Tends in avoidable mortality in England and Wales, 1993-2005

Avoidable mortality is a major public health concern but there has been little consensus among researchers on how it should be defined and reported. In this article two definitions of avoidable mortality are considered. These are used to present trends in avoidable deaths in England and Wales from 1993 to 2005, using two statistical indicators of mortality. Analysis of both definitions shows a substantial decline in causes of mortality that are considered amenable to medical intervention over this period. This article discusses which mortality indicator is most appropriate for measuring avoidable deaths, and highlights key issues in developing a National Statistics definition of avoidable mortality.     

Birthweight and gestational age by ethnic group, England and Wales 2005: introducing new data on births

Low birthweight babies and babies born preterm are at increased risk of morbidity and mortality in the first year of life, as well as in the longer-term. Since information on ethnic group is not recorded at birth registration in England and Wales, it has not been possible to produce routine statistics on birthweight or gestational age by ethnic group. A new system, introduced in 2002, for allocating NHS numbers at birth (NN4B) provided the opportunity to obtain ethnic group information. The NN4B record includes information on the ethnic group of the baby classified according to the 2001 Census categories. This paper presents the first analyses of ethnic differences in birthweight and gestational age at birth for England and Wales as a whole. Utilising NN4B records linked with birth registration records for all births occurring in England and Wales in 2005, birthweight and gestational age distributions, including the percentages low birthweight and preterm, are compared between ethnic groups. The paper also examines how parental socio-demographic circumstances vary by ethnic group.     

Height and mortality in the counties of England and Wales

Average heights of adults and children in the counties of England and Wales were examined using national samples of people born between 1920 and 1970. Although height increased over this 50-year period the differences between counties persisted. Average height in a county is closely related to its pattern of death rates, which were derived from all deaths during 1968-78. Counties with taller populations have lower mortality from chronic bronchitis, rheumatic heart disease, ischaemic heart disease and stroke, and higher mortality from three hormone-related cancers, of the breast, prostate and ovary. The inverse relation of height with bronchitis and cardiovascular disease is further evidence of risk factors acting in early childhood. The positive relation between height and cancers of the breast, ovary and prostate could suggest that promotion of child growth has disadvantages as well as benefits.     

Estimated daily mortality during July 2006 in England and Wales

During July 2006, temperatures in England and Wales triggered the Government to initiate its Heatwave Plan and issue advice to the public on how to keep healthy during hot weather, and guidance to health care professionals on minimising heat-related health risks. This report presents provisional daily mortality during July by age and region, and estimates excess deaths at the hottest times. The high temperatures during July 2006 did not affect mortality in England and Wales to the extent seen in August 2003--the first hot period of July 2006 showed no increase in mortality nationally and there was a 4 per cent increase over baseline mortality in the second hot period (680 excess deaths). This compares to a 16 per cent increase during the August 2003 heat wave.     

Trends in MRSA in England and Wales: analysis of morbidity and mortality data for 1993-2002

This article examines trends in infection and mortality from methicillin-resistant Staphylococcus aureus (MRSA) over the period 1993 to 2002. Trends in the number of deaths where MRSA was mentioned on the death certificate were compared with national reporting of microbiologically-confirmed bacteraemia to the Health Protection Agency Communicable Disease Surveillance Centre (CDSC). Alongside national trends, patterns in the place of death were examined. Both the number of deaths and number of laboratory reports increased substantially over the period examined. MRSA mortality rates increased over 15-fold during the period 1993 to 2002. Reporting rates for bacteraemia increased 24-fold.     

Trends in premature mortality in England and Wales, 1950-2004

Premature mortality is a major public health concern but there has been little consensus among researchers on how it should be defined and reported. In this article four means of measuring early deaths are considered using four different age thresholds to define prematurity. Using these four indicators, trends in premature mortality are reported for England and Wales from 1950 to 2004. All measures show that, however 'premature' is defined, levels of premature mortality have decreased markedly over time. This article discusses which mortality indicator and age threshold would be most appropriate for a measure of premature mortality for use in national mortality statistics for England and Wales.     

Investigation into sudden infant deaths and unascertained infant deaths in England and Wales, 1995-2003

This article investigates whether the decline in the sudden infant death rates and the rise in unascertained death rates during the period 1995-2003 were linked. It concludes that changes in certification practices surrounding sudden infant deaths and unascertained deaths suggest that it is becoming more difficult to distinguish between these two causes of death. In addition, there is a huge overlap in the characteristics of babies whose deaths are certified as sudden infant death and those whose death is unascertained. These terms are to some extent used interchangeably. Based on this evidence it seems appropriate to include both groups in any analysis of unexplained infant deaths.     

Geographical variations in premature mortality in England and Wales, 1981-2006

Levels of premature mortality in England and Wales have declined markedly over time, with the probability of survival to age 75 increasing from 38 to 66 per cent for males, and from 54 to 77 per cent for females, between 1950 and 2004. To assess the application of this measure to monitor premature mortality in sub-national geographical areas, this article presents an analysis of the probability of survival at local authority level. Results for 1981-83 and 2004-06 are presented for Government Office Regions in England, Wales and local authorities in England and Wales. Significant differences in premature mortality are described within, and between, regions. Patterns of probability of survival to age 75 for local authorities are compared with other measures of mortality.