National public health officials have said they will further investigate falls in life expectancy among older people, after finding it was ‘too early’ to conclude they had stopped living for longer.
Public Health England’s report follows concerns being raised about falling life expectancy for 85-year-olds in recent years in some areas, as revealed by HSJ last month.
The report, due to be published imminently and seen by HSJ, confirms “a small fall in female life expectancy at age 65, 75, 85 and 95 in 2012 compared with 2011, and a small fall in male life expectancy at ages 85 and 95”.
It says: “On the whole, data for 2013 does not show any further falls, although for some age groups there was not a return to 2011 levels, which were the highest to date.
“The upward trend in life expectancy in recent years has also flattened in some English regions,” the report said. This is against a background of “an overall upward trend in life expectancy” for over 65s and in older age groups “since the early 1980s”.
The report says PHE’s analysis “suggests it is too early to conclude that there has been a significant change in the overall upward trend in life expectancy at older ages”. It notes a “fall in life expectancy at older ages in 2012 was also seen in many other European countries”, and that there have been fluctuations in the past.
The research considers potential causes including statistical anomaly, weather and “the level of influenza type illness” for the 2012 fall but suggests none of these explain it entirely. It also acknowledges “the economic recession” as a potential cause for a Europe-wide decrease.
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The report says the “first step towards any explanation is to monitor the trend to see whether any further falls in life expectancy occur, and if so at what ages and in which areas”.
“PHE will continue to monitor these trends closely and will report on the figures for 2014 as soon as they are available,” it says. The organisation “is planning further analysis of these recent trends”, and will “be inviting external experts to join a steering group for this work and publishing the results”.
The analysis finds no regional trends across England and says there “does not appear to be a relationship” with an area’s deprivation.
A Q&A document produced with the report, also seen by HSJ, states: “This report has not looked at social care cuts and their influences on health.”
Social care cuts were one of the potential causes considered by Blackburn with Darwen Council’s public health director Dominic Harrison, who first raised concern about the issue in December.
He said in a statement on the PHE’s report: “I’m very pleased that [PHE] published this initial analysis… The data confirms our local concerns.”
It was “a sentinel warning [which] confirms that in a significant number of English local authorities, the old are no longer getting older, and I agree with [PHE’s] conclusion that we urgently need find out why”, he said.
Mr Harrison added: “However, the report has not looked at any relationship [with] cuts in adult social care… Over the last 10 years, [these] budgets in England have been cut by 20 per cent and since 2010, funding for meals on wheels services by 63 per cent.
“It is an unlikely, improbable and a frankly heroic assumption to assume that cuts such as these will have no effect at all on frail elderly populations over 85-years-old.”
UK Faculty of Public Health vice president John Middleton said the further research should consider “cold related health risks, availability of social support and care and impacts of welfare reform [which] cannot be ruled out as contributors to this reduction in life expectancy”. Other factors to consider include “long term cohort effects” such as “the effect of the 1980s recession on the health of people then in their 50s but dying before their time at 85”, and “the after effects of the H1N1 [influenza] pandemic” which may have had the effect of “shifting population susceptibility to other flu viruses”.
PHE: More deaths than expected in January
Recent weeks have seen significantly more deaths than normal and expected, according to Public Health England.
These recent deaths are not the subject of the report described above.
PHE’s latest weekly monitoring report, covering the final week of January, notes that “significant excess mortality has been seen in England from week 50 [beginning 8 December] to 5 [the final week of January] 2015, coinciding with circulating influenza and the recent cold snaps”.
“Excess” deaths have been recorded across most age groups in some weeks since 8 December, and in every week for those 65 and older.