An exploratory spatial data analysis approach to understanding the relationship between deprivation and mortality in Scotland.

This paper considers the spatial characteristics of the relationship between deprivation and mortality rates in Scotland. Scotland not only has higher average mortality rates than England and Wales but the greatest spatial concentrations of the poorest health areas in Britain. Recent analysis has suggested that degree of deprivation alone cannot explain the majority of Scotland's 'excess' poor health relative to England and Wales, a finding referred to as the 'Scottish effect'. This analysis considers if the spatial patterning of deprivation could be significant to understanding of high mortality in Scotland. Exploratory spatial data analysis methods are implemented to study the spatial relationships between deprivation and standardised mortality ratios (SMRs) in post-code sectors in Scotland. Deprivation was measured using the 2001 Carstairs score, and the total number of deaths during a 3-year period around the 2001 census was used to calculate SMRs. A strong spatial relationship is observed between deprivation and mortality. Deprivation impacts mortality levels not only within the same areas but also in spatially proximate areas. It is concluded that, further research on the 'Scottish effect' can benefit from new methodological approaches which assess the variation in both the extent and spatial arrangement of deprivation and mortality in small areas.