Are there gender differences in the geography of alcohol-related mortality in Scotland? An ecological study

Cross-sectional, ecological design. A comparison was made between spatial variation in men's and women's age-standardised alcohol-related mortality rates in Scotland using maps, Moran's Index, linear regression and spatial analyses of residuals. Directly standardised mortality rates were derived from individual level records of death registration, 2000–2005 (n = 8685).As expected, men's alcohol-related mortality rate substantially exceeded women's and there was substantial spatial variation in these rates for both men and women within Scotland. However, there was little spatial variation in the relationship between men's and women's alcohol-mortality rates (r2 = 0.73); areas with relatively high rates of alcohol-related mortality for men tended also to have relatively high rates for women. In a small number of areas (8 out of 144) the relationship between men's and women's alcohol-related mortality rates was significantly different.In as far as geographic location captures exposure to social and economic environment, our results suggest that the relationship between social and economic environment and alcohol-related harm is very similar for men and women. The existence of a small number of areas in which men's and women's alcohol-related mortality had an different relationship suggests that some places may have unusual drinking cultures. These might prove useful for further investigations into the factors which influence drinking behaviour in men and women.There is growing concern about harmful alcohol consumption in Europe [1], in the United Kingdom [2], and within Scotland in particular [3]. Scotland currently has one of the highest rates of mortality due to cirrhosis of the liver in western Europe [4]. Men's alcohol-related death rates in Scotland rose from 16.1 per 100,000 in the early 1990s to 39.1 deaths per 100,000 a decade later; the comparative rise for women was from 8.1 to 15.7 deaths per 100,000 [5]. These figures illustrate the persistence of substanti