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Title: Live long in Scotland : the relative contribution of medicine and standards of living to Scotland's falling mortality rates
Author: Macdonald, Catriona
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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Between 1950 and 1999 the Scottish death rate, standardised to the 1950 population, declined from 13.1 per 1000 to 7.8 for men and from 12 per 1000 to 6.3 for women. The main aim of this thesis has been to establish the key influences on this doctrine. Thomas McKeown examined the decline of mortality in an earlier time period (up to the 1970s) and concluded that: falls in deaths from infectious diseases were responsible for the majority of the decline in mortality rate; and the main influence on their decline was standards of living, in particular diet. The causes of death which contributed most to the decline in mortality rates 1950-1999 were established by digitising GRO(S) mortality records and calculating ‘potential lives saved’ . This method allows an estimate to be made of the number of deaths which would be expected to occur in 1999, taking into account changing age structure, if the death rates from 1950 still applied. Tuberculosis (TB), stomach cancer (SC), ischemic heart disease (IHD) and stroke were selected as case studies; these accounted for over 70% of the decline of male and female mortality. The trajectory of decline in these causes of death was then considered in detail and set in social and medical context. The thesis has reached an alternative conclusion from that of Thomas McKeown. It is argued that improving standards of living were responsible for some of the decline in SC and haemorrhagic stroke mortality, and the pre-1950 decline of TB; however, the main influence on the decline of TB, IHD and ischemic stroke mortality post-1950 was medicine. Using the wider definition of the influence of medicine adopted in this study, medicine is considered to account for the majority of the decline in the identified causes of mortality. Medicine has, at last, delivered important contributions to the life expectancy of the Scottish population.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available