A Comparison of the Mortality from Bronchitis in Scotland and in England and Wales

Abstract

A comparison of the bronchitis mortality rates in Scotland and in England and Wales for the years 1940 to 1960 shows that there is a considerable excess in England and Wales, but that there has been a recent rise in males in Scotland, particularly in the younger age groups. The excess in England and Wales is seen in every type of urban and rural area, and is not due to a lower proportion of the total population living under rural conditions. There does not appear to be any significant difference in the diagnosis of other forms of respiratory disease in the two countries, but a comparison of mortality rates from myocardial degeneration suggests that some of the recent rise in Scottish males could be due to a re-allocation of deaths formerly certified as myocardial degeneration, though reasons have been given which indicate that this is not the only factor. An analysis based on the Report of the Registrar-General for Scotland in 1956 listing secondary causes of death shows that, even if every death where bronchitis is listed as a secondary cause were attributed to bronchitis, the enhanced death rate from bronchitis is still below the level reached in England and Wales. Analyses in England and Wales show that there is an amount of “ complicating ” and “ contributory ” bronchitis which is similar to that found in Scotland. Though the difference of bronchitis mortality rates between the two countries may not be as large as at first sight appears, it remains true that Scotland has a lower rate at the present time than England and Wales. The evidence suggests that the degree of difference is becoming less, particularly in the younger males. This may be due to the cigarette-smoking habit having spread more slowly in Scotland. Cigarette smoking may have begun to show its major effect on mortality only in the last few years. © 1965, British Medical Journal Publishing Group. All rights reserved.