The poor health profiles of Scotland, and especially that of its largest city, Glasgow, are well known. Much of this is explained by recent experiences of deindustrialisation, deprivation and poverty: the latter are the root causes of poor health in all societies, not just Scotland. However, in addition, high levels of excess mortality – that is, higher mortality over and above that explained by differences in socioeconomic deprivation – have been observed for Scotland compared with England & Wales, as well as for Glasgow compared with similar post-industrial UK cities such as Liverpool, Manchester and Belfast.

The key features of this excess are:
• it is observed in all parts of Scotland compared with the rest of Great Britain, but is greatest in and around the post-industrial West Central Scotland (WCS) conurbation and, in particular, Glasgow
• it is increasing over time
• it is seen across all adult age groups, but is highest among those of working age (especially younger working age)
• it is observed across all social classes, although for premature mortality, it is more pronounced in comparisons of the poorest populations
• it is observed for a broad range of causes of death, although with important distinctions between excess premature mortality (particularly influenced by higher rates of death from alcohol, drugs and suicide) and excess mortality at all ages (driven particularly by higher numbers of deaths from cancer, heart disease and stroke)
• and given the relationship between socioeconomic factors and health behaviours, the excess persists even after statistical adjustment for differences in behaviours such as smoking, physical activity, diet etc.