Age-standardised mortality rates are calculated for vaccination status groups using the Public Health Data Asset (PHDA) dataset. The PHDA is a linked dataset combining the 2011 Census, the General Practice Extraction Service (GPES) data for pandemic planning and research, and the Hospital Episode Statistics (HES). We linked vaccination data from the National Immunisation Management Service (NIMS) to the PHDA based on NHS number, and linked data on positive coronavirus (COVID-19) Polymerase Chain Reaction (PCR) tests from Test and Trace to the PHDA, also based on NHS number.
The PHDA dataset contains a subset of the population and allows for analyses to be carried out that require a known living population with known characteristics. These characteristics include age-standardised mortality rates (ASMRs) by vaccination status and the use of variables such as health conditions and census characteristics.
In 1989, only 12.4% of the population was age 65 or older. In 2019, we had 16.5% of the population in that age bucket.
The changing age structure means that one can have mortality rates trending down for all ages, but the crude death rate climbs because the population is getting older. It’s definitely driven by people living longer (due to those lower mortality rates), but also driven by fewer babies being born.
The observation that downward mortality trends have reversed in recent years for some groups of Americans is not new. Economists Ann Case and Angus Deaton helped start the discussion with their 2015 paper on rising mortality among middle-aged, non-Hispanic White Americans, and subsequently gave the phenomenon a resonant name: “deaths of despair.” Research has also identified those without college degrees and rural Americans as especially troubled.
In March, a National Academies of Sciences, Engineering, and Medicine committee summed up the current state of knowledge in a 475-page report on “High and Rising Mortality Rates Among Working-Age Adults.” Advances in overall life expectancy stalled in the U.S. after 2010 even while continuing in other wealthy countries, the committee summed up, attributing this mainly to (1) rising mortality due to external causes such as drugs, alcohol and suicide among those aged 25 through 64 and (2) a slowing in declines in deaths from internal causes, chiefly cardiovascular diseases.
The aim of this site is to give comprehensible information about trends for cause-specific mortality in different population. Charts may be viewed or downloaded after choice of population, age group and cause of death group. The measures shown in the charts have been calculated using open data from WHO (2017), but the WHO are not responsible for any content on the site. For some countries where population is not available from WHO (2017) for recent years, estimates from United Nations Department of Economic and Social Affairs, Population Division (2015) is used instead.
There are several other websites with visualizations of mortality trends. One of the most advanced is IHME (2015), which contains data for all countries in the world, and uses complicated algorithms to adjust for uncertainties in the underlying data. On this website, the charts are generated dynamically, and the sites may sometimes be slow. Moreover, the visualizations do not go further back in time than 1980, while WHO (2017) has data available from 1950, for several populations. Whitlock (2012) is a website with a great number of static charts based on WHO (2017). This website is no longer maintained, however, because its creator has died.
According to Centers for Disease Control (CDC) data, the age-adjusted COVID-19 mortality rate is now higher for AIAN people than for any other group (Figure 1); it is almost two and a half times the death rate for whites and Asians. Figure 1 also shows that the disparities for Blacks and Hispanics/Latinos relative to whites, that we identified in June, remain substantial. (That post also explains why it is important to adjust for age when comparing across groups.)