How does age of death vary across England and Wales?

A lack of coordination between the many services involved in end of life care is a major challenge for people and their families. With public expenditure on health care for people at the end of life mostly spent in hospitals, it is vital that the integrated care boards tasked with ensuring these services are provided are working across local health systems to understand people's needs and address gaps in services.

Needs in a given area are largely driven by the age structure of the population, as well as deprivation. Both impact on the illnesses that people live with in their final months and weeks. This in turn affects where people are cared for and where they ultimately die. For example, people who die of cancer are most likely to die at home, people who die of dementia are most likely to die in care homes, and people who die of respiratory disease are most likely to die in hospital.

There is wide variation at local authority level in the proportion of people who die aged under 75 – from 50% in Tower Hamlets, to only 22% in Dorset. In Slough, 45% die under the age of 75, compared with 24% in adjoining Windsor and Maidenhead. The higher proportion of deaths among younger people in cities and more deprived areas reflects the lower proportion of older people in those areas, and higher mortality rates at younger ages. A higher proportion of people who live in cities die in hospital, while fewer die in care homes.

While there are challenges with the national data available about end of life care, many local health systems have linked health and social care data. Along with mortality data, that could be used to identify needs for end of life care and to address gaps – for the benefit of individuals, families and the wider population.