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expert reaction to ONS data on mortality trends

The Office for National Statistics has just published new data on mortality trends.

 

Prof Martin McKee FMedSci, Professor of European Public Health, London School of Hygiene & Tropical Medicine, said:

“We and others have been voicing concern in a series of papers about what appeared to be a slowing in the rate of improvement in life expectancy in the UK since 2011.  Our focus has been on increasing deaths among older people in some parts of the country but the new ONS data shows that there are also concerns about rising deaths among younger people.  Importantly, it also dismisses one of the frequent criticisms of our work, that the UK is not unusual as slowdowns have been seen in other countries too.  Of the 20 countries compared, over the past six years the improvement for women was smallest in the UK and, for men, it was the second smallest, just above the USA.  The ONS figures also refute the suggestion that the slowing of the improvement is due to the UK reaching a maximum attainable level as it is still several years less than the highest performing countries.  Importantly, in some of these countries the rate of improvement is even faster than before.  There are also some specific factors to take into account.  Even though Germany still outperforms the UK by some margin, its rate of improvement has also slowed and this may be related to the very large influx of Syrian refugees in 2015, including many who were old and ill.  The Czech Republic and Poland both do well but, given many of their fittest young people have moved to countries such as the UK, it is likely that they would otherwise have done even better.

“It is not possible, with these data, to draw a conclusion about the reasons why the UK is performing so poorly.  Our previous research has provided some pointers, suggesting the need to look in more detail at some consequences of austerity.  It may also be relevant to note how the UK is following a trajectory similar to the USA, which has suffered greatly from what have been termed the ‘diseases of despair’.  The increasing deaths from external causes among young people in the UK suggest that something similar may now be happening here.  What is in no doubt is the importance that the research needed to explain what we are now seeing is undertaken as soon as possible.”

 

Prof Jeremy Pearson, Associate Medical Director, British Heart Foundation, said:

“Heart and circulatory diseases are still responsible for 1 in 4 deaths in the UK, and there are more than 7 million people living with the daily burden of these conditions.

“These figures confirm that death rates from heart and circulatory diseases are falling, but the progress we’ve made is now at risk of stalling.  We must not get complacent.  The need to fund research into the prevention, treatment and cures for heart and circulatory diseases is now more urgent than ever.

“People now have an increased chance of surviving a heart attack as treatments have improved over the years.  However, the likelihood of dying later in life from subsequent heart failure has increased.  Almost a million people in the UK are now living with heart failure, for which these people urgently need better treatments.

“The rising number of deaths from dementia is a growing concern, with a substantial number being the result of the damage caused by a stroke.  With so many of these life-threatening conditions being connected, and a growing number of people living with more than one long-term condition, we all need to maintain better heart and circulatory health throughout our lives.”

 

Dr David Clancy, Lecturer, Division of Biomedical and Life Sciences, Lancaster University, said:

“Since 1996 the number of people with diagnosed diabetes rose from 1.4million to 3.7million (164% increase, while the UK general population increased by only 14%).  Modelling suggests there are also now an extra 1million who have undiagnosed diabetes, so that approximately 1 in 14 of the population now have the lifespan-shortening condition.  The population’s genetics have not suddenly changed to make them more susceptible to this disease; it is due to unhealthier lifestyles (and some increased diagnosis).

“This disease on its own is not responsible for the flattening of life expectancy but is probably an indicator for lifestyle-induced reductions in health more generally across the population.  When health is significantly suboptimal, surviving illness is compromised.

“But nor is this to say that lifestyle-related reduced health is solely responsible for the life expectancy slowdown.  Diseases such as dementia in particular, some cancers, and lung disease are now becoming the killers that heart disease was in the past, and treatments for these conditions, where they even exist, are not nearly as effective as our treatments for heart disease.  This in particular is probably driving the biggest slowdown in mortality improvement, which is among the over-90s, such that mortality rates among that group have been flat since 2009.

“However lifestyle-related mortality, as well as suicides and risk-taking behaviour, may be responsible for the more recent slowdowns among females and males aged 35-89.  In fact mortality among females and males aged 15-54 is actually increasing.”

 

Dr David Reynolds, Chief Scientific Officer at Alzheimer’s Research UK, said:

“Dementia is the leading cause of death across the UK and we’ve continued to see the number of people dying from the condition rise in recent years.  The slowing in life expectancy gains reflects this trend and emphasises the need for research into finding a way to prevent, slow down or cure the diseases that cause dementia.

“Official statistics show that while deaths from Alzheimer’s and other dementias continue to rise, deaths from diseases such as cancer, circulatory and respiratory diseases have generally decreased during the last two decades.  This is largely a result of advances in research that have produced more effective treatments and improved understanding of how to reduce the risk of these conditions, whereas support for dementia research has lagged behind other serious health conditions.

“Despite disturbing trends in dementia death rates and slowing life expectancy, dementia has been absent from leading health priorities for the Department of Health and Social Care and NHS England.  We must see a greater emphasis from government on funding research into dementia if we are to enable people to live in good health as they grow older.”

 

* https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/articles/changingtrendsinmortality/acrossukcomparison1981to2016

https://www.ons.gov.uk/releases/changingtrendsinmortalityacrossukcomparison1981to2016

 

Declared interests

Prof Martin McKee: “None except that we have written several unfunded papers on this topic, which have been criticised by the government.”

Dr David Clancy: “Nothing to declare.”

None received.

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