- There were 501,424 deaths registered in England and Wales in 2014, compared with 506,790 in 2013 (a fall of 1.1%)
- Age-standardised mortality rates (ASMRs) have continued to decrease in 2014. There were 11,213 deaths per million population for males and 8,219 deaths per million population for females
- The infant mortality rate decreased in 2014 to 3.9 deaths per thousand live births, compared with 4.0 in 2013
- There were 3,254 stillbirths in England and Wales in 2014, compared with 3,284 in 2013 (a fall of 0.9%)
- In 2014, cancer was the most common broad cause of death (29% of all deaths registered) followed by circulatory diseases, such as heart disease and strokes (27% of all deaths registered). Cancer was the most common broad cause of death for both sexes
This bulletin presents summary statistics on deaths, stillbirths and infant mortality in England and Wales in 2014. All statistics are based on deaths registered in England and Wales in a particular year. For information on registration delays for a range of causes, see Impact of registration delays on mortality statistics.
The death statistics reported include counts of deaths by age and sex, and by selected cause and age-standardised mortality rates. Standardised mortality ratios (SMRs) and counts of stillbirths and infant mortality rates by area of usual residence are also included.
This is the first time that 2014 annual figures for deaths in England and Wales have been published.Back to table of contents
There were 501,424 deaths registered in England and Wales in 2014, compared with 506,790 in 2013 (a fall of 1.1%), and 514,250 in 2004. This continues the long-term downward trend in the number of deaths. The number of registration days in a calendar year can have a small effect on the number of deaths registered in that year. The number of deaths is also affected by the size and age structure of the population. Statistics on the number of deaths in England and Wales are available back to 1938 in the Vital statistics: population and health reference tables and back to 1901 in the 20th century mortality files.Back to table of contents
Mortality rates calculated using the 2013 European Standard Population (ESP) have continued the downward trend, with 11,213 deaths per million population for males and 8,219 deaths per million population for females in 2014 (Figure 1). Since 2001, age-standardised mortality rates (ASMRs) have decreased by 26% for males and 21% for females. The male ASMR has decreased each year since 2001, whereas the female ASMR has decreased with the exception of 3 small rises, the latest being in 2012.
Mortality rates are generally falling, as people are tending to live longer for a variety of reasons, including improved lifestyles and medical advances in the treatment of many illnesses and diseases. This is illustrated by the reduction in ASMRs for many causes of death. Since 2004, ASMRs across all 5 year age groups by sex have either decreased or remained unchanged (see Table 1 (312 Kb Excel sheet)). Mortality rates for males and females in 2014 have continued to decline, as have the number of deaths, while there has been an increase in the population at older ages.
The ASMRs produced in this report and in the associated reference tables have been calculated using the 2013 ESP. In 2013, Eurostat updated the ESP for the first time since it was introduced in 1976, to make it more representative of the current population in Europe (Eurostat, 2013).
The impact of the change from the 1976 ESP to the 2013 ESP was greatest for conditions commonly associated with older ages (where ASMRs increased) and those almost exclusive to very young ages (where ASMRs decreased). More information about the impact of this change can be found on our websiteBack to table of contents
The number of stillbirths in England and Wales decreased to 3,254 in 2014 compared with 3,284 in 2013 (a fall of 0.9%). In comparison, the total number of births (both live births and stillbirths) decreased by just 0.5% in 2014. Stillbirths in England decreased by 1.8% from 3,103 in 2013 to 3,047 in 2014. Stillbirths in Wales increased by 15.7% from 153 in 2013 to 177 in 2014. Due to the small number of stillbirths in Wales, small changes in the number of stillbirths in a year can result in large percentage changes.
The stillbirth rate takes into account the total number of births and so provides a more accurate indication of trends than just analysing the number of stillbirths over time. In 2014, the stillbirth rate for England and Wales remained at 4.7 per thousand total births, the same as in 2013. In 2013, this was the lowest stillbirth rate since 1992 when it was 4.3. In England, the stillbirth rate in 2014 was 4.6 per thousand total births, the same as in 2013. There has been a general downward trend in the stillbirth rate since 2004 with a decrease of 19.3% over the last 10 years (Figure 2). In Wales the stillbirth rate in 2014 was 5.2 per thousand total births, up from 4.5 in 2013 but, has fallen from 5.7 in 2004 (Figure 2).
Small fluctuations in the number of stillbirths and the stillbirth rate in England and Wales have occurred during the last decade, with the highest stillbirth rate during the period being 5.7 per thousand total births in 2004. The main risk factors for stillbirths include maternal obesity, smoking, and fetal growth restriction (Gardosi et al., 2013).
Stillbirths and neonatal mortality rates are an indicator within the NHS Outcomes Framework 2014/15, measuring the number of deaths in new born babies younger than 28 days in England. The Department of Health (DH), together with the stillbirth and neonatal death charity (Sands) and a number of important organisations such as NHS England, Public Health England (PHE), the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, are working on an ongoing stillbirth programme. This has included identifying and agreeing the main messages that can be used to raise awareness of the risk factors for stillbirths among pregnant women and health professionals and the actions that can be taken to minimise these risks.
In Wales, a National Stillbirth Working Group was set up within the 1000 Lives Plus programme of work in April 2012, and includes representation of important stakeholders in maternity care. The National Assembly for Wales published a report in 2013 which identified a number of actions to improve the stillbirth rate in Wales. Further information can be found on the 1000 Lives Plus website.Back to table of contents
In 2014, there were 2,689 infant deaths (under 1 year of age) registered in England and Wales, a decrease from 2,767 in 2013. The infant mortality rate (based on death registrations – see background note 8) decreased in 2014 to 3.9 deaths per thousand live births, compared with 4.0 in 2013.
In 2014, the perinatal mortality rate (stillbirths and deaths under 7 days), the neonatal mortality rate (deaths under 28 days) and the postneonatal mortality rate (deaths between 28 days and 1 year) remained the same as in 2013, 6.7 deaths per thousand total births, 2.7 deaths per thousand live births, 1.2 deaths per thousand live births and respectively.
Small fluctuations in the infant mortality rate have occurred over recent years, after a series of larger drops in the early 1980s and again between 1987 and 1991 (Figure 3). Between 1984 and 2014, the infant mortality rate fell by 59%, while the neonatal and postneonatal mortality rates fell by 52% and 69% respectively. Although the overall trend has been one of decreasing rates, the rates of change have not been constant over the period; change in the first decade was nearly twice that in the latter two decades.
There are many established risk factors for infant mortality; prematurity, low birthweight and multiplicity are the most significant in terms of strength of association and consistency. Risk factors are known to vary according to age at death. For example, the effect of low birthweight and prematurity is stronger in the neonatal period than the postneonatal period, while socio-economic status is strongly associated with deaths under 1 year (Oakley, et al., 2009 (720.5 Kb Pdf)).Back to table of contents
On 1 January 2014, ONS changed the software used to code cause of death to a package called IRIS (version 2013). Further information can be found in background note 5.
Cancer accounted for nearly a third (29%) of all deaths registered in 2014, with an age-standardised rate of 3,446 deaths per million population for males and 2,359 deaths per million population for females. For both males and females, cancer was the most common broad cause of death (32% of all male deaths registered in 2014 and 27% of all female deaths registered in 2014). Cancer was also the most common broad cause of death in 2013 (29% of all deaths). Since 2004, death rates for cancer have fallen by 11% for males and 8% for females.
Circulatory diseases, such as heart disease and stroke, accounted for just over a quarter (27%) of all deaths registered in 2014. Between 2004 and 2014, the age-standardised death rates for circulatory diseases fell by 40% to 3,194 deaths per million population for males, and by 42% to 2,102 deaths per million population for females.
Over the course of the 20th century, there have been fairly steady decreases in mortality rates for the main 3 broad disease groups (cancer, circulatory and respiratory) in England and Wales. The reasons for this include improvements in the treatment and diagnosis of these diseases.
There have also been initiatives to improve people's health through better diet and lifestyle, for example, in England, the Department of Health’s “Change4life campaign“, which began in 2009. There have been other high-profile awareness campaigns such as the “Be clear on cancer campaign“, which has been active since January 2010, and “Stoptober“, which runs every October.
In March 2013, DH published Living Well for Longer: National support for local action to reduce premature avoidable mortality. This sets out the actions national partners for health and care, including Government, the National Health Service (NHS) and Public Health England (PHE) would take in 2014/15 to reduce premature avoidable mortality. A report, Living Well for Longer – One Year On has been published on progress towards these commitments. This also explained how the system would continue to prioritise actions towards reductions in premature death as part of mainstream functions.Back to table of contents
Standardised mortality ratios (SMRs) allow for useful comparisons to be made against a national average, as the results take into account differing age structures in the populations of local areas (see background note 4). Local authorities find these ratios useful to gauge how deaths in their area compare with England and Wales as a whole in a given year.
The North East had the highest SMR among the regions of England in 2014, with mortality levels 14 percentage points above the national level. Mortality levels were lowest in London, at 9 percentage points below the national level.
In 2014, the local authority in England with the highest SMR was Middlesbrough (37 percentage points above the national level). The City of London had the lowest (57 percentage points below the national level, although this rate may have low reliability as a measure due to the small number of deaths registered – 28 deaths).
In Wales, Blaenau Gwent had the highest SMR (27 percentage points above the national level) while Monmouthshire had the lowest (12 percentage points below the national level).
It is recognised that there are generally higher levels of deprivation in the north of England than in the south (Department for Communities and Local Government, 2011), and in the Welsh valleys in comparison to counties such as Monmouthshire (Welsh Index of Multiple Deprivation (WIMD), 2014). Increased mortality rates for many causes of death have long been associated with higher levels of deprivation (Romeri et al., 2006 (522.9 Kb Pdf)). This is a reflection of underlying differences in factors such as income deprivation, smoking status and other health-related behaviour. For further information see Life expectancy at birth and at age 65 for local areas in the United Kingdom.Back to table of contents
Infant mortality rates (based on death registrations – see background note 8) vary by region and can fluctuate over time. In 2014, the West Midlands had the highest regional infant mortality rate, with 5.5 deaths per thousand live births. London had the lowest, with 3.1 deaths per thousand live births. Wales had an infant mortality rate of 3.7 deaths per thousand live births.
The variation between different regions may reflect underlying differences in maternal factors such as the mother’s country of birth, socio-economic status and age (for further information, see Child mortality statistics).Back to table of contents
The provisional number of UK deaths registered in 2014 was 570,341 (see background note 2). This is a fall of 1.1% compared with 2013, when there were 576,458 deaths.
Northern Ireland recorded a fall in the number of deaths, decreasing by 1.9% to 14,678 in 2014, from 14,968 in 2013. In Scotland the number of deaths also decreased, from 54,700 in 2013 to 54,239 in 2014 (provisional figure), a fall of 0.8%.Back to table of contents
ONS uses mortality data for the following purposes:
- producing population estimates and population projections at both national and subnational level
- reporting on social and demographic trends
- carrying out further analysis, for example, on life expectancy, health expectancy and by cause of death (including avoidable mortality, drug-related deaths and suicides)
- further analysing infant mortality, where infant deaths are linked to their corresponding birth record, to enable more detailed analyses on characteristics such as age of parents, birthweight, gestational age, ethnicity and whether the child was born as part of a multiple birth
- quality assuring Census estimates
The Department of Health (DH) is an important user of mortality statistics. The Public Health Outcomes Framework sets out the desired outcomes for public health and how these will be measured, while the NHS Outcomes Framework measures performance in the health and care system at a national level. Data from both frameworks are used, for example, to inform policy decisions and to reduce premature mortality from the major causes of death.
The Welsh Government (WG) is another important user of mortality statistics. The Programme for Government sets out the indicators, one of which is 21st Century Healthcare. Data are then used to determine delivery priorities, such as those relating to cancer and circulatory diseases, as outlined in the Wales NHS health delivery plans.
Infant mortality is also seen as an important measure among health outcomes and there is a long established link between social and health inequalities, and infant mortality. Infant mortality continues to take a central role in DH and WG’s work on health inequalities.
Other important users of mortality data are local authorities and other government departments, for planning and resource allocation. The Department for Work and Pensions uses detailed mortality statistics to feed into statistical models they use for pensions and benefits.
Users also include other public sector organisations, such as the Police and the Home Office, who are interested in data on external causes of death. Private sector organisations such as banks, insurance and investment companies, are particularly interested in deaths by single year of age and region to feed into risk estimation. Funeral directors are interested in the number of deaths occurring at the local area level.
Other users include academics, demographers and health researchers who conduct research into trends. Lobby groups and charities use death statistics to support their cause, for example, campaigns against alcohol and drug misuse, or suicide. Organisations such as Eurostat and the UN use death statistics for making international comparisons. The media also report on main trends in mortality.Back to table of contents
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