Stalling mortality trends
The importance of mortality measures for understanding population health
Measures of mortality, such as life expectancy and mortality rates, provide a reliable summary of the occurrence of deaths across the whole population. This allows us to track the overall changing health of the population.
Life expectancy provides a summary measure of rates of deaths across a population. Life expectancy is not (as it is sometimes misreported to be) a measure of the average lifespan of someone born today. Rather, period life expectancy at birth measures the average number of years a newborn is expected to live if current age-specific mortality rates continue to apply.
Age-standardised mortality rates allow us to monitor the number of deaths occurring, after accounting for the size of the population at each age and by sex.
In Scotland, life expectancy has consistently improved since the 1800s, with the only exceptions being periods of war (World Wars I and II) and pandemics (Spanish Flu and COVID-19).
Changing trends since 2012
From around 2012, improvements in life expectancy and mortality rates have stalled in the UK (see Chart 1). In contrast, other high-income countries such as Japan and South Korea are still experiencing increasing life expectancy rates.
This ‘stalling’ of improving life expectancy and mortality rates represents an overall UK picture which masks a widening of inequalities. For those living in the most deprived areas of the UK, death rates are actually increasing (see Chart 2 and 3).
All age groups, genders and the vast majority of causes of deaths have been affected by these stalling and worsening trends in mortality.
What is causing these changing trends?
The Glasgow Centre for Population Health’s (GCPH) May 2022 report critically appraised all the evidence for the changing mortality rates and life expectancy trends across Scotland and the rest of the UK. It concluded that the principal driver was the UK Government’s austerity measures. The billions of pounds cut from public services and social security have impacted particularly on the poorest and most vulnerable in society.
Additional factors that may be contributing towards these changing trends include:
- stalled improvements in cardiovascular death rates
- increased drug-related deaths
- increased prevalence of obesity.
However, these possible contributors are related to other factors including austerity, and must be considered not in isolation, but within the context of their own causal mechanisms. It is austerity, which operates at multiple levels, that has likely impacted across causes of deaths and made the most substantial contribution to the overall stalled mortality trends in Scotland and across the UK.
For the full appraisal of the evidence for the stalled mortality trends, see the GCPH ‘Resetting the course for population’ May 2022 report, where an accompanying short animation summarising the evidence can also be accessed.
What needs to be done?
To address these adverse changes in mortality trends and widening health inequalities, the GCPH report recommends an increase in government public spending to ensure that vital public services and the social security system can meet people’s needs. For the full list of detailed recommendations, see Section 6 of the report.
