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How have mortality rates by age changed over the last 50 years?

Comparison of mortality rates by age and sex in 1963 and 2013

Age-specific mortality rates1 in England and Wales are lower for both males and females in 2013 compared with 1963 (Figure 1). These rates provide a more accurate indication of trends than the number of deaths. This is because they take account of the size of the population in each age-sex group, which impacts on the number of deaths. Age-specific mortality rates represent the number of deaths in a particular age-sex group per 1,000 population.

Figure 1. Age-Specific Mortality Rates, 1963 and 2013

England and Wales

Figure 1. Age-Specific Mortality Rates, 1963 and 2013
Source: Office for National Statistics

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In 1963, the male mortality rate remained relatively constant through the younger age groups with the exception of infants (those aged under 1 year) where rates were higher. The rate then began to increase noticeably for those aged 55 and over (Figure 1) and continued to rise through to those aged 85 and over.

Female mortality rates followed a similar pattern to those for males in 1963, but the rate began to increase for those aged 60 and over (Figure 1).

For both males and females the 2013 trend traces that for 1963, but at a consistently lower rate. The mortality rates for infants and those aged 55 and over are notably lower in 2013 than in 1963.

What ages have had the greatest decrease in mortality rates?

Children aged under 10 have had the greatest percentage decrease in mortality rates since 1963. For males aged under 1, 1 to 4 years and 5 to 9 years mortality rates fell by between 80% and 81%. This was similar for female mortality rates for ages under 1 and 1 to 4 years, with decreases of 81% and 75% respectively. Mortality rates for females aged 5 to 9 years decreased by a slightly smaller amount, 67%. 

General improvements in healthcare and more specific improvements in midwifery and neonatal2 intensive care can partially explain the overall fall in the infant mortality rate. There are many established risk factors for infant mortality. Premature births, low birthweight and multiple births are the most significant in terms of strength of association and consistency. These risk factors are known to vary according to age at death. For example, the effect of low birthweight and prematurity is stronger in the neonatal period than the postneonatal3 period, while socio-economic status is strongly associated with infant deaths ( Oakley, et al., 2009 (720.5 Kb Pdf) ).

Infant mortality rates for males remain higher than those for females although the gap has narrowed. This could be due to males being more likely to be born prematurely, or because they have weaker immune systems (Drevensteadt, et al., 2008).

In recent years, the Department of Health have released guidance documents on the National service framework: children, young people and maternity services (2004) and policies such as the Healthy Child Programme: Pregnancy and the first five years of life (2009). These aim to improve health and wellbeing at younger ages and thus work towards reducing child mortality rates. The developments of medicines and vaccines have also aided in the reduction of child mortality rates since 1963.

With people now generally living longer, how much have mortality rates at older ages decreased?

Among males, those aged 65 to 69 have had the largest percentage decrease in mortality rates, with a 69% decline since 1963. For females, the largest percentage decrease (60%) was for those aged 70 to 74. 

Mortality rates at older ages are thought to be improving because of a combination of factors. One major factor is improvements in mortality from circulatory diseases, such as heart disease and strokes. This is partly driven by changing smoking habits and medical and technological advances such as the introduction of statins4 (National Life tables 2011-2013, Mills et al., 2009).

In Great Britain from 1974 to 1990 the percentage of males aged 60 and over smoking was considerably higher than females (44% to 26% respectively in 1974). For the period spanning 1994 to 2012 the percentage of males and females aged over 60 smoking has decreased to similar rates (13% and 12% respectively in 2012) (Opinions and Lifestyle Survey, Smoking Habits Amongst Adults, 2012).

Has the gap narrowed between male and female mortality?

In 1963, male mortality rates at all ages were higher than those for females. In 2013, infant mortality rates remain slightly higher for males, with 4.4 deaths per 1,000 live births compared with 3.5 for females. Mortality rates in 2013 for ages 1 to 4, 5 to 9 and 10 to 14 years were the same for both sexes, whilst male rates were higher for those aged 15 years and over.

For those aged under 1, the mortality rate for males was 1.3 times higher than for females in both 1963 and 2013 (the relative difference in mortality5). But the absolute difference in mortality6 (the difference between the male and female mortality rates) has reduced for infants from 5.3 deaths per 1,000 population in 1963 to 0.9 in 2013.

At older ages the relative difference in mortality between males and females is more notable. In 1963, at ages 55 to 69, male mortality rates were double those for females. By 2013, the relative difference in mortality for these ages had reduced, with mortality rates around 1.5 times higher for males than females. The absolute difference in mortality at these ages also reduced by more than half over the same period.

At ages 85 and over, the relative difference in mortality between males and females has reduced slightly. In 1963, male rates were 1.2 times higher than female rates, compared with 1.1 times higher in 2013. The absolute difference in male and female mortality has reduced from 52.8 deaths per 1,000 population in 1963 to 18.7 in 2013. Mortality rates for this age group are much higher than at other ages and so larger reductions in the absolute number of deaths are required to reduce the relative difference in mortality between males and females.

Reductions in the absolute difference between male and female mortality rates have occurred at all ages with the exception of ages 30 to 39. In contrast reductions in relative mortality have occurred at ages 1 to 14, 20 to 24, 50 to 79 and 85 and over. For those aged under 1 and 80 to 84, there has been no change in relative terms while at ages 15 to 19 and 25 to 49 the relative difference in mortality has increased between males and females.

The general narrowing of the gap between male and female mortality rates can be explained by a number of reasons including improvements in male health leading to a rise in male life expectancy which has increased at a greater rate than for females (National Life tables 2011-2013). Increases in women entering the labour force over the last 50 years are considered to have had an impact on levels of stress, smoking and drinking, leading to changes in the health of females. (General Lifestyle Survey, 2011, Women in the Labour Market, 2013, Steptoe, et al., 1998).

How do the male and female numbers compare?

In 1963, deaths were highest for males aged 70 to 74 years (15% of all male deaths) whereas deaths were highest for females at ages 80 to 84 and 85 and over (each with 18% of all female deaths). By 2013, deaths were highest for both males and females aged 85 and over (29% of all male deaths and 48% of all female deaths).

Age-specific mortality rates have declined but there has been an increase in the number of deaths at older ages due to the increase in the size of the older population. People are living longer and females are generally living longer than males. Please see the National Life tables 2011-2013 for more information.

Where can I find out more?

To find out more about the latest mortality statistics please see Death Registrations Summary Tables, England and Wales. Our website also shows the leading causes for deaths by age and gender. For more information on population change, please see the population change page. If you have any comments or suggestions, please email us at: vsob@ons.gsi.gov.uk.

Notes

1 Age-specific mortality rates are calculated by dividing the number of deaths registered in a particular age-sex group in a calendar year by the mid-year population estimates for that age-sex group. For those aged under 1, mortality rates have been calculated using the number of live births rather than the mid-year population.

2 Neonatal refers to babies aged under 28 days. 

3 Postneonatal refers to babies aged 28 days to 1 year.

4 Statins are a group of medicines that can help lower the level of bad cholesterol in the blood.

5 Relative differences in mortality express how many times larger mortality rates were for those belonging to one sub-population compared to the mortality rates for those in a different sub-population, such as males and females. Relative differences are calculated by dividing the male rate by the female rate.

6 Absolute differences in mortality were calculated by subtracting the female mortality rates from the male rates.

Categories: Population, Mortality Rates, Deaths, Death Registrations, Health and Social Care, Health of the Population, Causes of Death
Content from the Office for National Statistics.
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