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. 2012 Dec;22(6):756-60.
doi: 10.1093/eurpub/ckr136. Epub 2011 Oct 22.

Has Scotland always been the 'sick man' of Europe? An observational study from 1855 to 2006

Gerry McCartney  1 , David Walsh, Bruce Whyte, Chik Collins
Affiliations

Has Scotland always been the 'sick man' of Europe? An observational study from 1855 to 2006

Gerry McCartney et al. Eur J Public Health. 2012 Dec.

Abstract

Background: Scotland has been dubbed 'the sick man of Europe' on account of its higher mortality rates compared with other western European countries. It is not clear the length of time for which Scotland has had higher mortality rates. The root causes of the higher mortality in Scotland remain elusive.

Methods: Life expectancy data from the Human Mortality Database were tabulated and graphed for a selection of wealthy, mainly European countries from around 1850 onwards.

Results: Scotland had a life expectancy in the mid-range of countries included in the Human Mortality Database from the mid-19th century until around 1950. After 1950, Scottish life expectancy improved at a slower rate than in comparably wealthy nations before further faltering during the last 30 years. Scottish life expectancy now lies between that of western European and eastern European nations. The USA also displays a marked faltering in its life expectancy trend after 1981. There is an inverse association between life expectancy and the Index of Economic Freedom such that greater neoliberalism is associated with a smaller increase, or a decrease, in life expectancy.

Conclusion: Life expectancy in Scotland has only been relatively low since around 1950. From 1980, life expectancy in Scotland, the USA and, to a greater extent, the former USSR displays a further relative faltering. It has been suggested that Scotland suffered disproportionately from the adoption of neoliberalism across the nations of the UK, and the evidence here both supports this suggestion and highlights other countries which may have suffered similarly.

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Figures

Figure 1
Figure 1
Life expectancy at birth of Scotland (in red) compared with all other available nations from 1850 (males and females; data from the Human Mortality Database, 2010). Data from: Australia, Austria, Belgium, Belarus, Bulgaria, Canada, Chile, Czech Republic, Denmark, East Germany, England and Wales, Estonia, Finland, France, Germany, Hungary, Ireland, Iceland, Israel, Italy, Japan, Latvia, Lithuania, Luxembourg, Netherlands, New Zealand, Northern Ireland, Norway, Poland, Portugal, Russia, Scotland, Slovakia, Slovenia, Spain, Sweden, Switzerland, Taiwan, West Germany, Ukraine and USA
Figure 2
Figure 2
Life expectancy at birth of Scotland compared with other western European countries from 1950 (males and females; data from the Human Mortality Database, 2010)
Figure 3
Figure 3
Life expectancy at birth of Scotland compared with eastern European countries from 1950 (males and females; data from the Human Mortality Database, 2010)
Figure 4
Figure 4
Percentage change in female life expectancy (1980–2006) and in the Index of Economic Freedom (for the longest period available 1980–2006). Includes data for: Australia, Austria, Belgium, Bulgaria, Canada, Czech Republic, Denmark, Estonia, Finland, France, Hungary, Iceland, Ireland, Italy, Japan, Latvia, Lithuania, Luxembourg, Netherlands, Norway, Poland, Portugal, Russia, Slovak Rep., Spain, Sweden, Switzerland, Taiwan, Ukraine, UK and USA
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