Assessing differences in mortality risk between England and Wales and Scotland by country of birth

Frank Popham and Paul Boyle, University of St Andrews

[Project number 30117]

The project is a prospective observational study to explore the risk of mortality in England and Wales by country of birth (limited to Scotland versus England), to compare the risk to that for residents of Scotland (using the Scottish Longitudinal Study) and to assess whether any differences in risk are attenuated by accounting for socio-economic differences.

Despite steadily increasing life expectancy, it is well established that residents of Scotland have higher mortality risk than residents of most other Western European countries including England and Wales. It is for those of working age that Scotland's mortality record is particularly poor. Why Scotland has a worse mortality rate is the subject of continuing research. To date mortality comparisons between the two countries have had to rely on unlinked data sources as there was no Scottish equivalent of the ONS LS. However the recent establishment of the Scottish Longitudinal Study (SLS) allows linked prospective comparison of mortality in the two countries. The research has two main aims, first to establish the risk of death in Scotland (using the SLS) compared to England and Wales (using the ONS LS) taking account of place of birth (limited to Scotland and England). Second to assess the extent to which differences in mortality can be accounted for by differences in socio-economic factors. This research is part of a wider project funded by the Scottish Collaboration for Public Health Research and Policy in which we are using the SLS to assess mortality risk by socio-economic factors in Scotland.