Analysis of age–sex and deprivation stratified trends in assault deaths in Scotland (1974–2015) to identify age, period or cohort effects

OBJECTIVES: Mortality rates in Scotland are higher, and health inequalities are greater, than in the rest of Western and Central Europe. There was a marked divergence during the 1980s and 1990s in the Scottish rates partly due to rises in alcohol-related and drug-related deaths, suicide and deaths by assault. This study examines whether age, period or cohort effects account for the trends in death by assault in Scotland and any sex or deprivation inequalities in these. DESIGN: We calculated crude and age-standardised mortality rates for deaths by assault for Scottish men and women from 1974 to 2015 for the population overall and for populations stratified by Carstairs area of deprivation. We examined age–sex stratified trends to identify obvious age–period–cohort effects. SETTING: This study was conducted in Scotland. PARTICIPANTS: Men and women whose registered death by the International Classification of Diseases was due to assault from 1974 to 2015 (n=3936) were included in this study. RESULTS: Whereas age-standardised mortality rates from this cause fell gradually for women since 1974, for men they increased in the early 1990s and remained higher until around 2006, before falling. Death by assault was substantially more common among men aged around 15–50 years and in the most deprived areas. There was little change in the age groups most impacted over time, which made cohort effects unlikely. A period effect for the 15 years until 2006, with a consistent age–sex–area deprivation patterning, was evident. CONCLUSIONS: Mortality due to assault in Scotland is unequally felt, with young men living in the most deprived areas suffering the highest rates. There is a 15-year period effect up until 2006, impacting on young men as an age–period interaction, with no obvious cohort effects. Exploration of the demographics of criminological data may identify age, period or cohort effects among perpetrators of assault.