October 31, 2019 | News | New Publication

Stagnation of mortality improvement in England and Wales

Long overlooked and recently discovered through a detailed data analysis: young and middle-aged men and women in England and Wales have significantly higher mortality rates than the same age groups in comparable countries since the early 2000s.

The pace of improvement of life expectancy at birth in England and Wales has fallen since 2011. It is now among the lowest compared to a group of high-income countries according to new analyses published in the journal Lancet Public Health.

In the most in-depth study of this negative public-health trend so far, the research team from the Max Planck Institute for Demographic Research Rostock (MPIDR) and the London School of Hygiene & Tropical Medicine (LSHTM), compared mortality and life expectancy in England and Wales from 1970 to 2016 with that of 22 other high income countries. The group of comparator countries were made up of 17 from western Europe, plus Australia, Canada, New Zealand, Japan, and the USA.

From the early 1970s up until 2010, life expectancy for men in England and Wales had followed the average level seen for the group of 22 other countries. However, women in England and Wales over this period lagged behind most of the other high-income countries, falling to 18^th place by the mid-1980s and by 2016 had fallen to 20^th position, with only Denmark, Scotland, and the USA having lower life-expectancy. "The decisive factor for the poor situation of women since the mid-1970s is probably the epidemic of female smoking with its maximum on women born around 1925 which was strongly contributing to mortality in the 1970s-2000s", says Dmitri Jdanov, Head of the Laboratory of Demographic Data at the MPIDR.

Unexpected stagnation for the young and middle aged

In 2011, England and Wales faced an unprecedented for the last 50 years stagnation in life expectancy. Over the 5-years up to 2016 the life expectancy for men increased by just 0.4 years. Women’s life expectancy increased even less, just by 0.1 years. In contrast the average level for the 22 countries increased by 1.0 year for males and 0.7 for females – an appreciably higher rate of increase. A slowing in the rate of increase of life expectancy since 2011 was observed in several of the comparator countries but the trends in England and Wales between 2011 and 2016 are among the worst.

This is what Vladimir Shkolnikov, research scientist at the MPIDR, Dmitri Jdanov, and their colleague David Leon from the LSHTM found in analysis of data from the Human Mortality Database.

The most surprising and unanticipated finding was that mortality rates among men and women between the ages of 25 and 50 years in England and Wales are now 20 to 40 percent higher than the average for the 22 other countries studied. This increasing divergence started in the early 2000s and has gradually gathered pace over the years to 2016.

So far, research has focused primarily on the slowdown of mortality improvement at old ages in the United Kingdom and overlooked the stagnation for the younger population between 25 and 50. Only the new detailed analysis discovered that this age group shows a negative dynamic in comparison with other countries. “Higher mortality among young working-age adults in England and Wales relative to other countries deserves urgent attention”, says Vladimir Shkolnikov.

General scope on human longevity

The researchers considered the slowdown in improvements in life expectancy in England and Wales in the broader context of whether this might be because we are reaching a limit of life expectancy. They noted that this was almost certainly not the case, as there are examples of several countries and broad population groups that have appreciably higher life expectancy than seen in the UK and are continuing to improve.

In particular, life expectancy trends in 2011–16 have not slowed down in Italy, Japan, New Zealand, Norway, and Switzerland, although they had higher life expectancies in 2011 than England and Wales. Life expectancy continues to rise also in highly educated groups in many countries who have higher life expectancies than does any national population. Thus, regardless of what the upper biological limit to longevity might be, people in the UK have a long way to go before they approach any absolute limit.

Original publication

Leon, D., Jdanov, D., Shkolnikov, V.:Trends in life expectancy and age-specific mortality in England and Wales, 1970–2016, in comparison with a set of 22 high-income countries: an analysis of vital statistics data. The Lancet Public Health (2019). DOI: doi.org/10.1016/S2468-2667(19)30177-X