Analysis of falling mortality rates in Edinburgh and Glasgow.

BACKGROUND

The aims of the study were to describe and interpret trends in mortality in Glasgow and Edinburgh

METHODS

A comparison was made between observed all-cause and cause-specific mortality rates for 1989-1993 for men and women aged 35-74 and rates predicted on the basis of modelled mortality data for residents of Glasgow and Edinburgh aged 25-74 in quinquennia based on Census years 1961, 1971 and 1981.

RESULTS

All-cause mortality rates fell between 1979-1983 and 1989-1993 by a larger amount in Edinburgh than in Glasgow (24.5 versus 14.5 per cent in men; 20.4 versus 10.5 per cent in women). Differences in life expectancy between the cities at age 35 increased by 44 per cent to 4.7 years in men and by 19 per cent to 2.5 years in women. Mortality rates improved in all age and sex groups but trends were least favourable in Edinburgh men and women aged 35-44. Mortality rates in both cities fell by a larger amount than predicted, by 10 per cent in men and 6 per cent in women.

CONCLUSIONS

The widening of differences in life expectancy between Glasgow and Edinburgh is mainly due to a historical trend of longevity increasing more quickly in Edinburgh. Although precise explanations are not possible, it seems likely that this difference between the cities is explained in large measure by their consistently and markedly contrasting socio-economic profiles. Comparison of the cities conceals, however, a trend of falling mortality rates in both populations, comprising most of the observed reduction in mortality rates in Glasgow, which appears to result in part from factors operating in the short term. Interpretation of trends in cause-specific mortality rates needs to take account of the possibility of long-term and short-term trends in all-cause mortality in different social groups.