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GCPH 2013 Symposium: From Early Understanding to New Perspectives - Seeking to Understand 'Excess' Mortality in Glasgow and West Central Scotland
In the second session of the Symposium, David Walsh of the Glasgow Centre for Population Health talks about excess mortality in Glasgow and West Central Scotland in respect of what was known when the GCPH started, what was assumed, what was done and what needs to be done. David discusses a number of reports produced externally and internally on the poor health in Scotland compared to elsewhere in Europe when looking at post industrialisation, deprivation and poverty. Important as these drivers are to explaining the poor health and high mortality rates in Scotland, other factors were indicated which led to the term ‘The Scottish Effect’. Further research then showed that mortality was still higher in Scotland than other areas of the UK. The Centre carried out two phases of work, the first quantified the level of de-industrialisation experienced in West Central Scotland and formed the basis for finding other regions across Europe which had undergone a similar process, then undertook a detailed analysis of mortality over a number of years across the different regions. The second phase focused on broader health determinants and was carried out alongside other important work on economical, historical and political factors which provided important context for the comparison of such trends. Results indicated a number of factors but also identified that similar areas in the UK had better health than West Central Scotland, work was then carried out focusing on Liverpool, Manchester and deprivation as a driver of poor health. However, results from this work were not as you may have expected as Glasgow still had the highest excess mortality rate. What we now know in respect of Glasgow, Liverpool and Manchester is that although they have a similar deprivation profile, they have different mortality profiles with excess mortality across all sectors of the population in Glasgow, which is not explained by historical change in deprivation or the makeup of different populations. This forms the Centre’s continuing programme of research.

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