Chief Medical Officer for Scotland’s Annual Report summary 2017-2018: annex

Part A – Mortality Trends

• Mortality in Scotland has hardly improved in the last 5 years – this is almost unprecedented since the Second World War.
• Northern Ireland, Iceland, England and Wales and the USA have worse trends in mortality than Scotland but many other countries have had continuing improvements over the same time period.
• For women in Scotland, life expectancy increased by a mean of 2.5 weeks/year between 2012 and 2016.^[1] There were smaller increases in England and Wales (1.1 weeks/year) and in the USA (1.9 weeks/year). Other countries had much more stable and larger increases (Figure 1).
• For men in Scotland, life expectancy increased by a mean of 4.5 weeks/year between 2012 and 2016.^[1] This is similar to the 4.0 weeks/year gain in England and Wales but substantially lower than before 2012, when life expectancy was increasing for men by over 17 weeks/year. In the USA, there was a decline of life expectancy of 0.4 weeks/year between 2012 and 2016. Several other countries continued to see substantial increases (Figure 2).
• Mortality inequalities in Scotland started to increase after 2011. Mortality rates have worsened in the most deprived fifth of Scottish areas, and overall inequalities by deprivation have widened.
• As yet we are not clear what is causing these trends but there is some evidence that austerity measures, influenza and pressures on health and social care services may be contributing.
• Further work is being undertaken urgently to improve our understanding^[1],[2.]

Figure 1: Mean annual change in female life expectancy at birth (weeks), for five year periods 1991-2016, by country

Source: Fenton et al.^[1]

*no data available for Croatia and Korea for periods prior to 2002

Figure 2: Mean annual change in male life expectancy at birth (weeks), for five year periods 1991-2016, by country

Source: Fenton et al.^[1]

* no data available for Croatia and Korea for periods prior to 2002