Scottish ‘excess’ mortality: comparing Glasgow with Liverpool and Manchester

This research programme was established to help understand what lay behind the ‘excess’ levels of mortality (i.e. that which does not appear to be explained by socioeconomic deprivation alone) seen in Scotland and, in particular, Glasgow, compared to other parts of the UK.

Excess mortality infographic - if you require an accessible version or transcript, please email info@gcph.co.ukIn May 2016, GCPH and NHS Health Scotland, in collaboration with the University of the West of Scotland and University College London, published a synthesis report which identified the most likely underlying causes of this excess. The causes are multiple, complex and interwoven, but in large part relate to a greater vulnerability among the Scottish population to the main drivers of poor health in any society – poverty and deprivation – caused by a series of historical decisions and processes.

The research findings, alongside a detailed set of resultant policy recommendations aimed at national and local government, were endorsed by a range of experts in public health and other relevant disciplines.

Download the report. There is also a PDF version of the infographic available.

Many different strands of research were involved in reaching this understanding. Principally (but not exclusively) based on comparisons of Glasgow with Liverpool and Manchester (cities with similar socio-economic characteristics and histories), these are summarised below.

Previous work

2010: the original analyses of deprivation and mortality in Glasgow compared with Liverpool and Manchester, which showed that while the deprivation profiles of the cities were very similar, mortality in Glasgow was significantly higher (30% higher for premature deaths; 15% higher for deaths at all ages). 
Report and related journal article available.

2011: an initial synthesis of the most likely causes of the excess, now updated by the 2016 report.
Initial synthesis report and related journal article available.

2013: a population survey of Glasgow, Liverpool and Manchester.
Report and briefing paper available. 

2013: analyses of the spatial patterning of deprivation in the cities.
Report and briefing paper available.

2013: early years research.
Report and briefing paper available.

2013: A systematic review of the link between Vitamin D deficiency and all-cause mortality.
Journal article available. 

2014: research into alcohol harm in Glasgow, Liverpool and Manchester.
Briefing paper and related journal article available.

2015: qualitative research based on interviews with key informants in the three cities.
Report available.

2016: analyses which quantified the levels of excess mortality in Scotland between 1981 and 2011.
Journal article available. 

2016: analyses of the nature (and scale) of urban change experienced in the post-war decades.
Report available (PDF). 

Ongoing work

2016: research into the vulnerability of populations and political impacts - to be published shortly.

2016: research into housing conditions, employment and diet, as well as a review of explanations for differences in population health between high income countries (this research was commissioned to contribute to the 2016 synthesis report).

A PhD studentship examining historical changes in deprivation and city structures.

A PhD studentship examining policy and practice of local government in the cities.

It should be noted other research included within the GCPH website (e.g. comparing health and its determinants in West Central Scotland with other post-industrial regions of Europe) is also highly relevant to this work area of research. 

Further information

Access further information about excess mortality in Scotland and Glasgow on the ScotPHO website. For information or enquiries about this research, please email David Walsh.