Analysis of falling mortality rates in Edinburgh and Glasgow

Background The aims of the study were to describe and interpret trends in m ortality in Glasgow and Edinburgh Methods A comparison was made between observed all-cause and cause-specific mortality rates for 1989-1993 for men and women aged 35-74 and rates predi cted on the basis of modelled mortality data for residents of Glasgow and E dinburgh aged 25-74 in quinquennia based on Census years 1961, 1971 and 198 1. Results All-cause mortality rates fell between 1979-1983 and 1989-1993 by a larger amount in Edinburgh than in Glasgow (24.5 versus 14.5 per cent in m en; 20.4 versus 10.5 per cent in women). Differences in life expectancy bet ween the cities at age 35 increased by 44 per cent to 4.7 years in men and by 19 per cent to 2.5 years in women. Mortality rates improved in all age a nd sex groups but trends were least favourable in Edinburgh men and women a ged 35-44. Mortality rates in both cities fell by a larger amount than pred icted, by 10 per cent in men and 6 per cent in women. Conclusions The widening of differences in life expectancy between Glasgow and Edinburgh is mainly due to a historical trend of longevity increasing m ore quickly in Edinburgh. Although precise explanations are not possible, i t seems likely that this difference between the cities is explained in larg e measure by their consistently and markedly contrasting socio-economic pro files. Comparison of the cities conceals, however, a trend of falling morta lity rates in both populations, comprising most of the observed reduction i n mortality rates in Glasgow, which appears to result in part from factors operating in the short term. Interpretation of trends in cause-specific mor tality rates needs to take account of the possibility of long-term and shor t-term trends in all-cause mortality in different social groups.