Increasing mortality among adults in Scotland 1981 to 1999

Background: The aim of the study was to describe the change in overall and cause-specific mortality in Scotland between the early 1980s and late 1990s, with particular reference to the mortality experience of young adults. Method: The study was based on death records for Scottish residents. Changes in age and cause-specific death rates between 1981–83, 1989–91 and 1997–99 were compared. Results: Between 1981–83 and 1989–91 death rates in Scotland began to rise among young men aged 20–24 while for those aged over 25 rates declined. The greatest fall in rates was experienced at ages 40 to 59. When death rates during 1997–99 were compared to rates in 1989–91 this pattern had changed. During the 1990s death rates among 20 to 34-year-olds increased, with a slight rise at ages 35–44. At older ages overall mortality continued to decline but the greatest fall was at ages 60 and over. Trends among women shared similarities with men. For both men and women falls in mortality from heart disease, stroke, and cancers were being differentially offset by increases in other causes of death across all age groups. The causes of death that contributed to the increased death rate among young adults include to various degrees, suicides, drug deaths, alcohol and violence. Conclusion: In Scotland changes in mortality result from a complex combination of different trends in mortality from various causes of death. The rate of decline in mortality among men aged 59 and below is slowing down, and death rates among young men aged 15–44 are increasing. If these trends continue there is a suggestion that future death rates may begin to rise at older ages.