Rise in mortality—when will the government take note?

Hiam, Lucinda; Dorling, Danny; McKee, Martin

doi:10.1136/bmj.k2747

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…Other explanations for the recent trends have included: that the UK, along with much of the rest of Western Europe, has experienced exceptionally high winter mortality 7–9 ; that an increase in ‘deaths of despair’—those from alcohol, drugs and suicides—have offset broader health improvements 10 ; that funding for health and social care services has not kept up with demand 11 12 ; and, relatedly, that austerity policies have impacted on health through mechanisms such as reduced social security payments and underemployment. 13 14 Such explanations are likely neither mutually exclusive nor exhaustive, and some (such as additional winter deaths and slowing improvements in ischaemic heart disease (IHD) mortality) may plausibly result from other causes, such as increased pressure on healthcare services and associated unmet need. 15…”

Section: Introductionmentioning

confidence: 99%

How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

et al. 2020

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ObjectiveAnnual gains in life expectancy in Scotland were slower in recent years than in the previous two decades. This analysis investigates how deaths in different age groups and from different causes have contributed to annual average change in life expectancy across two time periods: 2000–2002 to 2012–2014 and 2012–2014 to 2015–2017.SettingScotland.MethodsLife expectancy at birth was calculated from death and population counts, disaggregated by 5 year age group and by underlying cause of death. Arriaga’s method of life expectancy decomposition was applied to produce estimates of the contribution of different age groups and underlying causes to changes in life expectancy at birth for the two periods.ResultsAnnualised gains in life expectancy between 2012–2014 and 2015–2017 were markedly smaller than in the earlier period. Almost all age groups saw worsening mortality trends, which deteriorated for most cause of death groups between 2012–2014 and 2015–2017. In particular, the previously observed substantial life expectancy gains due to reductions in mortality from circulatory causes, which most benefited those aged 55–84 years, more than halved. Mortality rates for those aged 30–54 years and 90+ years worsened, due in large part to increases in drug-related deaths, and dementia and Alzheimer’s disease, respectively.ConclusionFuture research should seek to explain the changes in mortality trends for all age groups and causes. More investigation is required to establish to what extent shortcomings in the social security system and public services may be contributing to the adverse trends and preventing mitigation of the impact of other contributing factors, such as influenza outbreaks.

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Section: Introductionmentioning

confidence: 99%

How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

et al. 2020

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“…This surprising change led a number of newspaper articles to report this decrease as a signal of an alarming health crisis. Several experts supported this assessment with their comments and attempts to identify the cause of this phenomenon [3][4][5][6][7]. Consequently, future trends in PLE are now forecast more conservatively than they used to be, in particular regarding women for whom mortality statistics suggest a recent reduction in PLE improvements [8].…”

Section: Introductionmentioning

confidence: 99%

“…Life Expectancy: Frequently Used, but Hardly Understood 99 Gerontology 2020;66:95-104 DOI: 10.1159/000500955 y axis. 6 The graphs elucidate the connection between the PLE decrease in 2015 and the PLE increase in 2014. This is an important observation because it suggests that the decrease in PLE in 2015 results primarily from the exceptional high survival in 2014, and not -at least not as much -from a mortality crisis in 2015.…”

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confidence: 97%

Life Expectancy: Frequently Used, but Hardly Understood

et al. 2019

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Period life expectancy is one of the most used summary indicators for the overall health of a population. Its levels and trends direct health policies, and researchers try to identify the determining risk factors to assess and forecast future developments. The use of period life expectancy is often based on the assumption that it directly reflects the mortality conditions of a certain year. Accordingly, the explanation for changes in life expectancy are typically sought in factors that have an immediate impact on current mortality conditions. It is frequently overlooked, however, that this indicator can also be affected by at least three kinds of effects, in particular in the situation of short-term fluctuations: cohort effects, heterogeneity effects, and tempo effects. We demonstrate their possible impact with the example of the almost Europe-wide decrease in life expectancy in 2015, which caused a series of reports about an upsurge of a health crisis, and we show that the consideration of these effects can lead to different conclusions. Therefore, we want to raise an awareness concerning the sensitivity of life expectancy to sudden changes and the menaces a misled interpretation of this indicator can cause.

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“…The Cameron government, which believed austerity was good economic policy, refuted this link and ignored widespread concern from public health experts. 12 While other causes may also have played a role in the poor state of population health in the UK prior to the pandemic, such as reductions in improving cardiovascular disease mortality (which may itself be related to austerity), 13 the evidence on the contribution of austerity policies on health outcomes is overwhelming. 14 As a result, the UK 'limped into the pandemic .…”

Section: Health In Britain Before 2020mentioning

confidence: 99%

Same storm, different boats: can the UK recapture improving life expectancy trends?

Hiam

Patel

2021

J R Soc Med

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The COVID-19 pandemic has led to devastating loss of life and livelihood across the world. It has resulted in falls in life expectancy, a widely used summary measure of contemporary age-specific mortality rates, in most European countries. 1 In England and Wales, life expectancy has fallen by 0.9 and 1.2 years for women and men, respectively, when compared to 2019. 2 These falls are, however, part of a longer-term trend that began long before the COVID-19 pandemic. For the past decade, life expectancy in the UK has been stalling, and falling in some regions and social groups, and inequality in age at death has been rising. 3 In this piece, we consider the health of the UK population before the pandemic, compare this to the health of the populations in the USA and Japan, as investigated in a recent paper, 3 and ask if it is possible to recapture previous improving life expectancy trajectories.

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Rise in mortality—when will the government take note?

Cited by 6 publications

References 3 publications

How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

Life Expectancy: Frequently Used, but Hardly Understood

Same storm, different boats: can the UK recapture improving life expectancy trends?

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