Tuesday, November 20, 2012

Still the sick man of Europe?

This is the latest report from the Glasgow Centre for Population and Health. It provides a summary of Scotland’s mortality position relative to 19 other mainly Western European countries and highlights emerging trends.
Some of the key findings include:
·         Scotland’s relative ranking on infant mortality compared to other European countries has become progressively poorer for both sexes
·         Mortality rates among Scottish children (aged 1-14 years) have converged and rates for most of the selected European countries are now very similar to Scottish rates.
·         Scotland has had the highest mortality in Western Europe among working age men and women since the late 1970s.
·         Scotland’s relative ranking in relation to younger working age (aged 15-44 years) mortality compared to other European countries has become progressively worse for both sexes over the last 55 years. It is now the highest in Europe. 46% higher in Scotland for women and 54% higher for men than in England.
·         Mortality rates for elderly men (aged 75 years and over) has reduced but remains consistently above the Western European country mean. Elderly female mortality in Scotland has been the highest in Europe.
·         Mortality rates for oesophageal cancer are the highest in Europe although other cancers have improved. Lung cancer for women is very high and not improving at the same rate as men.
·         Male mortality rates for ischaemic heart disease (IHD), while still among the highest in Western Europe, have reduced and converged toward the Western European mean. Female IHD mortality in Scotland has reduced by over 80% since 1950, but has remained higher than in other Western European countries for the last 55 years.
·         Scottish mortality rates from chronic liver disease, including cirrhosis have risen steeply since the early 1990s among men and women. Female mortality is the highest in Western Europe.
In summary, mortality in the working age population remains comparatively high and mortality for circulatory diseases and many cancer related diseases is higher than in most other Western European countries. However, there have been notable improvements in Scottish mortality for a range of major conditions – both in terms of absolute trends and in relation to Scotland’s relative position in a Western European context. Growing concerns are evident, however, in relation to all-cause mortality among the younger working age population and elderly women, and for female lung cancer.
The report also concludes: “This prevailing economic context, which began with the financial crisis of 2008 and has led to rises in unemployment, job insecurity and widespread financial difficulties, makes it more likely than not that mental health problems, suicide incidence and poverty rates will increase.”
The report’s author Bruce Whyte said: "There has been no improvement in Scotland's mortality rates in the younger working age group at a time when other countries have improved. We know there are issues with alcohol, with alcoholic cirrhosis of the liver, accidental poisonings and suicides. There has also been a small contribution from things such as breast cancer and heart disease but we know the contribution of these chronic diseases is less."
Sadly, it would appear that the answer to the question "Still the sick man of Europe?" is 'yes'. But women are getting sicker too.

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