Background Public health aims to simultaneously improve average population health and reduce inequalities. Lifespan variation complements life expectancy by measuring the disparity in the age of death in the population. Countries that tackle premature mortality tend to have rising life expectancy and declining lifespan variation but Scotland lags behind other Western European countries. Recent Research shows deprived populations experience a double burden of inequality; shorter life expectancies and greater variation in the age of death. However it is unclear whether lifespan variation trends are the same for all socioeconomic groups or whether there are gradients in the trends, and if so how this impacts on Scotland’s poor mortality record.
Methods We calculate lifespan variation by area deprivation (Carstairs quintile) in Scotland by generating lifetables from death and population data surrounding three Censuses (1981, 1991 and 2001). Edagger was used to measure lifespan variation: this shows the average life expectancy lost per death and is calculated as the weighted average of the remaining life expectancy at all ages. The contribution of each age group to the change in lifespan variation by Carstairs quintile over time was estimated using stepwise decomposition. Confidence intervals and a sensitivity analysis using an alternative measure of lifespan variation will be calculated.
Results Lifespan variation for all men was 11.8, 11.5 and 11.7 years in 1981, 1991 and 2001 respectively. For men in the least deprived quintile lifespan variation decreased between 1981 and 2001 from 11.2 years to 10.4 but increased in the most deprived from 12.2 years to 12.9. A rise in the death rates amongst men age 19 to 39 years old in the most deprived quintile accounted for 59% of the increase in lifespan variation over time. For women lifespan variation decreased across all quintiles between 1981 and 2001, but the level of change was patterned by socioeconomic deprivation. The least deprived quintile reduced lifespan variation by 0.9 years compared to 0.5 years in the most deprived quintile.
Conclusion Scotland’s continuing high levels of lifespan variation are due to increasing or persisting high levels for the most deprived while the least deprived have seen reductions overtime. Poor trends amongst the most deprived are attributable in part to persisting premature mortality. Tackling high premature mortality amongst the most deprived would reduce Scotland’s overall level of lifespan variation, reduce inequalities and improve population health, boosting its standing within Western Europe.
- Health inequality
- population health
- trend analysis
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