Key points

  • The overall trend for premature deaths is one of steady improvement.  For example, the rate of death among people aged 55 to 64 has fallen over the last decade by around 30% for men and 20% for women.
  • Similarly, the rate of premature deaths across all ages up to 64 has fallen over the last decade by 20% for men and 15% for women.
  • However, premature death is much more common in Scotland than in England and Wales.  For example, throughout the last decade, the rate of deaths amongst those aged 55 to 64 in Scotland has been at least a quarter higher than in England and Wales for both men and women.  Indeed, Scotland has by far the highest rates of premature death of any region in Great Britain, for both men and women.  Furthermore, all bar three of the local authority areas in Scotland have a higher premature death rate than the England and Wales average, which shows that the high Scottish rate is not just due a high rate in a few local authority areas.
  • Life expectancy at birth is also less in Scotland than in any EU country apart from Portugal. 1
  • The standardised mortality rate for stomach cancer, lung cancer and heart disease in Glasgow is almost twice as high as that in the best areas.
  • Total deaths of those aged under 65 show a similar geographic pattern with the rates in the worst local authority (Glasgow City) twice as high as those in the best (East Dunbarton).
  • The standardised mortality rate in the 10% most deprived neighbourhoods is a third higher than in the most prosperous 50%.
  • The difference in male life expectancy between the most and least socio-economically disadvantaged local government districts in Scotland was 7.6 years in 2001 (Glasgow City had a life expectancy of 68.7 years, whereas East Renfrewshire was 76.3 years). 2
  • Research has suggested that the serious economic decline experienced by areas such as Glasgow and Inverclyde might have “impacted on population health status over and above the aggregate health status of poor individuals living within that area”. 3
  • Differences in health behaviour account for some of the health outcome inequalities between social classes.  49% of men in the most deprived areas smoke regularly compared to 26% of men in the least deprived areas.  The divide is similar for women: 43% smoke in the most deprived areas, compared to 24% in the least deprived. 4

Definitions and data sources

Premature death is arguably the simplest, most accessible indicator for ill-health, being a summary measure of all major health problems which result in death.

The first graph shows the number of deaths of those aged under 65 (‘premature deaths’) per 1,000 people aged under 65, with separate statistics for men and women.  For comparison purposes, the equivalent data for England and Wales is also presented.

The second graph shows, for the latest year, how rate of premature deaths varies by region.

The third graph and map show how the rate of premature deaths varies by local authority.  To improve statistical reliability, the data is averaged over the latest three years.  For comparison purposes, the average for England and Wales is also shown on the graph.

The fourth graph shows mortality rates for people aged 55 to 64, with the rates shown separately for men and women.  For comparison purposes, the equivalent data for England and Wales is also presented.

The data source for the first four graphs and map is the General Register Office for Scotland and Mortality Statistics Division, ONS for England and Wales and the Registrar General for Northern Ireland (the data is not publicly available).  In all cases, the data is standardised to a constant European age structure.

The fifth graph shows the Comparative Mortality Factor for neighbourhoods with differing levels of deprivation.  The Comparative Mortality Factor is a direct age and sex standardised measure of mortality and morbidity.

This graph is based on data from the 2004 Scottish Index of Deprivation, using data averaged over the years 1998 to 2002.  This index uses something called ‘data zones’ to represent neighbourhoods.  The neighbourhoods are grouped together according to their overall Index of Deprivation score.

The data on SMRs, the 16-65 population and the index for each postcode sector is used to work out an average SMR (weighted by the population) for the 10% most deprived, next 15% most deprived, next 25% most deprived and most prosperous 50%, where deprivation/prosperity is per the deprivation index used in the SIMD.

The sixth graph is built around the average of the standardised mortality rates (SMRs) for coronary heart disease, stomach cancer and cancer of the lung, bronchus and trachea, this selection reflecting their connection with deprivation.  Thus, rates for lung cancer among people living in the most deprived areas of Scotland are three times higher than in the least deprived areas.  A similar pattern emerges for coronary heart disease, with those in the most deprived areas having a risk of dying that is two and a half times those in the least deprived areas.  The graph shows how the SMRs for the selected diseases varies by local authority.  To improve its statistical reliability, the data is averaged over the latest three years.

The data source for the sixth graph is the Scottish General Register Office.  In each case, the data is standardised to the total Scottish population.  So, an SMR of 100 suggests that local mortality rates are the same as national mortality rates when age and sex differences in the two populations are taken into account.  Scores over 100 suggest higher than average mortality in an area, scores less than 100 lower than average mortality.

Overall adequacy of the indicator: high.  Data on death rates is sourced from administrative data and represents counts of all deaths.

External links

1. 1998 data from Chasing the Scottish effect: why Scotland needs a step-change in health if it is to catch up with the rest of Europe, Hanlon P. et al, Public Health Institute of Scotland, 2001.  Excludes the accession countries. 
2. Macintyre, S., Socio-economic inequalities in health in Scotland, Social Justice Annual Report 2001, Scottish Government, 2001, page 116. 
3. Paterson, I., Geographic and social inequalities in health: the Scottish picture, in Blamey, A., Hanlon, P., Judge, K., and Muirie, J., (eds.), Health Inequalities in the New Scotland, Health Promotion Policy Unit and Public Health Institute of Scotland, 2002. 
4. Bain, M., Patterns and trends in health inequalities in Blamey, A., Hanlon, P., Judge, K., and Muirie, J., (eds.), Health Inequalities in the New Scotland’, Health Promotion Policy Unit and Public Health Institute of Scotland, 2002, Box 4, page 22.