Overall increases in life expectancy mask considerable variation, both across
and within the United Kingdom. For example, across the United Kingdom in
2011, life expectancy in England was the longest for both men and women
(78.9 and 82.9 years respectively), followed by Wales, Northern Ireland and
Scotland (Bevan et al., 2014). There is considerable variation within nations. For
example, life expectancy in the north east of England is closer to levels seen in
Scotland. Other examples include the city of Glasgow, where people living in
more affluent areas are expected to live nearly 30 years longer than those living
in the poorest areas; this phenomenon is commonly termed the “Glasgow effect”
(Reid, 2011). Scotland has historically had poorer health compared with the
rest of the United Kingdom, as well as compared to many other EU countries.
Similar to other high-income countries, the main causes of death in the
United Kingdom are circulatory diseases (ischaemic heart diseases and
cerebrovascular diseases); malignant neoplasms (most commonly lung,
colorectal, breast and cervical cancer); and respiratory diseases (Table 1.5).
Deaths from respiratory and circulatory diseases, as well as from cancers, have
fallen since 1990.
Although tobacco use has fallen, tobacco remains the leading health
risk factor, contributing to poor performance for some cancers and chronic
obstructive pulmonary disease (COPD). Alcohol consumption and high blood
pressure, as well as overweight and obesity, are other important health risk
factors (Table 1.6). Nearly two-thirds of the burden of cardiovascular diseases
in the United Kingdom has been attributed to poor diet and a lack of exercise;
these risk factors were estimated to have accounted for nearly 15% of disability
adjusted life years (DALYs) in 2010 (Murray et al., 2013). Additionally, air
pollution has been found to be responsible for approximately 1 in 20 deaths
across the United Kingdom (Committee on the Medical Effects of Air
Pollutants, 2010).