Visualising and quantifying ‘excess deaths’ in Scotland compared with the rest of the UK and the rest of Western Europe

Abstract

BackgroundScotland has higher mortality rates than the rest of Western Europe (rWE), with more cardiovascular disease and cancer among older adults; and alcohol-related and drug-related deaths, suicide and violence among younger adults.MethodsWe obtained sex, age-specific and year-specific all-cause mortality rates for Scotland and other populations, and explored differences in mortality both visually and numerically.ResultsScotland's age-specific mortality was higher than the rest of the UK (rUK) since 1950, and has increased. Between the 1950s and 2000s, ‘excess deaths’ by age 80 per 100 000 population associated with living in Scotland grew from 4341 to 7203 compared with rUK, and from 4132 to 8828 compared with rWE. UK-wide mortality risk compared with rWE also increased, from 240 ‘excess deaths’ in the 1950s to 2320 in the 2000s. Cohorts born in the 1940s and 1950s throughout the UK including Scotland had lower mortality risk than comparable rWE populations, especially for males. Mortality rates were higher in Scotland than rUK and rWE among younger adults from the 1990s onwards suggesting an age–period interaction.ConclusionsWorsening mortality among young adults in the past 30 years reversed a relative advantage evident for those born between 1950 and 1960. Compared with rWE, Scotland and rUK have followed similar trends but Scotland has started from a worse position and had worse working age–period effects in the 1990s and 2000s.

Patterns of hospital admission in 54 501 patients with epistaxis over a 20‐year period in Scotland, UK

“…Other factors relevant to epistaxis noted to be higher in Scottish populations are alcohol excess and resultant alcohol‐related liver disease . Despite our inability to link alcohol‐related liver damage at a patient level to epistaxis admissions, national data are showing the condition has been steadily rising over the past 4 years and is at its highest levels since the late 1990s…”

Recent adverse mortality trends in Scotland: comparison with other high-income countries

“…This has been observed for specific causes of death in Scotland and the USA (suicide, drug-related deaths and alcohol). [10][11][12][13] There has been an apparent polarisation of the debate regarding causes of recent adverse mortality trends, between explanations emphasising influenza, and those concerned with the impacts of austerity. [14][15][16][17][18] It may be that this split is in part attributable to studies seeking the answers to different questions (for example the causes of high numbers of deaths in short periods of time versus stalling of overall life expectancy over longer periods) and in variable comparator, or baseline, periods employed.…”

Lexis fields

“…Surfaces are often displayed as heat maps, contour maps, perspective plots, or variants of these things (Vaupel, Gambill, and Yashin 1987). Various kinds of quantities, such as raw magnitudes, differences (Minton et al 2017), excesses (Remund, Camarda, and Riffe 2018;Acosta and van Raalte 2019), ratios (Canudas-Romo and Schoen 2005), intensities, proportions, derivatives (Rau et al 2017), and even compositions (Schöley and Willekens 2017) can be displayed on Lexis surfaces to put age, period, cohort, or other patterns in relief.…”