Dying younger in Scotland: Trends in mortality and deprivation relative to England and Wales, 1981-2011
Dying younger in Scotland: Trends in mortality and deprivation relative to England and Wales, 1981-2011
复制标题
DOI：
10.1016/j.healthplace.2016.05.007
复制
发表时间：
2016-07-01
期刊：
影响因子：
4.8
通讯作者：
Leyland, Alastair H.
中科院分区：
文献类型：
--
作者：
Schofield, Lauren;Walsh, David;Leyland, Alastair H.
鉴于之前的证据表明，与英格兰和威尔士（E&W）相比，并非所有苏格兰的高死亡率都可以用贫困来解释，目的是通过分析1981年至2011年间苏格兰和E&W的贫困和死亡率变化，加强对这种过度的理解。死亡率通过直接标准化和对数线性泊松回归模型进行比较，调整了年龄、性别和贫困。在不同的空间尺度上，采用了不同的剥夺措施。结果显示，1981年至2011年间，苏格兰的贫困程度低于英国。然而，苏格兰的超额（经剥夺调整后的死亡率相对于E&W的差异）在2010- 2012年从高出4%（1981年）增加到高出10%。后一个数字相当于每年多死亡约5000人。这一增长的原因是癌症、自杀、与酒精有关的原因和与药物有关的中毒造成的死亡率上升。苏格兰超额死亡率的规模和增长是主要问题。对其根本原因的调查仍在继续，鉴于在英国其他地方也观察到类似的过度行为，调查结果将与其他人群相关。(C) 2016年作者。Elsevier Ltd.出版。这是一篇基于CC BY-NC-ND许可的开放获取文章（链接：// crealivcommons . orgificensesby-ric-nd /4.0/）。
Given previous evidence that not all Scotland's higher mortality compared to England & Wales (E&W) can be explained by deprivation, the aim was to enhance understanding of this excess by analysing changes in deprivation and mortality in Scotland and E&W between 1981 and 2011. Mortality was compared by means of direct standardisation and log-linear Poisson regression models, adjusting for age, sex and deprivation. Different measures of deprivation were employed, calculated at different spatial scales. Results show that Scotland became less deprived compared to E&W between 1981 and 2011. However, the Scottish excess (the difference in mortality rates relative to E&W after adjustment for deprivation) increased from 4% higher (c.1981) to 10% higher in 2010-12. The latter figure equates to c. 5000 extra deaths per year. The increase was driven by higher mortality from cancer, suicide, alcohol related causes and drugs-related poisonings. The size and increase in Scottish excess mortality are major concerns. Investigations into its underlying causes continue, the findings of which will be relevant to other populations, given that similar excesses have been observed elsewhere in Britain. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (hitp://crealivecommons.orgificensesiby-ric-nd/4.0/).