The Scottish effect: what's behind the numbers?

Scotland's mortality rate is higher than those for England and Wales and the presence of deprivation does not provide an adequate answer. A study in the Journal of Public Health tests the effect's reality at individual level by including in their analysis people who were Scottish born as well as those living in Scotland. They found that the higher mortality rate applied also to those who had left Scotland and subsequently lived in England and Wales, leading to the suggestion that taking a "life course" approach to the subject may well provide illumination. The Scottish national phenomenon can also be narrowed down to a Glasgow effect: a recent study in Health and Place asks whether this is associated with selective internal migration (they find there's no evidence for this). A comparative study, looking at premature mortality in deprived areas in England and Wales as well as Scotland, finds that between 1991 and 2001 rates amongst men rose by 14% in Scotland, while there was no significant change in England and Wales. The rise in Scottish mortality rates was largely driven by results for Glasgow (as rise of 15% for the period). The Glasgow Centre for Population Health is currently engaged on a programme of research into this effect, looking for insights provided by a comparison with Liverpool and Manchester.