History, politics and vulnerability: explaining excess mortality in Scotland and Glasgow

Abstract

The work has helped to further understanding of the underlying causes of Glasgow's and Scotland's high levels of excess mortality. The implications for policy include the need to address three issues simultaneously: to protect against key exposures (e.g. poverty) which impact detrimentally across all parts of the UK; to address the existing consequences of Glasgow's and Scotland's vulnerability; and to mitigate against the effects of future vulnerabilities which are likely to emerge from policy responses to contemporary problems which fail sufficiently to consider and to prevent long-term, unintended social consequences.

Estimating the Changing Nature of Scotland's Health Inequalities by using a Multivariate Spatiotemporal Model

“…Comparisons between other European countries and Scotland were the focus of Walsh et al . (), but they concentrated on explaining Scotland's, and particularly Glasgow's, excess mortality. However, this research collectively lacks a detailed analysis of health inequalities for multiple diseases at the small area scale in Scotland, which is the focus of this paper.…”

“…In this study we focus on Scotland for several reasons. First of all, Scotland has very poor health for a European country, with the lowest and most slowly improving life expectancy compared with all other western European countries (Walsh et al, 2016). Scotland also has the widest health inequalities in western Europe (Popham and Boyle, 2011).…”

“…On the research side, Taulbut et al (2014) compared west-central Scotland with other postindustrial regions of Europe, and Leyland et al (2007) examined patterns in, and causes of, inequalities for regions of Scotland. Comparisons between other European countries and Scotland were the focus of Walsh et al (2016), but they concentrated on explaining Scotland's, and particularly Glasgow's, excess mortality. However, this research collectively lacks a detailed analysis of health inequalities for multiple diseases at the small area scale in Scotland, which is the focus of this paper.…”

Capability and adversity: reframing the “causes of the causes” for mental health

“…Two thirds of the country's excess mortality is caused by high rates of suicide, alcohol and drug abuse and "external causes", including violence (Walsh et al, 2016).…”

“…Studies of a range of "unconventional" influences on health (including social capital, "sense of coherence", social mobility, climate, and sectarianism) failed to find any significant effects (McCartney and Collins et al, 2012;Walsh et al, 2013). More recent work has set out a complex, composite narrative which relates excess mortality in the West of Scotland to latent effects arising from historical deprivation, harmful social policy, educational under-attainment, the scope and scale of urban change, and measures of deprivation that probably underestimated the "lived reality" for many Scots (Walsh et al, 2016).…”