Latest statistics on excess winter mortality, drug-related deaths, healthcare associated infection (MRSA and Clostridium difficile) deaths, UK suicide and alcohol-related deaths from the Office for National Statistics (ONS), and mortality target monitoring figures from the Department of Health (DH).
Publications
Finalised data for all births, deaths, marriages, civil partnerships and divorces along with population data for the year in question.
Number of deaths registered in Northern Ireland where Clostridium Difficile was mentioned on the death certificate.
Number of deaths registered in Northern Ireland where MRSA was mentioned on the death certificate.
Presents mortality rates and details on the number of deaths involving Clostridium difficile (C. difficile) for England and Wales. National trend data are provided from 1999 to 2006. Data are also provided for deaths involving C. difficile from 2001-06 by individual communal establishment (for example, hospitals, nursing homes) where the death took place.
Details of deaths in England and Wales where Meticillin-Resistant Staphylococcus aureus (MRSA) was reported as a contributory factor. National trend data are provided from 1993 to 2006. Data are also provided for deaths involving MRSA from 2001-06 by individual communal establishment (for example, hospitals, nursing homes) where the death took place.
Contains data on deaths related to drug poisoning in England and Wales from 1993 onwards, by cause of death, sex, age and substances involved in the death.
Number of drug related deaths and deaths due to drug misuse registered in Northern Ireland.
The number of, and trends in, drug-related deaths in Scotland, broken down by, for example, age, sex, Health Board and Council areas and whether particular types of drug were found in the body.
A measure of the increase in winter mortality, provided on an annual basis, in the form of the excess winter mortality figure.
These tables include data on live births, infant deaths, and infant mortality rates by ethnic group as well as on infant deaths, and infant mortality rates by cause of death and ethnic group.
This reports examines trends in the stillbirth rate by known risk factors to explore the increase in the stillbirth rate in 2002 in England and Wales.
The indicator measures the change in Life expectancy at birth in Working Neighbourhood Fund (WNF) areas which are also Spearhead areas.
Discontinued. Presents statistics on deaths occurring annually in England and Wales.
Mortality monitoring.
Scottish Perinatal and Infant Mortality and Morbidity Report
Presents provisional numbers of deaths registered in England and Wales by age, sex and selected underlying causes of death together with mortality rates.
Suicide Statistics
Report on unexplained infant deaths in England and Wales which includes both sudden infant deaths and deaths for which the cause remained unknown or unascertained.
Overview
The Office for National Statistics (ONS) produces a set of annual reports on a range of specific causes of death, such as drug-related deaths, deaths associated with the healthcare associated infections MRSA and Clostridium difficile, and estimates of Excess Winter Mortality, England and Wales.
ONS also publishes annual UK figures for suicides and alcohol-related deaths on the ONS website, as well as figures for the probability of survival to age 75 years, England and Wales.
The Department of Health publishes a set of annual updates, based on ONS data, which are used to monitor progress against Department of Health Public Service Agreement (PSA) targets for cancer, circulatory diseases, suicide and injury of undetermined intent, accidents, life expectancy and infant mortality rates.
Technical Data
The Office for National Statistics (ONS) Centre for Health Analysis & Life Events (CHALE) produces the 20th century and 21st century mortality data sets, which are records of mortality in England and Wales from 1901 to 2000, and from 2001 to the latest year available, respectively. The files consist of an aggregated database of deaths by age group, sex, year and underlying cause. Also included are the International Classification of Diseases (ICD) dictionaries and populations for England and Wales.
CHALE also produces a set of annual reports based on specific mortality data for England and Wales. These are published in the
Health Statistics Quarterly journal
, which are available to download.
Topics covered (with links to specific product pages) include:
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deaths relating to drug poisoning: data on deaths related to drug poisoning in England and Wales from 1993 onwards, by cause of death, sex, age and substances involved in the death. Further information is available on the National Statistics website
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deaths associated with the healthcare associated infections MRSA and Clostridium difficile: details of deaths in England and Wales where either Meticillin-Resistant Staphylococcus aureus (MRSA) or Clostridium difficile (C. difficile) was reported as a contributory factor. National trend data are provided from 1993 onwards.
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Excess Winter Mortality: during the winter months, mortality in England and Wales reaches higher levels than during the summer months. A measure of this increase is provided, on an annual basis, in the form of the excess winter mortality figure. This figure is a simple way to assess mortality levels over the winter as a whole. Further information is available on the National Statistics website
CHALE also reports UK figures for suicides and alcohol-related deaths (latest data on numbers and rates of adult suicides and alcohol-related deaths in the UK from 1991 onwards, by sex and age group), and figures for the probability of survival to age 75 years. These figures are all available to download from the following links:
UK suicides and undetermined injury deaths
Probability of survival to age 75 years for local authorities in England and Wales
The Department of Health publishes a set of annual updates, based on ONS data, which are used to monitor progress against Department of Health targets:
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mortality rates, used to monitor progress against Department of Health mortality targets for cancer, circulatory diseases, suicide and injury of undetermined intent, and accidents in England. The inequality dimension of these targets is monitored by comparing the progress of England as a whole with equivalent progress of the ‘Spearhead Group’ of health deprived areas
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life expectancy data and all age, all cause mortality rates, used to monitor progress against Department of Health targets for overall life expectancy in England, and for the gap in life expectancy between the areas with the worst health and deprivation indicators (the Spearhead group) and the England average
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infant mortality rates, used to monitor progress against the Department of Health infant mortality inequality Public Service Agreement (PSA) target for the gap in infant mortality between the Routine and Manual socio-economic group and the population as a whole, for England and Wales
Glossary
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Accelerated registrations
The process by which a death can be registered at the time of adjournment of an inquest, instead of having to await the outcome of criminal proceedings.
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Alcohol-related deaths
Cause of death is defined in the alcohol-related deaths report and downloadable data set using the International Classification of Diseases, Ninth Revision (ICD-9) for the years 1991 to 2000, and the International Classification of Diseases, Tenth Revision (ICD-10) for 2001 onwards.
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Alcohol-related deaths, ICD-10 codes
Alcohol-related deaths are defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes: F10 (mental and behavioural disorders due to use of alcohol), G31.2 (degeneration of nervous system due to alcohol), G62.1 (alcoholic polyneuropathy), I42.6 (alcoholic cardiomyopathy), K29.2 (alcoholic gastritis), K70 (alcoholic liver disease), K73 (chronic hepatitis, not elsewhere classified), K74 excluding K74.3-K74.5 (fibrosis and cirrhosis of liver, excluding biliary cirrhosis), K86.0 (alcohol induced chronic pancreatitis), X45 (accidental poisoning by and exposure to alcohol), X65 (intentional self-poisoning by and exposure to alcohol), and Y15 (poisoning by and exposure to alcohol, undetermined intent).
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Alcohol-related deaths, ICD-9 codes
Alcohol-related deaths are defined using the International Classification of Diseases, Ninth Revision (ICD-9) codes: 291 (alcoholic psychoses), 303 (alcohol dependence syndrome), 305.0 (non-dependent abuse of alcohol), 425.5 (alcoholic cardiomyopathy), 571.0 (alcoholic fatty liver), 571.1 (acute alcoholic hepatitis), 571.2 (alcoholic cirrhosis of liver), 571.3 (alcoholic liver damage, unspecified), 571.4 (chronic hepatitis), 571.5 (cirrhosis of liver without mention of alcohol), 571.8 (other chronic non-alcoholic liver disease), 571.9 (unspecified chronic liver disease without mention of alcohol) and E860 (accidental poisoning by alcohol).
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Annual extract
The dataset taken from the main deaths database from which most mortality tabulations are derived.
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Assault
The ICD-10 terminology referring to homicide and injuries inflicted by another person with intent to injure or kill, by any means (excluding deaths from legal intervention and operations of war).
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Bridge coding
An exercise in which the same group of deaths are independently classified according to two different classifications or coding methods.
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CHALE
Centre for Health Analysis & Life Events at the Office for National Statistics (ONS).
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Clostridium difficile
C. difficile is a spore forming bacterium found naturally in the gut of a small proportion of the healthy adult population. C. difficile associated disease occurs when normal, healthy intestinal bacteria are subdued by the use of antibiotics. This allows C. difficile to flourish in the gut and produce a toxin that causes diarrhoea.
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Comparability ratio
A measure, expressed as a ratio, indicating the net effect of the change in classification (from ICD-9 to ICD-10) on a particular cause of death.
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Coroner
Public official responsible for the investigation of violent, sudden or suspicious deaths.
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Deaths related to drug poisoning
Cause of death is defined in the ‘deaths relating to drug poisoning report’ and downloadable dataset using the International Classification of Diseases, Ninth Revision (ICD-9) for the years 1993 to 2000, and Tenth Revision (ICD-10) for 2001 onwards. Deaths are included where the underlying cause was due to drug poisoning and where a drug controlled under the Misuse of Drugs Act 1971 was mentioned on the death certificate.
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Deaths related to drug poisoning, ICD-10 codes
Deaths relating to drug poisoning are defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes: F11-F16, F18-F19 (mental and behavioural disorders due to drug use, excluding alcohol and tobacco), X40-X44 (accidental poisoning by drugs, medicaments and biological substances), X60-X64 (intentional self-poisoning by drugs, medicaments and biological substances), X85 (assault by drugs, medicaments and biological substances) and Y10-Y14 (poisoning by drugs, medicaments and biological substances, undetermined intent).
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Deaths related to drug poisoning, ICD-9 codes
Deaths relating to drug poisoning are defined using the International Classification of Diseases, Ninth Revision (ICD-9) codes: 292, 304, 305.2-305.9 (mental and behavioural disorders due to drug use, excluding alcohol and tobacco), E850-E858 (accidental poisoning by drugs, medicaments and biological substances), E950.0-E950.5 (intentional self-poisoning by drugs, medicaments and biological substances), E962.0 (assault by drugs, medicaments and biological substances) and E980.0-E980.5 (poisoning by drugs, medicaments and biological substances, undetermined intent).
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Dual coding
The coding of the same data twice, using different methods of coding in order to assess inconsistencies.
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Early neonatal deaths
Deaths at ages up to six completed days of life.
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Epidemiologist
A person concerned with the incidence and distribution of diseases and other factors, including the environment, relating to health.
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Excess Winter Mortality (EWM)
Estimates of excess winter deaths are based on the difference between the number of deaths during the four winter months (December to March) and the average number of deaths during the preceding four months (August to November) and the following four months (April to July).
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External cause
Death resulting from accident or violence. An alternative term for the underlying cause of death. ICD codes from Chapter XX (see Secondary causes).
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HSQ
Health Statistics Quarterly journal (an Office for National Statistics (ONS) quarterly publication).
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Inquest
Inquiry into the cause of an unexplained, sudden or violent death held by a coroner.
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International Classification of Diseases (ICD)
The ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use. It is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records. In addition to enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, these records also provide the basis for the compilation of national mortality and morbidity statistics.
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MCCD
Medical Certificate of Cause of Death.
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Modification rules
Rules used in ICD-10 applied rules to select the correct underlying cause of death.
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Mortality rate
The usual practice in Office for National Statistics (ONS) publications is to calculate age-standardised mortality rates per 100,000 population, standardised to the European Standard Population. Age-standardised rates are used to allow comparison between populations which may contain different proportions of people of different ages.
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MRSA
MRSA is a variety of Staphylococcus aureus that is resistant to meticillin, and some of the other antibiotics that are usually used to treat Staphylococcus aureus. Those who die with MRSA are usually patients who were already very ill and it is instead their existing illness, rather than MRSA, which is often designated as the underlying cause of death. There is therefore, an interest in the number of deaths where MRSA contributed to the death.
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Neonatal
Relating to infants aged under 28 days.
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NHSCR
National Health Service Central Register.
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Perinatal deaths
Stillbirths and deaths at ages up to six completed days of life (early neonatal).
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Population Trends
An Office for National Statistics (ONS) quarterly publication.
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Postneonatal deaths
Deaths of infants aged 28 days and over but under one year.
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Probability of survival
The Office for National Statistics (ONS) definition of the probability of survival to age 75 estimates the likelihood of a person surviving between birth and age 75. The probabilities of survival figures are based on the assumption that individuals would experience that year's age-specific mortality rates throughout their lives.
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Registrar
Statutory officer responsible for the registration of births, deaths and marriages.
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Registrar General
Statutory appointment with responsibility for the administration of the registration Acts in England and Wales, and other related functions as specified by the relevant legislation.
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Registration officer
Generic term for registrar, superintendent registrar and additional registrars.
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Reports
Short articles on cause of death using registration data soon after they are available (in the Health Statistics Quarterly and Population Trends journals).
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RON
Registration online. A web-based system which enables registrars to record births, stillbirths, deaths and civil partnerships online.
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RSS
Registration Service Software.
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Rule 3
One of the rules used to select the correct underlying cause of death; its different use in ICD-10 results in significant differences from ICD-9 for some causes (see Selection rules).
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Secondary cause
The nature of injury, or main injury, that caused death (where the underlying cause is assigned to an external cause from Chapter XX in ICD-10, V01 to Y89). Nature of injury codes are taken mostly from Chapter XIX (prefixes S and T).
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Selection rules
Rules used in the ICD to determine the correct selection of the underlying cause of death (see Rule 3).
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Sequela (sequelae)
A condition (or conditions) reported as the result of a previous injury, a ‘late effect’ (under ICD-9), or that occurs as a late effect one year or more after the originating event.
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Spearhead group
The Spearhead Group consists of the 70 local authority areas that are in the bottom fifth nationally for three or more of the following five factors: male life expectancy at birth, female life expectancy at birth, cancer mortality rate in under 75s, cardiovascular disease mortality rate in under 75s, and Index of Multiple Deprivation 2004 (local authority summary), average score. For life expectancy, the ‘bottom’ fifth means those with the lowest figures; for mortality rates and deprivation scores, it means those with the highest figures.
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Standardised mortality ratio (SMR)
An SMR is the ratio of the observed number of deaths in an area (for example, an electoral ward) to the number expected if that area had the same age-specific rates as a reference area (for example, England and Wales). If an SMR is less than 100, the number of deaths in an area was less than would have been expected. Conversely, if an SMR is greater than 100, the number of deaths was greater than expected.
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Standard population
Used in the calculation of the age-standardised death rates; an element of the population (such as age and sex) is ‘held constant’ to control its effect, for example, the European Standard.
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Stillbirth
Refers to the Stillbirth (Definition) Act 1992; a child born after 24 or more weeks completed gestation who did not show any signs of life at any time after being born.
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Suicide & undetermined injury
Suicide is defined using the International Classification of Diseases, Ninth Revision (ICD-9) codes E950-E959 and E980-E989, excluding E988.8 for the years 1991 to 2000, and the International Classification of Diseases, Tenth Revision (ICD-10) codes X60-X84 and Y10-Y34, excluding Y33.9 (where the coroner’s verdict was pending) for the years 2001 to 2006. ‘Coroner’s verdict pending’ deaths do not need to be excluded from deaths assigned to ICD-10 Y33.9 from 2007 onwards, since these deaths are now coded to ICD-10 U50.9.
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Superintendent registrar
Statutory officer with responsibilities relating to births, deaths, marriage and other registration functions, as specified in the relevant legislation.
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Underlying cause of death
The cause of death selected for primary tabulation based on ICD rules.
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VSOB
Vital Statistics Outputs Branch (at the Office for National Statistics (ONS)).
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WHO
World Health Organisation.
Contact Details
For statistical enquiries about this topic, please contact:
Emma Gordon
Email: mortality@ons.gsi.gov.uk
Telephone: +44 (0) 16 3345 5866
Centre for Health Analysis & Life Events (CHALE) The Office for National Statistics Government Buildings Cardiff Road Newport NP10 8XG
