Mortality rates (the number of people who die each year per 100,000 population) give a general measure of the health of a population. They are affected by the quality of health care, but also by a range of wider social, economic and environmental factors.
Avoidable deaths are categorised as those that are either preventable or treatable. A death is considered preventable if it can be avoided through effective public health and primary prevention interventions. On the other hand, a treatable death is a premature death which could be avoided through timely and effective health care interventions, including secondary prevention. While preventable deaths indicate the state of public health, treatable deaths reflect on the availability, accessibility, or quality of health care interventions. They can provide a starting point to assess the quality and effectiveness of health care systems.
The mortality rate from all causes of death in England and Wales fell steadily between 1995 and 2011, from 1,392 deaths per 100,000 population to 979 deaths per 100,000 population. Since then, progress stalled to 925 deaths per 100,000 population in 2019. In 2020, mortality increased sharply to 1048 per 100,000 population, reversing a 15-year trend of declining mortality rates. This may have been caused by the high number of excess deaths during the coronavirus (Covid-19) pandemic, inclusive of deaths directly caused by the SARS-CoV-2 virus and those where it was labelled as a contributing or underlying factor. As of 2021, the mortality rate has reduced once again to 991 per 100,000 population.
Male mortality rates are consistently higher than female mortality rates; however, the gap has narrowed slightly over time. In 1994, the mortality rate for males was 1.5 times higher than for females, while in 2021 it was 1.4 times higher. This is associated with improvements in mortality from cardiovascular disease, which has historically been higher in men, as well as a greater reduction in risk factors such as smoking.
In 2020, approximately 23% of deaths in the UK were considered avoidable (deaths that were either preventable or treatable). Of these, 69% were preventable and the remaining 31% were considered treatable. As with all-cause mortality rates, avoidable mortality rates decreased steadily until 2014, after which improvements stalled for the next five years. The same trend can be observed for both treatable and preventable mortality rates. The surge in avoidable mortality for all four countries in 2020 is likely attributable to the coronavirus (Covid-19) pandemic, which was classified as a preventable source of mortality by the Office for National Statistics.
Avoidable mortality rates vary across the four countries of the UK. In 2020, Scotland had the highest avoidable mortality rate at 336 deaths per 100,000 population, and England had the lowest rate at 257 deaths per 100,000 population. However, it is worth noting that data for Scotland includes deaths of non-residents, which are excluded from the datasets of England, Wales and Northern Ireland.
There is a strong relationship between treatable mortality and deprivation. Treatable mortality rates are consistently higher in more deprived areas, and in the most deprived areas they are higher for men than women. In 2020, the treatable mortality rate was 3.3 times higher for men in the most deprived areas of England (174 deaths per 100,000 men) than in the least deprived areas (52 deaths per 100,000 men). For women, treatable mortality was 2.5 times higher in the most deprived areas (127 deaths per 100,000 women) than in the least deprived areas (50 deaths per 100,000 women).
Although there is a substantial difference in treatable mortality between males and females for those in the most deprived areas, there is little to no gender difference post 2006 for those in the least deprived areas. The treatable mortality rate decreased steadily between 2001 and 2013 for both men and women in all deprivation deciles. The decreases were proportionally greater in the least deprived areas, causing the inequality gap in treatable mortality between the most and least deprived deciles to increase.
Since treatable mortality rates represent deaths that could have been avoided in the presence of optimal quality health care, they can be used to compare health care access and quality across countries. Age-standardised treatable mortality rates have been decreasing over time in most of the comparator countries. The UK performs relatively poorly compared with other OECD countries; in 2019, the UK’s treatable mortality rate was 71 per 100,000, which is higher than that of seven comparator countries for which data is available for that year. The United States has consistently had the highest treatable mortality rate, at 98 per 100,000 in 2020, while Australia had the lowest at 48 per 100,000 in the same year. It is important to note that only 3 of the 19 countries depicted in the graph have available data for 2021, limiting the ability to make international comparisons for the most recent year.
About this data
Mortality rates are calculated as the total number of deaths registered in a calendar year divided by the mid-year population estimate for the respective year. Rates were calculated based on where the death was registered, rather than where the deceased was resident. For more information, see the Office for National Statistics (ONS) Quality and Methodology Information. Age-standardised mortality takes account of differences in size and age distribution of populations to avoid giving excessive weight to one dataset over another and ensure meaningful comparison.
Avoidable mortality has been classified into preventable and treatable mortality based on the Organisation for Economic Co-operation and Development (OECD)-developed internationally recognised definition in 2019. In the UK, this definition was implemented by the ONS in 2020 and updated avoidable mortality rates were published for 2001 to 2019 to allow comparisons over time. The attribution of causes of death to the preventable or treatable category is based on whether it is predominantly prevention or health care interventions that can reduce deaths. For those causes of death that can be both largely prevented and treated once they have occurred, the cause of death is classified as preventable on the rationale that if these diseases are prevented, there would be no need for treatment. For detailed definitions of the causes of death considered to be preventable or amenable, see the OECD’s Avoidable mortality: OECD/Eurostat lists of preventable and treatable causes of death.
Deprivation has been categorised based on the Index of Multiple Deprivation (IMD), a framework that considers factors such as income, employment, education and crime to assign a deprivation index to each small area in England. For more information, see English Indices of Deprivation 2019.
Age-standardised treatable mortality rates were calculated using the OECD/Eurostat list of treatable causes of death. Figures refer to premature mortality (aged under 75). For more information, see Health at a Glance 2019: OECD Indicators.