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bioRxiv · 10.1101/542472

Socioeconomic inequality in recent adverse mortality trends in Scotland.

Fenton, L.·Wyper, G. M.·McCartney, G.·Minton, J.
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Abstract

Structured AbstractO_ST_ABSBackgroundC_ST_ABSGains in life expectancies have stalled in Scotland, as in several other countries, since around 2012. The relationship between stalling mortality improvements and socioeconomic inequalities in health is unclear. MethodsWe calculate the percentage improvement in age-standardised mortality rates (ASMR) in Scotland overall, by sex, and by Scottish Index of Multiple Deprivation (SIMD) quintile and gender, for two periods: 2006-2011 and 2012-2017. We then calculate the socioeconomic gradient in improvements for both periods. ResultsBetween 2006 and 2011, ASMRs fell by 10.6% (10.1% in females; 11.8% in males), but between 2012 and 2017 ASMRs only fell by 2.6% (3.5% in females; 2.0% in males). The socioeconomic gradient in ASMR improvement more than quadrupled, from 0.4% per quintile in 2006-2011 (0.7% in females; 0.6% in males) to 1.7% (2.0% in females; 1.4% in males). Within the most deprived quintile, ASMRs fell in the 2006-2011 period (8.6% overall; 7.2% in females; 9.8% in males), but rose in the 2012-2017 period (by 1.5% overall; 0.7% in females; 2.1% in males). ConclusionAs mortality improvements in Scotland stalled in 2012-2017, socioeconomic gradients in mortality became steeper, with increased mortality rates over this period in the most socioeconomically deprived fifth of the population. O_TEXTBOXWhat we already knowO_LIImprovements in mortality rates slowed markedly around 2012 in Scotland and a number of other high-income countries. C_LIO_LIScotland has large socioeconomic health inequalities, and the absolute gap in premature mortality between most and least deprived has increased since 2013. C_LIO_LIThe relationship between stalling mortality improvements and socioeconomic inequalities in health is unclear. C_LI What this study addsO_LIStalling in mortality improvement has occurred across the whole population of Scotland, but is most acute in the most socioeconomically deprived areas. C_LIO_LIMortality improvements went into reverse (i.e. deteriorated) in the most deprived fifth of areas between 2012 and 2017. C_LIO_LIResearch to further characterise and explain recent aggregate trends should incorporate consideration of the importance of socioeconomic inequalities within proposed explanations. C_LI C_TEXTBOX

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Fenton, L., Wyper, G. M., McCartney, G., Minton, J.. 2019-02-07. Socioeconomic inequality in recent adverse mortality trends in Scotland.. https://doi.org/10.1101/542472

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