Monthly mortality analysis, England and Wales: June 2022

Provisional death registration data for England and Wales, broken down by sex, age and country. Includes deaths due to coronavirus (COVID-19) and leading causes of death.

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25 July 2022 12:00

In Figure 3, the mortality rate for deaths due to COVID-19 in Wales in June 2022 was incorrect. This did not affect any other figures and has now been corrected.

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Release date:
25 July 2022

Next release:
23 August 2022

1. Main points

  • In June 2022, there were 41,441 deaths registered in England, 3,261 deaths (8.5%) above the June five-year average (2016 to 2019, and 2021); there were 2,740 deaths registered in Wales, 235 deaths (9.4%) above the June average.
  • The leading cause of death in England in June 2022 was dementia and Alzheimer's disease (10.8% of all deaths); in Wales, the leading cause was ischaemic heart diseases (10.7% of all deaths).
  • Coronavirus (COVID-19) was the 15th leading cause of death in June 2022 in England (accounting for 1.6% of all deaths) and 19th leading cause in Wales (1.4% of all deaths); it was the sixth leading cause for both countries in May 2022.
  • Deaths involving COVID-19 in the UK reached 200,335 between March 2020 and June 2022.
  • Accounting for the population size and age structure, the age-standardised mortality rate (ASMR) for deaths due to COVID-19 decreased significantly between May and June 2022 in England (from 31.3 to 14.0 deaths per 100,000 people) and Wales (from 33.3 to 12.9 deaths per 100,000 people).
  • The year-to-date (January to June) ASMR in 2022 was significantly lower than all years since our data time series began in 2001 (except for 2014 and 2019) in both England (957.3 deaths per 100,000 people) and Wales (1,040.4 deaths per 100,000 people).
  • In Quarter 2 (Apr to June) 2022, symptoms, signs and ill-defined conditions (which includes "old age" and "frailty") remained the most common pre-existing condition mentioned on death certificates for deaths due to COVID-19 in England and Wales (25.2% of all deaths due to COVID-19).

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2. Death registrations and the overall mortality rate for June 2022

Based on provisional data, there were 41,441 deaths registered in England in June 2022. This was 2,755 more deaths than in June 2021 and 3,261 more deaths (8.5%) than the five-year average (2016 to 2019, and 2021). Compared with the previous five-year average (2015 to 2019), there were 3,140 more deaths (8.2%) in June 2022 in England.

In Wales, the provisional number of deaths registered in June 2022 was 2,740. This was 180 more deaths than in June 2021 and 235 more deaths (9.4%) than the five-year average for June. Compared with the previous five-year average (2015 to 2019), there were 206 more deaths (8.1%) in June 2022 in Wales.

The five-year average for 2022 has been provided for 2016 to 2019 and 2021. This moves our five-year average along by a year but does not include the exceptionally high number of deaths seen in 2020. This is so that deaths in 2022 are compared with a five-year average that is up to date (rather than 2015 to 2019) while still being close to representing a usual (non-coronavirus (COVID-19) pandemic) year. For more information, see the Calculating excess deaths section.

Age-standardised mortality rates (ASMRs) are used for comparisons over time rather than numbers of deaths, because ASMRs account for changes to the population size and age structure.

In England, the highest mortality rate for the month of June within our data time series was in 2004 (1,170.7 deaths per 100,000 people). This was statistically significantly higher than the June ASMR in all other years since the start of the data time series in 2001.

Following this, overall mortality rates generally decreased to 814.7 deaths per 100,000 people in June 2019, which was significantly lower than the June ASMR for all other years. The mortality rate subsequently increased significantly in June 2020 (891.0 deaths per 100,000 people), before significantly decreasing in June 2021 to 844.1 deaths per 100,000 people.

In June 2022, the ASMR significantly increased again, to 886.6 deaths per 100,000 people. This pattern in ASMRs over time was similar in both males and females (Figure 1).

In Wales, mortality rates for June have generally decreased over time; from a high of 1,222.3 deaths per 100,000 people in June 2005, to 854.5 deaths per 100,000 people in June 2019, the lowest ASMR since the start of the data time series in 2001.

In June 2020, the ASMR in Wales increased significantly (982.3 deaths per 100,000 people) compared with the previous year. The ASMR decreased in June 2021 (914.3 deaths per 100,000 people), and subsequently increased to 960.3 deaths per 100,000 people in June 2022. However, neither of these changes were significantly different than the year prior. This pattern in ASMRs over time was similar in both males and females (Figure 1).

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3. Deaths due to COVID-19 registered in June 2022

The doctor certifying a death can list all causes in the chain of events that led to the death, and pre-existing conditions that may have contributed to the death. Using this information, we determine an underlying cause of death. More information on this process can be found in our User guide to mortality statistics.

The first deaths involving coronavirus (COVID-19) were registered in England and Wales in March 2020. Since then, COVID-19 was the underlying cause of death in most cases (86.0% in England, 84.8% in Wales).

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In this bulletin, we use the term "due to COVID-19" when referring only to deaths with an underlying cause of death of COVID-19. We use the term "involving COVID-19" when referring to deaths that had COVID-19 mentioned anywhere on the death certificate, whether as an underlying cause or not.

In England, the highest proportion of deaths involving COVID-19 that were also due to COVID-19 was in April 2020 (95.2%), whereas the lowest proportion was in June 2022 (59.0%). In Wales, the highest proportion of deaths involving COVID-19 that were also due to COVID-19 was also in April 2020 (94.1%), whereas the lowest proportion was in June 2021 (42.9%). These proportions generally correspond with periods of low or high numbers of COVID-19 deaths in England and Wales.

The proportion of deaths due to COVID-19 (of all deaths involving COVID-19) decreased between May and June 2022 in England (from 63.1% to 59.0%) and in Wales (from 66.7% to 59.7%).

For more information on our definition of COVID-19 deaths, see the Measuring the data section.

Of the 41,441 deaths registered in June 2022 in England, 1.6% (655 deaths) were due to COVID-19, a smaller proportion than in May 2022 (3.3%). Including all deaths involving COVID-19 (1,110 deaths), this percentage increases to 2.7% of all deaths in England.

In Wales, 1.4% of the 2,740 deaths registered in June 2022 were due to COVID-19 (37 deaths), a smaller proportion than in May 2022 (3.3%). Including all deaths involving COVID-19 (62 deaths), this percentage increases to 2.3% of all deaths in Wales.

Mortality rates for deaths due to COVID-19

When adjusting for the size and age structure of the population, age-standardised mortality rates (ASMRs) for deaths due to COVID-19 in England for June 2022 showed statistically significant decreases compared with May 2022 (Figure 3). The ASMR for deaths due to COVID-19 in England decreased to 14.0 deaths per 100,000 people in June 2022, over half the mortality rate of May 2022 (31.3 deaths per 100,000 people). This was the lowest mortality rate for deaths due to COVID-19 in England since June 2021 (8.6 deaths per 100,000 people).

In Wales, the ASMR also halved, significantly decreasing to 12.9 deaths per 100,000 people in June 2022 (compared with 33.3 deaths per 100,000 people in May 2022). This was the lowest mortality rate for deaths due to COVID-19 in Wales since July 2021 (11.6 deaths per 100,000 people).

In England, the ASMR for deaths due to COVID-19 in June 2022 significantly decreased for males (18.6 deaths per 100,000 males), compared with May 2022 (40.9 deaths per 100,000 males). The ASMR for deaths due to COVID-19 also significantly decreased for females in June 2022 (10.6 deaths per 100,000 females) compared with May 2022 (24.6 deaths per 100,000 females).

In Wales, the ASMR for deaths due to COVID-19 in June 2022 significantly decreased for males (11.9 deaths per 100,000 males) compared with May 2022 (43.2 deaths per 100,000 males). However, the rate for June is unreliable (15 deaths) and should therefore be interpreted with caution. The ASMR for deaths due to COVID-19 also decreased for females in June 2022 (13.1 deaths per 100,000 females) compared with May 2022 (25.7 deaths per 100,000 females), but this was not significant.

More information on mortality rates by sex is available in Tables 3a and 3b of our accompanying dataset.

More about coronavirus

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4. Leading causes of death

Figures 4 and 5 show the 10 most common underlying causes of death registered in June 2022, compared with the five-year average for June (2016 to 2019, and 2021), for England and Wales respectively. Causes of death are based on our leading causes of death groupings.

In England, dementia and Alzheimer's disease remained the leading cause of death in June 2022, with 94.7 deaths per 100,000 people (4,477 deaths). In Wales, ischaemic heart diseases remained the leading cause of death, with 102.4 deaths per 100,000 people (294 deaths).

In England, coronavirus (COVID-19) was the 15th leading cause of death in June 2022 (655 deaths), decreasing from the sixth leading cause in May 2022. In Wales, COVID-19 was the 19th leading cause of death in June 2022 (37 deaths), also decreasing from the sixth leading cause in May 2022. For the number of deaths per leading cause of death up until COVID-19 in each country in June 2022, see our related dataset published on our website.

In England in June 2022, 4 of the 10 leading causes of death were statistically significantly lower than the five-year average, and 5 of the 10 leading causes were not statistically significantly different than the five-year average. The mortality rate for symptoms, signs, and ill-defined conditions was statistically significantly higher than the five-year average for the 12th consecutive month in England (15.8% higher). This leading cause group includes mostly deaths with a code for "old age" but is also used for causes such as "frailty".

As in previous months, the mortality rate for deaths with an underlying cause of influenza and pneumonia was significantly lower in June 2022 than the five-year average for June (19.8% lower). This may be a mortality displacement effect, whereby people who would usually have died from influenza and pneumonia are dying due to other causes, such as COVID-19.

In Wales in June 2022, cerebrovascular diseases were the only leading cause of death that was statistically significantly lower than the five-year average (22.9% lower). All nine of the other remaining leading causes were not significantly different from the five-year average, including deaths due to influenza and pneumonia.

This is the first time that the mortality rate for influenza and pneumonia has not been significantly below the average since October 2020. This could be a mortality displacement effect, where these deaths have previously been below average as people are dying due to other causes, such as COVID-19, but deaths are now returning to pre-coronavirus pandemic trends.

Leading causes of death registered in the year-to-date

In the first six months (January to June) of 2022, the leading cause of death in England was dementia and Alzheimer's disease (107.7 deaths per 100,000 people). In Wales, the year-to-date leading cause of death was ischaemic heart diseases (116.8 deaths per 100,000 people).

In England, the year-to-date COVID-19 mortality rate decreased to the fifth leading cause of death (46.7 deaths per 100,000 people) from the third in May 2022. This was statistically significantly lower than the top two leading causes of death (dementia and Alzheimer's disease, and ischaemic heart diseases), and significantly lower than four of the other seven leading causes.

In Wales, deaths due to ischaemic heart diseases, and dementia and Alzheimer's disease were also the top two leading causes of deaths. They were statistically significantly higher than any other cause of death. Deaths due to COVID-19 decreased to the sixth leading cause of death in the year-to-date (46.9 deaths per 100,000 people), from fourth in May 2022. This was significantly higher than all leading causes ranked lower.

More information on the 2022 year-to-date leading causes of death is available in Tables 11a and 11b of our accompanying dataset. More in-depth analysis of leading causes of death is available in our annual publication, based on finalised mortality data.

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5. Deaths registered in the year-to-date

There were 269,013 deaths registered in England and 17,824 in Wales during the first six months (January to June) of 2022.

To gain a better idea of year-to-year differences in mortality rates, we calculated year-to-date age-standardised mortality rates (ASMRs) based on deaths registered in January to June of each year from 2001 to 2022 (Figure 6).

For England, the year-to-date ASMR for 2022 (957.3 deaths per 100,000 people) was statistically significantly lower than all years since our data time series started in 2001. This is except for 2014, which was not significantly different (961.2 deaths per 100,000 people), and 2019, which was significantly lower (949.4 deaths per 100,000 people).

For Wales, the year-to-date ASMR for 2022 was 1,040.4 deaths per 100,000 people. This was statistically significantly lower than all years since our data time series began, except 2014 and 2019 (1,023.1 and 1,031.4 deaths per 100,000 people respectively).

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6. Calculating excess deaths

This bulletin predominantly analyses age-standardised mortality rates (ASMRs) as it enables us to make comparisons across areas and time. This is because ASMRs account for changes in the population and its age structure.

Another useful measure is the number of excess deaths in a particular year. For excess deaths, we compare numbers and rates with a five-year average. This ensures that we are comparing like for like in terms of life expectancy, advances in healthcare, population size and age structure. Averaging over five years removes the fluctuations seen year-on-year. Usually, we use the most recent five years; for example, we compared deaths in 2020 with the five-year average for 2015 to 2019.

Because of the coronavirus (COVID-19) pandemic, 2020 saw the second highest number of deaths since 1838. If this was used to calculate the five-year average, then the number of deaths in the five-year average would be abnormally high and would not be comparable with a "normal" (non-coronavirus pandemic) year.

The further we move away from 2019, the less robust the 2015 to 2019 five-year average becomes. The decision was made for 2022 to move to an average of the following five years: 2016, 2017, 2018, 2019 and 2021. This moves our five-year average along by a year but does not include the exceptionally high number of deaths seen in 2020. It allows deaths in 2022 to be compared with a five-year average that is as up to date as possible, while still being close to representing a "normal" year. However, this does include some COVID-19 deaths, especially at the start of the year when there was a COVID-19 wave.

In June 2022, when considering the 2016 to 2019 and 2021 five-year average, excess deaths in England were 3,261 above what we would expect in a "normal" year (Figure 7). This is compared with 3,140 when using the 2015 to 2019 average. The year-to-date (January to June) excess in England, when using the 2016 to 2019 and 2021 five-year average, was 3,756 above what we would expect. This increases to 7,547 deaths above what we would expect when the 2015 to 2019 average is used.

In Wales in June 2022, there were 235 deaths above what we would expect in a "normal" year, when considering the 2016 to 2019 and 2021 five-year average (Figure 8). This decreases to 206 excess deaths when the 2015 to 2019 five-year average is used. The year-to-date excess in Wales, when using the 2016 to 2019 and 2021 five-year average, was 148 deaths above what we would expect. This is compared with 240 deaths above when using the 2015 to 2019 average.

This is the first time both year-to-date excess deaths have been above average in Wales regardless of which five-year average is used. In Wales, the difference in year-to-date excess deaths between the two averages remained relatively similar (92 deaths difference) in June 2022 compared with May (120 deaths difference).

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7. Death occurrences in June 2022 and year-to-date

This section is based on the date a death occurred, rather than the date of registration used in the previous sections, to monitor current mortality trends. Further information can be found in the Measuring the data section.

In England, 34,619 deaths occurred in June 2022 (and were registered by 7 July 2022). This was 2,255 fewer deaths than the five-year average (2016 to 2019, and 2021) for June (6.1% lower). In June 2022, of all deaths that occurred, 585 deaths (1.7%) were due to coronavirus (COVID-19); this is a 43.1% decrease compared with May 2022.

In Wales, 2,390 deaths occurred in June 2022 (and were registered by 7 July 2022). This was 45 fewer deaths than the five-year average (1.8% lower). Of all deaths that occurred in June 2022, 37 deaths (1.5%) were due to COVID-19; this is a 44.8% decrease compared with May 2022.

The first death due to COVID-19 occurred on 30 January 2020 in England and 15 March 2020 in Wales. Figures 9 and 10 show the trends in COVID-19 death occurrences from March 2020 onwards for England and Wales, respectively.

Figure 9: In England, the number of daily deaths due to COVID-19 has been decreasing since April 2022

Number of deaths occurring on each day from March 2020 to June 2022, five-year average and range, England

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Notes:
  1. Figures are for deaths occurring on each day rather than deaths registered, registered up to 7 July 2022. Death occurrences will increase as more deaths are registered, particularly for later dates.

  2. Figures for 2021 and 2022 (including deaths that occurred in previous years but were registered in 2021 or 2022) are based on provisional mortality data.

  3. Figures exclude non-residents.

  4. "COVID-19" includes only deaths where COVID-19 was the underlying cause.

  5. This chart includes deaths from 1 March 2020. Three deaths due to COVID-19 occurred prior to this in England (one death in January 2020 and two deaths in February 2020), but are not included here.

  6. For deaths occurring in 2020 and 2021 the five-year average consists of deaths occurring between 2015 and 2019, whereas for deaths occurring in 2022 the five-year average consists of deaths occurring between 2016 and 2019 and 2021.

  7. The five-year average for 2022 has been provided for 2016 to 2019 and 2021, because of the impact of the coronavirus pandemic on deaths occurring in 2020. This provides an up-to-date comparison (rather than 2015 to 2019) of the number of deaths expected per day in a usual (non-coronavirus pandemic) year.

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Figure 10: In Wales, the number of daily deaths due to COVID-19 has been decreasing since April 2022

Number of deaths occurring on each day from March 2020 to June 2022, five-year average and range, Wales

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Notes:
  1. Figures are for deaths occurring on each day rather than deaths registered, registered up to 7 July 2022. Death occurrences will increase as more deaths are registered, particularly for later dates.

  2. Figures for 2021 and 2022 (including deaths that occurred in previous years but were registered in 2021 or 2022) are based on provisional mortality data.

  3. Figures exclude non-residents.

  4. "COVID-19 deaths" include only deaths where COVID-19 was the underlying cause.

  5. For deaths occurring in 2020 and 2021 the five-year average consists of deaths occurring between 2015 and 2019, whereas for deaths occurring in 2022 the five-year average consists of deaths occurring between 2016 and 2019 and 2021.

  6. The five-year average for 2022 has been provided for 2016 to 2019 and 2021, because of the impact of the coronavirus pandemic on deaths occurring in 2020. This provides an up-to-date comparison (rather than 2015 to 2019) of the number of deaths expected per day in a usual (non-coronavirus pandemic) year.

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It is important to note that the number of death occurrences is incomplete because it is likely that more deaths need to be registered. Therefore, comparisons should be treated with caution.

In particular, instances where the number of death occurrences on each day in June was below the range of the last five years are likely to be a result of when the data extract was created. Specifically, deaths that occurred towards the end of the month may not have been registered by the time the data extract was created. We would therefore expect the number of death occurrences to be higher in future releases.

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8. Pre-existing conditions of people whose death was due to COVID-19, deaths registered in April to June 2022

In this section, we use the multiple health conditions that can be recorded on a death certificate to identify deaths where there were pre-existing health conditions that contributed to the cause of death where death was due to coronavirus (COVID-19). Health conditions are recorded on the death certificate only if the certifying doctor or coroner believed they made some contribution to the death, directly or indirectly. The death certificate does not include all health conditions from which the deceased might have suffered if they were not considered relevant. However, the fact that a pre-existing condition was recorded does not suggest that the deceased was likely to have died from that condition in the absence of the COVID-19 infection.

This section analyses data from Quarter 2 (Apr to June) 2022, whereas the rest of the bulletin focuses on the month of June 2022.

This analysis of pre-existing conditions covers England and Wales as a whole. This is because of the small number of deaths due to COVID-19 in Wales in Quarter 2 (309 deaths). We will continue to monitor this and provide analysis if the number of deaths in Wales increases.

When comparing pre-existing conditions for COVID-19 deaths in Quarter 2 with Quarter 1 (Jan to Mar), the top 20 most common pre-existing conditions remained consistent, but varied in ranking. Symptoms, signs, and ill-defined conditions, which includes "old age" and "frailty", remained the most common pre-existing condition mentioned in Quarter 2 (25.2%), followed by dementia and Alzheimer's disease as the second most common at 17.1%.

In addition, patterns in the proportion of COVID-19 deaths for each age group in Quarter 2 followed the same trajectory as seen in Quarter 1. The proportion of deaths due to COVID-19 among those aged 0 to 64 years continued to decrease (7.6% in Quarter 2 compared with 12.6% in Quarter 1), whereas the proportion among those aged 65 years and over continued to increase (92.4% in Quarter 2 compared with 87.4% in Quarter 1). Overall, the proportion of COVID-19 deaths with no pre-existing conditions decreased from 13.9% in Quarter 1 to 12.1% in Quarter 2. However, the average number of different pre-existing conditions per COVID-19 death remained at 2.0 in Quarter 2, consistent with Quarter 1.

In Quarter 2, symptoms, signs, and ill-defined conditions remained the most common pre-existing condition for deaths due to COVID-19 occurring in hospitals (27.4%, an increase from 23.9% in Quarter 1). Dementia and Alzheimer's disease remained the most common pre-existing condition for deaths occurring in care homes (40.8%, a decrease from 42.8% in Quarter 1).

Chronic lower respiratory diseases remained the most common pre-existing condition of COVID-19 deaths occurring in private homes, with the proportion decreasing from 14.8% in Quarter 1 to 12.8% in Quarter 2.

For further analysis of pre-existing conditions of people whose death was due to COVID-19 in Quarter 2 2022 for England and Wales, see our accompanying dataset.

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9. Monthly mortality data

Monthly mortality analysis, England and Wales
Dataset | Released 25 July 2022
Provisional data on death registrations and death occurrences in England and Wales, broken down by sex and age. Includes deaths due to coronavirus (COVID-19) by date of death occurrence, and comparisons of COVID-19 with the leading causes of death.

Deaths due to COVID-19 by English region and Welsh health board
Dataset | Released 25 July 2022
Provisional age-standardised mortality rates for deaths due to COVID-19 by age, sex, local authority and deprivation indices, and numbers of deaths by Middle layer Super Output Area.

Deaths involving COVID-19 by month of registration, UK
Dataset | Released 25 July 2022
Provisional age-standardised mortality rates for deaths involving COVID-19 by sex and month of death registration, for England, Wales, Scotland and Northern Ireland.

Deaths registered monthly in England and Wales
Dataset | Released 25 July 2022
Number of deaths registered each month by area of usual residence for England and Wales, by region, county, local and unitary authority, and London borough.

Single year of age and average age of death of people whose death was due to or involved COVID-19
Dataset | Released on 25 July 2022
Provisional deaths registration data for single year of age and average age of death (median and mean) of persons whose death involved coronavirus (COVID-19), England and Wales. Includes deaths due to COVID-19 and breakdowns by sex.

Pre-existing conditions of people who died due to COVID-19, England and Wales
Dataset | Released 25 July 2022
Pre-existing conditions of people who died due to COVID-19, broken down by country, broad age group, and place of death occurrence, usual residents of England and Wales.

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10. Glossary

Age-specific mortality rates

Age-specific mortality rates are used to allow comparisons between specified age groups.

Age-standardised mortality rates

Age-standardised mortality rates (ASMRs) are used to allow comparisons between populations that may contain different proportions of people of different ages. The 2013 European Standard Population is used to standardise rates. In this bulletin, we have adjusted the monthly ASMRs to allow for comparisons with annual rates. For more information see the Measuring the data section.

Coronaviruses

The World Health Organization (WHO) defines coronaviruses as "a large family of viruses that are known to cause illness ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS)". Between 2001 and 2018, there were 12 deaths in England and Wales due to a coronavirus infection, with a further 13 deaths mentioning the virus as a contributory factor on the death certificate.

Coronavirus (COVID-19)

COVID-19 refers to the "coronavirus disease 2019" and is a disease that can affect the lungs and airways. It is caused by a type of coronavirus. Further information about coronavirus (COVID-19) disease is available from the WHO.

Pre-existing condition

A pre-existing condition is defined as any condition that either preceded the disease of interest (for example, COVID-19) in the sequence of events leading to death, or was a contributory factor in the death but not part of the causal sequence.

More information on the pre-existing conditions methodology is available in our accompanying dataset.

Registration delay

Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration, a legal requirement. According to the Births and Deaths Registration Act 1953, a death should be registered within five days unless it is referred to a coroner for investigation. Mortality statistics for a given time period can be based on occurrence (death date) or registration (registration date); registration delay is the difference between date of occurrence and date of registration.

Statistical significance

The term "significant" refers to statistically significant changes or differences. Significance has been determined using the 95% confidence intervals, where instances of non-overlapping confidence intervals between estimates indicate the difference is unlikely to have arisen from random fluctuation.

95% confidence intervals

A confidence interval is a measure of the uncertainty around a specific estimate. If a confidence interval is 95%, it is expected that the interval will contain the true value on 95 occasions if repeated 100 times. As intervals around estimates widen, the level of uncertainty about where the true value lies increases. The size of the interval around the estimate is strongly related to the number of deaths, prevalence of health states and the size of the underlying population. At a national level, the overall level of error will be small compared with the error associated with a local area or a specific age and sex breakdown. More information is available on our uncertainty pages.

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11. Measuring the data

This bulletin provides timely surveillance of mortality in England and Wales, based on the best available provisional data, including all-cause mortality and coronavirus (COVID-19) deaths.

Analysis contains deaths registered in June 2022 by age and sex, and also includes deaths that occurred in June 2022 by date of death. Non-residents of England and Wales are excluded. In June 2022, there were 104 deaths of non-residents that were registered in England and Wales.

Data sources

This bulletin is based primarily on death registrations. Analysis by month of death registration is consistent with the weekly death registrations bulletin and allows for a more timely analysis than would be possible using death occurrences. There is a section on death occurrences for surveillance of recent mortality trends. Death occurrences show the number of deaths that occurred within a calendar period and give a better indication of exactly when deaths were at their highest. This allows mortality to be related to other factors such as weather patterns.

A provisional extract of death registrations and death occurrences data is taken on the first working day after the eighth of the month, to allow time for deaths to be registered. For more detail on the data sources used, see our methodology article.

Definition of COVID-19 deaths

We use the term "due to COVID-19" when referring only to deaths with an underlying cause of death of COVID-19. When considering all of the deaths that had COVID-19 mentioned anywhere on the death certificate, whether as an underlying cause or not, we use the term "involving COVID-19". The International Classification of Diseases (ICD-10) codes used to define COVID-19 are:

  • U07.1: COVID-19, virus identified
  • U07.2: COVID-19, virus not identified
  • U09.9: post-COVID condition, unspecified (this cannot be assigned to the underlying cause of death so is not included in the "deaths due to COVID-19" definition)
  • U10.9: multisystem inflammatory syndrome associated with COVID-19, unspecified

Our definition of COVID-19 (regardless of whether it was the underlying cause or mentioned elsewhere on the death certificate) includes some cases where the certifying doctor suspected the death involved COVID-19 but was not certain (U07.2). For example, a doctor may have clinically diagnosed COVID-19 based on symptoms but this diagnosis may not have been confirmed with a test, so they may write "suspected COVID-19" on the death certificate. Of the 154,847 deaths due to COVID-19, 4,156 (2.7%) were classified as "suspected" COVID-19. Including all 180,366 deaths involving COVID-19, "suspected" COVID-19 was recorded on 4,789 deaths (2.7%) of all deaths involving COVID-19 in England and Wales (excluding non-residents). For more information on the ICD-10 definition of COVID-19, see our methodology article.

There are several ICD-10 codes not included in our definitions of deaths due to COVID-19 and deaths involving COVID-19. These are:

  • U08.9: personal history of COVID-19, unspecified
  • U11.9: need for immunisation against COVID-19, unspecified
  • U12.9: COVID-19 vaccines causing adverse effects in therapeutic use, unspecified

Table 12 and 13 of our accompanying datasets provide figures of each COVID-19 ICD-10 code registered since March 2020. Our figures usually consist of first registrations only. On occasion, and after further investigation, a death can be re-registered as a different cause of death. For transparency of our statistics, these tables include re-registrations as well as initial registrations; all other figures remain as first registration only.

Monthly mortality rates

To calculate monthly mortality rates that are comparable with annual rates, adjustments must be made to annual population estimates to account for the time period covered. Our methodology article provides more detail on how this is calculated.

Acknowledgement

We would like to thank Andreas Christofi, Heidi Wilson, Alex Cooke and Paul Brown for their valued contribution to this bulletin.

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12. Strengths and limitations

Provisional data are used

Provisional death registrations and death occurrences data are used in this bulletin. This enables timely analysis to be completed to monitor mortality trends. However, as the data for 2021 and 2022 are provisional, they are subject to change.

Data coverage, timeliness and registration delays

Mortality data give complete population coverage. They ensure the estimates are of high precision and representative of the underlying population at risk. However, because of registration delays, monthly death occurrence data are always somewhat incomplete. This is especially true for deaths that occurred towards the end of the month.

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in our Mortality statistics in England and Wales Quality and Methodology Information and our User guide to mortality statistics.

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Contact details for this Statistical bulletin

Health Statistics and Research
health.data@ons.gov.uk
Telephone: +44 1329 444110