FOI reference: FOI-2023-1640
You asked
Please provide the number of death certificates where malnutrition was listed as an underlying cause or a contributory factor (or mentioned anywhere on the death certificate) in 2022.
We said
Thank you for your request.
Our mortality data comes from the information collected at death registration. All the conditions mentioned on the death certificate are coded using the International Classification of Diseases, Tenth Revision (ICD-10). From all of these causes, an underlying cause of death is selected using ICD-10 coding rules.
The underlying cause of death is defined by the World Health Organisation (WHO) as:
The disease or injury that initiated the train of events directly leading to death, or
The circumstances of the accident or violence that produced the fatal injury.
At the Office for National Statistics (ONS), we use the term "due to" to refer to the underlying cause of a death and the term "involving" where a cause is mentioned anywhere on the death certificate.
The ICD-10 cause codes used for malnutrition are E40 to E46, which come under the endocrine, nutritional, and metabolic diseases sub-chapter. This consists of:
E40 - Kwashiorkor.
E41 - Nutritional marasmus.
E42 - Marasmic kwashiorkor.
E43 - Unspecified severe protein-energy malnutrition.
E44 - Protein-energy malnutrition of moderate and mild degree.
E45 - Retarded development following protein-energy malnutrition.
E46 - Unspecified protein energy malnutrition.
For deaths involving malnutrition, we have also included the following ICD-10 code:
T73.0 - Effects of hunger (deprivation of food; starvation)
In 2022, there were 436 deaths involving malnutrition registered in England and Wales. Of those, 77 deaths had this recorded as the underlying cause.
Please note:
Figures are for deaths registered rather than occurred. For more information, see our Impact of Registration Delays publication.
For deaths over 28 days, the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) has been used to classify cause of death. The ICD is used to translate diagnoses of diseases and other health problems from words into alphanumeric code to permit easier storage, retrieval, and analysis. For deaths registered from 1 January 2022, cause of death is coded to the ICD-10 classification using MUSE 5.8 software. Deaths registered between 1 January 2020 and 31 December 2021 were coded to the using MUSE 5.5 and previous years were coded to IRIS 4.2.3. For more information click here.
Figures exclude neonatal deaths as it is not possible to identify a single underlying cause of death for neonatal deaths or stillbirths. More information can be found in section 6 of our User Guide to Infant and Child Mortality Statistics.
Figures for 2022 use finalised data.
Figures include deaths of non-residents.
These data do not provide enough information to link the deaths to poor care. It is not possible to determine from these figures how or where a condition originated. There are many explanations as to why someone becomes malnourished: for example, they may have cancer of the digestive tract, which means they can't eat properly or can't absorb nutrients; they may have suffered from a stroke or have advanced dementia which can cause difficulties chewing and swallowing; or they may abuse alcohol and so not eat properly.
For further information, please contact health.data@ons.gov.uk.