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. 2017 Apr;110(4):153-162.
doi: 10.1177/0141076817693599. Epub 2017 Feb 16.

Why has mortality in England and Wales been increasing? An iterative demographic analysis

Lucinda Hiam  1 , Danny Dorling  2 , Dominic Harrison  3 , Martin McKee  1
Affiliations

Why has mortality in England and Wales been increasing? An iterative demographic analysis

Lucinda Hiam et al. J R Soc Med. 2017 Apr.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] J R Soc Med. 2017 Oct;110(10):389. doi: 10.1177/0141076817735063. J R Soc Med. 2017. PMID: 29043896 Free PMC article. No abstract available.

Abstract

Objectives To understand why mortality increased in England and Wales in 2015. Design Iterative demographic analysis. Setting England and Wales Participants Population of England and Wales. Main outcome measures Causes and ages at death contributing to life expectancy changes between 2013 and 2015. Results The long-term decline in age-standardised mortality in England and Wales was reversed in 2011. Although there was a small fall in mortality rates between 2013 and 2014, in 2015 we then saw one of the largest increases in deaths in the post-war period. Nonetheless, mortality in 2015 was higher than in any year since 2008. A small decline in life expectancy at birth between 2013 and 2015 was not significant but declines in life expectancy at ages over 60 were. The largest contributors to the observed changes in life expectancy were in those aged over 85 years, with dementias making the greatest contributions in both sexes. However, changes in coding practices and diagnosis of dementia demands caution in interpreting this finding. Conclusions The long-term decline in mortality in England and Wales has reversed, with approximately 30,000 extra deaths compared to what would be expected if the average age-specific death rates in 2006-2014 had continued. These excess deaths are largely in the older population, who are most dependent on health and social care. The major contributor, based on reported causes of death, was dementia but caution was advised in this interpretation. The role of the health and social care system is explored in an accompanying paper.

Keywords: Non-clinical; health service crisis; life expectancy; public health; social care crisis.

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Figures

Figure 1.
Figure 1.
Age-standardised death rate per 100,000 population, England and Wales, 1980–2015.
Figure 2.
Figure 2.
Percentage increase in death rates at individual years over 75 from 2014 to 2015, England and Wales. Source: Authors’ calculations from ONS mortality data and population estimates.
Figure 3.
Figure 3.
Excess deaths per month in 2015 compared to the monthly average 2006–2014, England and Wales.
Figure 4.
Figure 4.
Number of deaths per week, weeks 1–5, 2010–2015, England and Wales.
Figure 5.
Figure 5.
Decomposition showing the contribution of deaths at different ages from different causes to change in male life expectancy, England and Wales, 2013–2015.
Figure 6.
Figure 6.
Decomposition showing the contribution of deaths at different ages from different causes to change in female life expectancy, England and Wales, 2013–2015.
Figure 7.
Figure 7.
Number of deaths and age-standardised mortality rates for dementia and Alzheimer’s disease, persons 75 and over, England and Wales, 2001–2015.
Figure 8.
Figure 8.
Recorded prevalence of dementia, all ages, England, 2014/15 to 2015/16. Source: HSCIC.
See this image and copyright information in PMC

Comment in

References

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