United Kingdom
Premature death
Key points
- The rate of premature death has fallen by a sixth over the last decade for both men and women.
- The rate of premature deaths is one and a half times as high among men as among women.
- Premature death of men is much higher in Scotland than elsewhere, particularly for men.
- Over the period 2001 to 2003 (the latest available data), men aged 25 to 64 from routine or manual backgrounds were twice as likely to die as those from managerial or professional backgrounds. Such social class differences existed for all the major causes of death, the two biggest of which are malignant neoplasms (cancers) and circulatory diseases (including heart disease).
- Over the same period, women aged 25 to 59 from routine or manual backgrounds were also much more likely to die as those from managerial or professional backgrounds. Whilst the scale of differences for women in the published data is somewhat less than that for men (the ratio between the death rates among those from routine or manual backgrounds compared to those from managerial or professional backgrounds is of 1.4 for women and 2.0 for men), this rises to a similar scale (1.8) if the social class allocations of the women are amended to take the husband's social class into account - see discussion in Health Services Quarterly, edition 42.
Graph 1: Over time
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Graph 2: By region
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Map
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Download a spreadsheet with the district-level statistics
Graph 3: By social class
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Graph 4: By cause (men only)
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Graph 5: By social class and cause (men only)
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Why this indicator was originally chosen
Standardised Mortality Rates (SMRs) are a reliable illustrator of overall health inequalities.
There are a variety of ways of presenting SMRs. The chosen indicator is the proportion of those aged under 65 who die each year, providing an overall indicator of premature death, with the second graph showing the inequalities between different parts of the country.
Definitions and data sources
The first graph shows the number of deaths of people aged under 65 per 100,000 population aged under 65, with the data shown separately for males and females.
The second graph shows, for the latest year, how the proportion of the population aged under 65 who died varies by region.
The map shows how the proportion of the population aged under 65 who died varies by local authority, with the data averaged for the latest three years.
The data source for the first graph and map is Mortality Statistics Division, ONS (England and Wales) and the General Register Office (Scotland). The data is not publicly available and relates to Great Britain. The data for the second graph comes from the same sources but with the addition of Northern Irish data from the Registrar General. All data has been standardised to a constant European age structure.
The third graph shows how death rates vary by social class, with data for men aged 25 to 64 and for women aged 25 to 59. The data is the average for 2001 to 2003 and covers England and Wales. The data source is the ONS publication Health Statistics Quarterly (HSQ), editions 36 - Winter 2007 (for men) and 42 - Summer 2009 (for women). The data is the latest publicly available and the age group is the only one for which published data is available. All data has been standardised to a constant European age structure and the social class allocations are based on the individual's own occupation using the NS-SEC three class scheme. Note that, as discussed in the relevant HSQ reports, there may be some biases in the data arising from the use of the 2001 Census for the social class population denominators and the way that HSQ treats these possible biases appears to be a bit different for men and for women. Furthermore, as also discussed in HSQ, the social class allocations for women are less satisfactory than those for men and somewhat different figures are obtained if these allocations are done using a combined classification which also takes the husband's social class into account.
For men, the fourth and fifth graphs provide a further breakdown by cause of death (equivalent figures using the same social class groupings are not available for women).
The fourth graph show the distribution of deaths among men aged 25 to 64 by cause. The data is for 2007 and covers England and Wales. The data source is HSQ edition 39 - Autumn 2008.
The fifth graph shows the death rates among men aged 25 to 64 by cause and social class. The data is the average for 2001 to 2003 and covers England and Wales. The data source is HSQ edition 38 - Summer 2008. The data is the latest publicly available and the age group is the only one for which published data is available.
In the fourth and fifth graphs, the grouping of causes is the only groupings for which social class data is available. Each death has been coded using the Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10), with malignant neoplasms (cancers) being ICD-10 codes C00-D48, heart and other circulatory diseases being codes I00-I99, digestive diseases being codes K00-K93, respiratory diseases being codes J00-J99, external causes being codes U509 plus V01-Y89 and other causes being all the other codes. All data has been standardised to a constant European age structure.
Overall adequacy of the indicator: medium. The underlying data are deaths organised according to the local authority area of residence of the deceased by the ONS in England and Wales and by the Registrar General for Scotland. The data by social class is, however, woefully out-of-date, as it is published only once a decade and is already six years out-of-date when first published.
External links
- See the ESRC Health Variations Programme.
- See the Department of Health's Programme for action in tackling health inequalities, , which includes annually published status reports.
- See the Department of Health health inequalities website.
- See the ONS Health Statistics Quarterly publications.
- See Eurostat's atlas on mortality in the European Union.
Relevant 2007 Public Service Agreements
Overall aim: Promote better health and well-being for all
Lead department
Department of Health.
Official national targets
By 2010, increase the average life expectancy at birth in England to 78.6 years for men and to 82.5 years for women monitored using mortality rates as a proxy.
Reduce health inequalities by 10% by 2010 as measured by life expectancy at birth (monitored using AAACM as a proxy).
To reduce reducing adult (16+) smoking rates to 21% or less by 2010, with a reduction in prevalence among routine and manual groups to 26% or less.
Other indicators of progress
Proportion of people supported to live independently.
Access to psychological therapies.
Previous 2004 targets
Substantially reduce mortality rates by 2010:
- from heart disease and stroke and related diseases by at least 40 % in people under 75; with at least a 40 % reduction in the inequalities gap between the fifth of areas with the worst health and deprivation indicators and the population as a whole;
- from cancer by at least 20% in people under 75, with a reduction in the inequalities gap of at least 6% between the fifth of areas with the worst health and deprivation indicators and the population as a whole; and
- from suicide and undetermined injury by at least 20%.
Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth.
Relevant government policies
The numbers
Graph 1
| Year | Age-standardised deaths per 100,000 population | |
|---|---|---|
| Men | Women | |
| 1991 | 322 | 191 |
| 1992 | 310 | 185 |
| 1993 | 308 | 185 |
| 1994 | 293 | 177 |
| 1995 | 293 | 177 |
| 1996 | 290 | 175 |
| 1997 | 280 | 172 |
| 1998 | 277 | 168 |
| 1999 | 270 | 166 |
| 2000 | 266 | 165 |
| 2001 | 265 | 161 |
| 2002 | 260 | 157 |
| 2003 | 257 | 157 |
| 2004 | 245 | 150 |
| 2005 | 240 | 148 |
| 2006 | 239 | 147 |
| 2007 | 233 | 144 |
| 2008 | 230 | 143 |
Graph 2
| Age-standardised deaths per 100,000 population | |||
|---|---|---|---|
| Region | Men | Women | All |
| East | 189 | 126 | 158 |
| East Midlands | 215 | 146 | 181 |
| London | 229 | 133 | 181 |
| North East | 253 | 159 | 206 |
| North West | 266 | 164 | 215 |
| Northern Ireland | 246 | 153 | 199 |
| Scotland | 304 | 177 | 240 |
| South East | 188 | 120 | 154 |
| South West | 197 | 127 | 162 |
| Wales | 236 | 155 | 196 |
| West Midlands | 239 | 149 | 194 |
| Yorkshire and The Humber | 239 | 149 | 194 |
Graph 3
| Social class | Death rates per 100,000 | |
|---|---|---|
| Men aged 25 to 64 | Women aged 25 to 59 | |
| Routine or manual backgrounds | 454 | 194 |
| Intermediate backgrounds | 301 | 145 |
| Managerial or professional backgrounds | 231 | 137 |
Graph 4
| Cause of death among men aged 25 to 64 | |
|---|---|
| Malignant neoplasms (cancers) | 34% |
| Heart and other circulatory diseases | 28% |
| Digestive diseases | 9% |
| Respiratory diseases | 6% |
| External causes | 12% |
| Other causes | 11% |
Graph 5
| Social class | Death rates among men aged 25 to 64 per 100,000 | |||
|---|---|---|---|---|
| Malignant neoplasms (cancers) | Heart and other circulatory diseases | Digestive diseases | Respiratory diseases | |
| Routine or manual backgrounds | 149 | 152 | 37 | 29 |
| Intermediate backgrounds | 105 | 98 | 23 | 23 |
| Managerial or professional backgrounds | 92 | 74 | 16 | 10 |