Changing mortality trends in countries and cities of the UK: a population-based trend analysis
Objectives Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish wh...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e038135.full |
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| author | David Walsh Bruce Whyte Gerry McCartney Jon Minton Jane Parkinson Deborah Shipton |
| author_facet | David Walsh Bruce Whyte Gerry McCartney Jon Minton Jane Parkinson Deborah Shipton |
| author_sort | David Walsh |
| collection | DOAJ |
| description | Objectives Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail.Design Population-based trend analysis.Participants/setting Whole populations of countries and selected cities of the UK.Primary and secondary outcome measures European age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities.Results Changes in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow).Conclusions The study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest. |
| format | Article |
| id | doaj-art-85ab132fb4c242dd97b8ffa07a62924c |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-85ab132fb4c242dd97b8ffa07a62924c2025-08-20T02:48:10ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-038135Changing mortality trends in countries and cities of the UK: a population-based trend analysisDavid Walsh0Bruce Whyte1Gerry McCartney2Jon Minton3Jane Parkinson4Deborah Shipton5Glasgow Centre for Population Health, Glasgow, UK2 Glasgow Centre for Population Health, University of Glasgow, Glasgow, UKPublic Health Observatory, NHS Health Scotland, Glasgow, Scotland, UK1 Public Health Observatory, NHS Health Scotland, Glasgow, UK1 Public Health Observatory, NHS Health Scotland, Glasgow, UKPlace and Wellbeing Directorate, Public Health Scotland, Edinburgh, UKObjectives Previously improving life expectancy and all-cause mortality in the UK has stalled since the early 2010s. National analyses have demonstrated changes in mortality rates for most age groups and causes of death, and with deprived populations most affected. The aims here were to establish whether similar changes have occurred across different parts of the UK (countries, cities), and to examine cause-specific trends in more detail.Design Population-based trend analysis.Participants/setting Whole populations of countries and selected cities of the UK.Primary and secondary outcome measures European age-standardised mortality rates (calculated by cause of death, country, city, year (1981–2017), age group, sex and—for all countries and Scottish cities—deprivation quintiles); changes in rates between 5-year periods; summary measures of both relative (relative index of inequality) and absolute (slope index of inequality) inequalities.Results Changes in mortality from around 2011/2013 were observed throughout the UK for all adult age groups. For example, all-age female rates decreased by approximately 4%–6% during the 1980s and 1990s, approximately 7%–9% during the 2000s, but by <1% between 2011/2013 and 2015/2017. Equivalent figures for men were 4%–7%, 8%–12% and 1%–3%, respectively. This later period saw increased mortality among the most deprived populations, something observed in all countries and cities analysed, and for most causes of death: absolute and relative inequalities therefore increased. Although similar trends were seen across all parts of the UK, particular issues apply in Scotland, for example, higher and increasing drug-related mortality (with the highest rates observed in Dundee and Glasgow).Conclusions The study presents further evidence of changing mortality in the UK. The timing, geography and socioeconomic gradients associated with the changes appear to support suggestions that they may result, at least in part, from UK Government ‘austerity’ measures which have disproportionately affected the poorest.https://bmjopen.bmj.com/content/10/11/e038135.full |
| spellingShingle | David Walsh Bruce Whyte Gerry McCartney Jon Minton Jane Parkinson Deborah Shipton Changing mortality trends in countries and cities of the UK: a population-based trend analysis BMJ Open |
| title | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
| title_full | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
| title_fullStr | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
| title_full_unstemmed | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
| title_short | Changing mortality trends in countries and cities of the UK: a population-based trend analysis |
| title_sort | changing mortality trends in countries and cities of the uk a population based trend analysis |
| url | https://bmjopen.bmj.com/content/10/11/e038135.full |
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