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

Objective Gains in life expectancy have faltered in several high-income countries in recent years. Scotland has consistently had a lower life expectancy than many other high-income countries over the past 70 years. We aim to compare life expectancy trends in Scotland to those seen internationally an...

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Main Authors: Colin Fischbacher, Gerry McCartney, Jon Minton, Julie Ramsay, Maria Kaye-Bardgett, Grant M A Wyper
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e029936.full
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author Colin Fischbacher
Gerry McCartney
Jon Minton
Julie Ramsay
Maria Kaye-Bardgett
Grant M A Wyper
author_facet Colin Fischbacher
Gerry McCartney
Jon Minton
Julie Ramsay
Maria Kaye-Bardgett
Grant M A Wyper
author_sort Colin Fischbacher
collection DOAJ
description Objective Gains in life expectancy have faltered in several high-income countries in recent years. Scotland has consistently had a lower life expectancy than many other high-income countries over the past 70 years. We aim to compare life expectancy trends in Scotland to those seen internationally and to assess the timing and importance of any recent changes in mortality trends for Scotland.Setting Austria, Croatia, Czech Republic, Denmark, England and Wales, Estonia, France, Germany, Hungary, Iceland, Israel, Japan, Korea, Latvia, Lithuania, Netherlands, Northern Ireland, Poland, Scotland, Slovakia, Spain, Sweden, Switzerland and USA.Methods We used life expectancy data from the Human Mortality Database (HMD) to calculate the mean annual life expectancy change for 24 high-income countries over 5-year periods from 1992 to 2016. Linear regression was used to assess the association between life expectancy in 2011 and mean life expectancy change over the subsequent 5 years. One-break and two-break segmented regression models were used to test the timing of mortality rate changes in Scotland between 1990 and 2018.Results Mean improvements in life expectancy in 2012–2016 were smallest among women (<2 weeks/year) in Northern Ireland, Iceland, England and Wales, and the USA and among men (<5 weeks/year) in Iceland, USA, England and Wales, and Scotland. Japan, Korea and countries of Eastern Europe had substantial gains in life expectancy over the same period. The best estimate of when mortality rates changed to a slower rate of improvement in Scotland was the year to 2012 quarter 4 for men and the year to 2014 quarter 2 for women.Conclusions Life expectancy improvement has stalled across many, but not all, high-income countries. The recent change in the mortality trend in Scotland occurred within the period 2012–2014. Further research is required to understand these trends, but governments must also take timely action on plausible contributors.
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spelling doaj-art-6bb6c92b527d450a862bbaf879b7cbea2024-12-14T03:05:13ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-029936Recent adverse mortality trends in Scotland: comparison with other high-income countriesColin Fischbacher0Gerry McCartney1Jon Minton2Julie Ramsay3Maria Kaye-Bardgett4Grant M A Wyper5Information Services Division, NHS National Services Scotland, Edinburgh, Scotland, UK1 Place and Wellbeing Directorate, Public Health Scotland, Glasgow, UKPublic Health Scotland, Glasgow, Scotland, UKVital Events Statistics, National Records of Scotland, Edinburgh, UK3 National Records of Scotland, Edinburgh, UKPublic Health Scotland, Glasgow, UKObjective Gains in life expectancy have faltered in several high-income countries in recent years. Scotland has consistently had a lower life expectancy than many other high-income countries over the past 70 years. We aim to compare life expectancy trends in Scotland to those seen internationally and to assess the timing and importance of any recent changes in mortality trends for Scotland.Setting Austria, Croatia, Czech Republic, Denmark, England and Wales, Estonia, France, Germany, Hungary, Iceland, Israel, Japan, Korea, Latvia, Lithuania, Netherlands, Northern Ireland, Poland, Scotland, Slovakia, Spain, Sweden, Switzerland and USA.Methods We used life expectancy data from the Human Mortality Database (HMD) to calculate the mean annual life expectancy change for 24 high-income countries over 5-year periods from 1992 to 2016. Linear regression was used to assess the association between life expectancy in 2011 and mean life expectancy change over the subsequent 5 years. One-break and two-break segmented regression models were used to test the timing of mortality rate changes in Scotland between 1990 and 2018.Results Mean improvements in life expectancy in 2012–2016 were smallest among women (<2 weeks/year) in Northern Ireland, Iceland, England and Wales, and the USA and among men (<5 weeks/year) in Iceland, USA, England and Wales, and Scotland. Japan, Korea and countries of Eastern Europe had substantial gains in life expectancy over the same period. The best estimate of when mortality rates changed to a slower rate of improvement in Scotland was the year to 2012 quarter 4 for men and the year to 2014 quarter 2 for women.Conclusions Life expectancy improvement has stalled across many, but not all, high-income countries. The recent change in the mortality trend in Scotland occurred within the period 2012–2014. Further research is required to understand these trends, but governments must also take timely action on plausible contributors.https://bmjopen.bmj.com/content/9/10/e029936.full
spellingShingle Colin Fischbacher
Gerry McCartney
Jon Minton
Julie Ramsay
Maria Kaye-Bardgett
Grant M A Wyper
Recent adverse mortality trends in Scotland: comparison with other high-income countries
BMJ Open
title Recent adverse mortality trends in Scotland: comparison with other high-income countries
title_full Recent adverse mortality trends in Scotland: comparison with other high-income countries
title_fullStr Recent adverse mortality trends in Scotland: comparison with other high-income countries
title_full_unstemmed Recent adverse mortality trends in Scotland: comparison with other high-income countries
title_short Recent adverse mortality trends in Scotland: comparison with other high-income countries
title_sort recent adverse mortality trends in scotland comparison with other high income countries
url https://bmjopen.bmj.com/content/9/10/e029936.full
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