2.jpg)
Bespoke Specialist Services (BSS)
Income generation structure
More flexible access to cost-effective bespoke specialist information
![Page 3: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/3.jpg)
What Services do we offer?Consultancy Services
Survey work (Patient Experience Survey, SALSUS)
Staff Placements (SG, NHS Board)
Contact: [email protected]
![Page 4: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/4.jpg)
![Page 5: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/5.jpg)
Example of recently completed work
An update of the 'Scottish Effect' work
![Page 6: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/6.jpg)
Overview
• Results of new national analyses for 2011 (update of previous paper 1981 – 2001)
• ‘Scottish effect’– By deprivation decile– By sex and age group– Specific causes
![Page 7: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/7.jpg)
Excess mortality• Higher mortality observed in Scotland
(compared to elsewhere in the UK) over and above that explained by differences in socio-economic deprivation
• Also referred to as the ‘Scottish Effect’
![Page 8: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/8.jpg)
Methods• Directly standardised mortality rates (by age,
sex and deprivation decile) for census years 1981 - 2011
• Carstairs deprivation (ward/pc sector)-four standardised census variables
• Male unemployment, lack of car ownership, low social class and overcrowding
• Deprivation scores used to categorise into deprivation deciles by population
![Page 9: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/9.jpg)
![Page 10: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/10.jpg)
![Page 11: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/11.jpg)
![Page 12: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/12.jpg)
![Page 13: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/13.jpg)
Specific causes• Respiratory Disease• Cerebrovascular Disease• Ischaemic Heart Disease• Malignant Neoplasms• Lung Cancer• Intentional self-harm and events of undetermined
intentAdditional causes• External causes• Alcohol related deaths• Drug poisoning
![Page 14: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/14.jpg)
![Page 15: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/15.jpg)
![Page 16: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/16.jpg)
![Page 17: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/17.jpg)
![Page 18: Why is mortality higher in Scotland than in England and Wales? An update of the 'Scottish Effect' work using 2011 Census data Rosalia Munoz-Arroyo Lauren.](https://reader036.fdocuments.us/reader036/viewer/2022062721/56649f265503460f94c3d532/html5/thumbnails/18.jpg)
Conclusions• Excess increasing over time• Affects all levels of deprivation, but highest among
comparisons of most deprived, increasing over time
• Seen for many different causes of death• Additional work – alternative measures of
deprivation, new smaller, more comparable geography
• David Walsh (GCPH) and Gerry McCartney (Health Scotland) large piece of work synthesise explanations of ‘Scottish Effect’