Public health officials are closely monitoring death rates as mortality among older people has been unexpectedly increasing since the beginning of 2012, HSJ has learned.
Experts are considering whether the shift − bucking a long term trend of falling mortality − may be related to particularly virulent viruses. However, one expert warned it could also be related to cuts to social support services, particularly relied on by older females.
The data is revealed in a deaths tracking report by Public Health England, seen by HSJ.
It said: “During 2012, female mortality [for all ages] increased slightly, while male mortality continued to reduce… Since December 2012, both male and female mortality are estimated to have increased.
“When we focus on mortality over 75, we observe rapidly increasing mortality for both males and females, presenting throughout 2012, and continuing into 2013.
“Female 12 month mortality over 75 is currently higher than in any year since 2009; and April 2013 saw a particularly sharp increase.”
The analysis also looks at “Spearhead” local authorities, which are the most deprived fifth of council areas. It says: “Worryingly, female 75-plus mortality trends appear to have been worse in the Spearhead areas.”
The year 2012 is the first in which mortality has increased since 2003. At that time, the rise was followed by a marked reduction in deaths in 2004, rebalancing the long term trend in England of a fall in mortality and a rise in life expectancy.
However, the PHE report says that, more than halfway through 2013, there has been “if anything, a further deterioration in mortality compared with that observed” in the same period in 2012.
The report, dated 16 July and with figures up to 5 July, said deaths have fallen in the most recent week’s figures, but that in 2013 mortality remains notably high. It also said the Office for National Statistics’ projection of deaths between the middle of 2012 and 2013 was 455,000. A comparison with actual deaths shows that “deaths in England in 2012-13 were 23,400 (5 per cent) above ONS expectations”.
HSJ understands officials monitoring the figures consider them to be “unexpected”, but that they do not yet confirm a change in long term trends. If increased mortality continues through 2013 and into 2014, there will have to be more detailed consideration.
The officials consider the issue to be completely unrelated to recent reports of hospital deaths.
Danny Dorling, professor of human geography at Sheffield University, told HSJ the figures were unusual because “they carried on being high week after week for more than a year”. He said it could have been caused by an “influx of elderly women returning to the UK”.
However he said: “Elevated mortality amongst the elderly… is often about people dying two or five years earlier than would be expected given recent rates. Often [they are] people who are quite ill to begin with.
“It is possible that cuts or freezes to services have a particular bad effect on this group - even cuts and freezes that might appear very minor - because the group is so vulnerable.
“Increased anxiety resulting from knowing you might have to move home or even have no home has long been known to be very damaging for the health of very elderly people. The timing of this recent rising in mortality coincides with the crisis in the funding of a large number of care homes.
“It is worth thinking… who gets left a little longer in A&E than they were left when there was funding growing year on year. Who is most neglected when the carer visiting them has only 15 minutes when they used to have 30?”