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Related to: Births and Fertility, Socio-economic Inequality, Excess Winter Deaths, Life Expectancy, Ageing Population, Wellbeing, Children and Young People

Caused by: Major Causes of Mortality

Key Facts

  • All-Cause mortality in Bath and North East Somerset has decreased from 1,236 per 100,000 in 1995 to 908 per 100,000 in 2013.
  • In B&NES 2013 all cause mortality rate was lower than the South West (931 per 100,000) and England (979 per 100,000).
  • All cause mortality rates are lower in women than men in B&NES, the South West, and England.
  • The rate of all-cause mortality in under 75’s in B&NES decreased from 459.31 per 100,000 in 1995 to 288.78 per 100,000 in 2013.
  • The B&NES 2013 all cause mortality rate for the under 75s was lower than the South West (308.59 per 100,000) and England (337.97 per 100,000).
  • All cause mortality rates for the under 75s in 2013 were lower in women than men in B&NES, the South West, and England.
  • Rates of preventable deaths have been decreasing in B&NES, the South West and England. In B&NES they have decreased from 181.4 per 100,000 in 2001-03 to 147.3 per 100,000 in 2011-13. Rates in B&NES have been lower than the South West and England.
  • There is a significant relationship between mortality and Socio-economic Inequality
  • The infant mortality rate in B&NES has decreased, from 2.3 per 1,000 live births in 2008-10 to 1.3 per 1,000 of live births in 2011-13 and were lower than the South West and England.

What does the data say?

All-cause mortality in B&NES decreased from 1,236 per 100,000 in 1995 to 908 per 100,000 in 2013, a percentage decrease of 27%; this downward trend is reflected in England and the cluster average as Life Expectancy increases and people live longer. 1  

B&NES 2013 all-cause mortality rate was lower than the South West (931 per 100,000) and England (979 per 100,000). 2  

All-cause mortality rates are lower in women than men in B&NES, the South West, and England. However, the gap is larger nationally.

 

Males

Females

B&NES

1,058.15

790.66

South West

1,095.41

802.02

England

1,149.65

847.14

Table 1: 2013 Directly age standardised mortality rates per 100,000 for males and females 3 

Under 75s

The rate of all-cause mortality in under 75’s in B&NES has also decreased, from 459.31 per 100,000 in 1995 to 288.78 per 100,000 in 2013. 4 

The B&NES 2013 all cause mortality rate for the under 75s was lower than the South West (308.59 per 100,000) and England (337.97 per 100,000). 5 

All cause mortality rates for the under 75s in 2013 were lower in women than men in B&NES, the South West, and England. However, the gap is larger nationally.

 

Males

Females

B&NES

346.75

234.12

South West

380.03

240.82

England

412.41

267.43

Table 2: 2013 Directly age standardised mortality rates per 100,000 for under 75 year olds - males and females 6 

Preventable deaths 7.

As with the South West and England, rates of preventable deaths in B&NES have been decreasing, from 181.4 per 100,000 in 2001-03 to 147.3 per 100,000 in 2011-13.

Rates of preventable deaths in B&NES in 2011-13 were lower than in the South West (165.2 per 100,000) and England (183.9 per 100,000).

Mortality from causes amendable to healthcare

Mortality from causes amendable to healthcare in B&NES in 2011 was significantly lower than England average 8

CCG post-operative survival rates

Figure 1: shows survival rates post discharge for different age groups for BANES spells (note not patients).

B&NES CCG has a near 100% 12 month post-operative survival rate for patients aged under 45.

Survival rates drop of faster with age, to under 85% at 12 months for patients aged 75+.

Socio-economic Inequality

There are significant inequalities in Life Expectancy between the most and least deprived residents of B&NES.  For a someone living in the most deprived area of B&NES, they can expect to die at a younger age than someone in the most affluent area of B&NES (9.2 years for men and 5.2 years for women).

Infant and child mortality

Infant mortality rates in rich countries comparative overview 9

In Unicef’s 2013 infant mortality in rich countries comparative overview, Unicef’s compares 29 of the world’s most advanced economies.

According to Unicef’s report the UK’s average infant mortality rate is 4.4 deaths under 12 months old per 1,000 live births. This is in the bottom third of the league table of the 29 countries. The two other richest countries in the bottom third are Canada and the United States. The only countries with infant mortality rates higher than 6 per 1,000 births are: Latvia, Romania, Slovakia and the United States. In contrast, three Nordic countries – Finland, Iceland and Sweden – plus Luxembourg and Slovenia – head the table with infant mortality rates of fewer than 2.5 deaths per 1,000 births.

It is possible that the low ranking of the United States in the league table of infant mortality is not justified: there is an as yet unresolved debate about whether infant mortality rates in the United States might include the deaths of extremely premature and/or low birth weight babies who are kept alive for a time by advanced neonatal care but who, in other countries, might not be classified as ‘live births’.

The UK’s average child and youth mortality rate is 17 deaths per 100,000 aged 1 to 19, 11th in the table. Iceland, Luxembourg, the Netherlands, Spain, Sweden and Switzerland head the table with child death rates below 15 per 100,000. Romania, Latvia and Lithuania have the highest rates of child and youth mortality, all with rates higher than 30 per 100,000 aged 1 to 19. In absolute numbers, the differences between countries are small. But it is worth noting that if all European countries had the same child death rate as Iceland or Luxembourg then over 8,000 child deaths a year could be prevented

Bath and North East Somerset  10 11

The infant mortality rate in B&NES has decreased, from 2.3 per 1,000 live births in 2008-10 to 1.3 per 1,000 of live births in 2011-13. Infant mortality rates in B&NES in 2011-13 were lower than the South West (3.5 per 1,000 live births) and England (4.0 per 1,000 live births).

The child mortality (1-17 years) rate in B&NES has increased, from 9.6 per 100,000 of 1-17 year old population in 2010-12 to 12.3 in 2011-13. The child mortality rates in B&NES in 2011-13 were higher than the South West (11.2 per 100,000 1-17 year olds) and England (11.9 per 100,000 1-17 year olds).

Are we meeting the needs?

The number of patients who died following treatment at the Royal United Hospital in Bath in 2013/14 (1,830) was lower than the number expected to die (1,925) given the hospitals caseload and case-mix. 12