Shrinking areas and mortality: an artefact of deprivation effects in the West of Scotland?

A number of studies have shown that mortality rates are highest in areas that are experiencing population decline. A recent study suggests that this relationship disappears when area deprivation is accounted for. We extend this research to consider the relationship between population change and mortality in five Health Boards in the West of Scotland-a region with some of the worst mortality rates in Europe. For the area as a whole and all five Health Boards separately, we find a significant negative association between population change and mortality, but in each case this relationship disappears when small area deprivation is accounted for. This confirms our previous conclusion that it is more important to account for deprivation than population decline in health resource allocation.