Scotland is a much healthier place in which to live in the 21st century than it was in the 19th and 20th centuries as measured by rates of mortality.
Causes of death today are significantly different than those in the middle of the 20th century.
Despite that, Scotland has higher rates of mortality than most other west European countries, and rates of improvement have been slower. There has even been a significant increase in some, notably chronic liver disease, in the last twenty years.
Explanations for Scottish mortality rates have focused on social class effects which continue to generate significant inequalities in health.
There also seem to be ‘ecological’ effects such that Glasgow and Clydeside do significant worse in terms of ‘excess mortality’ than comparable cities and towns.
Explanations for these effects are tentative and hypothetical, and include differential out-migration, and epigenetic differences embedded in the population over time.
