Geographical inequalities in burden of disease at local authority level in Scotland: A subnational analysis for the Scottish Burden of Disease Study 2016
(2020) MPHN40 20201Social Medicine and Global Health
- Abstract
- Background: Scotland possesses the worst mortality outcomes and slowest improvement in life expectancy of Western Europe. Within Scotland, stark inequalities exist in both morbidity and mortality. There remains paucity in assessment of subnational variation in disease burden.
Aim: This thesis explored geographical inequalities in burden of disease (BoD) across 32 Scottish authorities. Secondary analysis assessed association between geographical deprivation and disease burden.
Methods: Local data was extracted from the Scottish Burden of Disease 2016 study and encompassed disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) for 68 causes of disease across 32 Scottish local authorities.... (More) - Background: Scotland possesses the worst mortality outcomes and slowest improvement in life expectancy of Western Europe. Within Scotland, stark inequalities exist in both morbidity and mortality. There remains paucity in assessment of subnational variation in disease burden.
Aim: This thesis explored geographical inequalities in burden of disease (BoD) across 32 Scottish authorities. Secondary analysis assessed association between geographical deprivation and disease burden.
Methods: Local data was extracted from the Scottish Burden of Disease 2016 study and encompassed disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) for 68 causes of disease across 32 Scottish local authorities. Geographical trends were assessed for age-standardised all cause rates and for national 10 leading causes, in addition to age- and sex-specific rates. The association between all cause DALY and deprivation was analysed using the Scottish Index of Multiple Deprivation (SIMD).
Findings: Glasgow City possessed highest burden for all cause age-standardised rates. Western authorities had largest burden in 8 leading causes whilst Eilean Siar led in 2. Across authorities, working ages showed similar burden in lower back and neck pain, depression, and anxiety disorders. There was a significant association between all cause DALY and SIMD, increased disease burden was associated with increased deprivation. Generally, Western authorities showed greatest levels of deprivation and BoD; Western regions East Dunbartonshire and East Renfrewshire were exceptions, possessing lowest BoD and deprivation of 32 local authorities.
Conclusion: Findings show subnational variation in BoD, with nationwide trends of psychosocial morbidity. These estimates at local level will inform policy makers and key stakeholders of effective resource allocation and priority setting across Scottish authorities. Policies that redistribute income to most deprived of the population hold greatest promise in addressing key determinants of health and accordingly geographical inequalities in BoD. (Less) - Popular Abstract
- Burden of disease studies aim to quantify how non-fatal and fatal conditions contribute to the number of years a person lives in less than ideal health and how much of an individual’s maximum lifespan is shortened due to premature mortality. Through this approach, the Scottish Burden of Disease study has identified leading causes of disability and death affecting Scotland’s population. The importance of understanding subnational geographical variation in disease and socioeconomic deprivation are gaining increasing recognition. This thesis is the first account of subnational estimates of disease burden at local authority level in Scotland. Variation in leading causes of disease between local authorities are described and shown to strongly... (More)
- Burden of disease studies aim to quantify how non-fatal and fatal conditions contribute to the number of years a person lives in less than ideal health and how much of an individual’s maximum lifespan is shortened due to premature mortality. Through this approach, the Scottish Burden of Disease study has identified leading causes of disability and death affecting Scotland’s population. The importance of understanding subnational geographical variation in disease and socioeconomic deprivation are gaining increasing recognition. This thesis is the first account of subnational estimates of disease burden at local authority level in Scotland. Variation in leading causes of disease between local authorities are described and shown to strongly correlate with area-based deprivation. Western Scottish authorities showed greatest disease burden and deprivation, with the exception of two Western authorities East Dunbartonshire and East Renfrewshire which had the most positive health and deprivation outcomes of all local authorities. Non-fatal conditions of depression, anxiety disorders, and lower back and neck pain were found to have widespread burden in working age groups across all local authorities. The suggested underlying causes of geographical variation in disease burden and deprivation are discussed. Relevant prevention and mitigation strategies together with income-based policies for reducing overall burden of fatal and non-fatal conditions are then presented based upon findings. Overall, targeting the uneven deprivation across Scotland necessitates prime focus, specifically progressive policies that offer redistribution of income and assurance of universal capacity to afford healthy living. Collectively, local disease burden estimates inform public health interventions and appropriate policy responses for the effective improvement of Scotland’s population health. (Less)
Please use this url to cite or link to this publication:
http://lup.lub.lu.se/student-papers/record/9015903
- author
- Dyer, Georgia LU
- supervisor
- organization
- course
- MPHN40 20201
- year
- 2020
- type
- H2 - Master's Degree (Two Years)
- subject
- keywords
- Burden of disease, disability-adjusted life years, years of life lost, years lived with a disability, Scottish Index of Multiple Deprivation, local authorities, Scotland
- language
- English
- id
- 9015903
- date added to LUP
- 2020-08-11 10:28:01
- date last changed
- 2020-08-11 10:28:01
@misc{9015903,
abstract = {{Background: Scotland possesses the worst mortality outcomes and slowest improvement in life expectancy of Western Europe. Within Scotland, stark inequalities exist in both morbidity and mortality. There remains paucity in assessment of subnational variation in disease burden.
Aim: This thesis explored geographical inequalities in burden of disease (BoD) across 32 Scottish authorities. Secondary analysis assessed association between geographical deprivation and disease burden.
Methods: Local data was extracted from the Scottish Burden of Disease 2016 study and encompassed disability-adjusted life years (DALY), years of life lost (YLL), and years lived with disability (YLD) for 68 causes of disease across 32 Scottish local authorities. Geographical trends were assessed for age-standardised all cause rates and for national 10 leading causes, in addition to age- and sex-specific rates. The association between all cause DALY and deprivation was analysed using the Scottish Index of Multiple Deprivation (SIMD).
Findings: Glasgow City possessed highest burden for all cause age-standardised rates. Western authorities had largest burden in 8 leading causes whilst Eilean Siar led in 2. Across authorities, working ages showed similar burden in lower back and neck pain, depression, and anxiety disorders. There was a significant association between all cause DALY and SIMD, increased disease burden was associated with increased deprivation. Generally, Western authorities showed greatest levels of deprivation and BoD; Western regions East Dunbartonshire and East Renfrewshire were exceptions, possessing lowest BoD and deprivation of 32 local authorities.
Conclusion: Findings show subnational variation in BoD, with nationwide trends of psychosocial morbidity. These estimates at local level will inform policy makers and key stakeholders of effective resource allocation and priority setting across Scottish authorities. Policies that redistribute income to most deprived of the population hold greatest promise in addressing key determinants of health and accordingly geographical inequalities in BoD.}},
author = {{Dyer, Georgia}},
language = {{eng}},
note = {{Student Paper}},
title = {{Geographical inequalities in burden of disease at local authority level in Scotland: A subnational analysis for the Scottish Burden of Disease Study 2016}},
year = {{2020}},
}