Summer 2006
NO 30
Health Statistics Quarterly
In this issue
Page
In brief
3
Recent publications
4
Health indicators
5
Trends in mortality from Alzheimer’s disease, Parkinson’s disease and dementia,
England and Wales, 1979–2004
6
Examines trends in mortality from dementia, Alzheimer’s disease and Parkinson’s disease in
England and Wales, 1979–2004.
&ODUH*ULI¿WKVDQG&OHR5RRQH\
Risk factors for low birthweight based on birth registration and census information,
England and Wales, 1981–2000
15
Examines whether there are socio-demographic factors (collected at census) that are not routinely available
at birth registration that help to explain low birthweight in England and Wales.
$OHNV&ROOLQJZRRG%DNHRDQG/\QGD&ODUNH
Tables
List of tables
Notes to tables
Tables 1.1–6.3
22
23
24
Reports:
Death registrations in England and Wales, 2005: causes
Deaths involving &ORVWULGLXPGLI¿FLOH: England and Wales, 1999–2004
46
56
About the Office for National Statistics
The Office for National Statistics (ONS) is the Government
Agency responsible for compiling, analysing and disseminating
many of the United Kingdom’s economic, social and
demographic statistics, including the retail prices index, trade
figures and labour market data, as well as the periodic census
of the population and health statistics. It is also the agency that
administers the statutory registration of births, marriages and
deaths in England and Wales. The Director of ONS is also the
National Statistician and the Registrar General for England and
Wales.
A National Statistics publication
National Statistics are produced to high professional standards
set out in the National Statistics Code of Practice. They
undergo regular quality assurance reviews to ensure that they
meet customer needs. They are produced free from any political
influence.
About Health Statistics Quarterly and Population Trends
Health Statistics Quarterly and Population Trends are journals of
the Office for National Statistics. Each is published four times
a year in February, May, August and November and March,
June, September and December, respectively. In addition to
bringing together articles on a wide range of population and
health topics, Health Statistics Quarterly and Population Trends
contain regular series of tables on a wide range of subjects for
which ONS is responsible, including the most recently available
statistics.
Subscription
Annual subscription, including postage, is £100; single issues are
£27.50.
Online
Health Statistics Quarterly and Population Trends can be viewed
or downloaded as Adobe Acrobat PDF files from the National
Statistics website www.statistics.gov.uk/products/p6725.asp
(Health Statistics Quarterly) or www.statistics.gov.uk/products/
p6303.asp (Population Trends).
Editorial board
Peter Goldblatt (editor)
Roma Chappell (editor)
Angela Dale
Paul Hyatt
Judith Jones
Azeem Majeed
Jil Matheson
Ian R Scott
Articles: 5,000 words max.
A
er
in
t
W
ut
um
n
er
m
m
Su
Sp
ri
ng
Dates for submissions
Issue
Health Statistics Quarterly by 11 Sept by 11 Dec by 22 Mar by 21 June
Population Trends
People with enquiries about the statistics published regularly in
Health Statistics Quarterly and Population Trends can contact the
following enquiry points.
Topic enquiries
Abortions: 020 7972 5537 (Department of Health)
E-mail: abortion.statistics@dh.gsi.gov.uk
Births: 01329 813758
E-mail: vsob@ons.gsi.gov.uk
Conceptions: 01329 813758
E-mail: vsob@ons.gsi.gov.uk
Expectation of life: 020 7533 5222
E-mail: lifetables@ons.gsi.gov.uk
Marriages and divorces: 01329 813758
E-mail: vsob@ons.gsi.gov.uk
Migration: 01329 813872/813255
Mortality: 01329 813758
E-mail: vsob@ons.gsi.gov.uk
Population estimates: 01329 813318
E-mail: pop.info@ons.gsi.gov.uk
Population projections:
National – 020 7533 5222
E-mail: natpopproj@ons.gsi.gov.uk
Subnational – 01329 813474/813865
General enquiries
National Statistics Customer Contact Centre
Room 1015 Government Buildings
Cardiff Road
Newport NP10 8XG
Tel: 0845 601 3034
E-mail: info@statistics.gsi.gov.uk
Website: www.statistics.gov.uk
© Crown copyright 2006. Published with the permission of the
Controller of Her Majesty’s Stationery Office (HMSO).
Contributions
Title
Contact points at ONS
by 23 Oct
by 2 Feb
Please send to:
Clare Parrish, executive secretary
Health Statistics Quarterly
Office for National Statistics
Zone D2/22
1 Drummond Gate
London SW1V 2QQ
Tel: 020 7533 5125
E-mail: ian. thurman@ons.gsi.gov.uk
Natio n a l S t a t ist ic s
by 4 May
by 26 July
You may re-use this publication (excluding logos) free of charge in
any format for research, private study or internal circulation within
an organisation.You must re-use it accurately and not use it in a
misleading context. The material must be acknowledged as Crown
copyright and you must give the title of the source publication.
Where we have identified any third party copyright material you will
need to obtain permission from the copyright holders concerned.
This publication is also available at the National Statistics website:
www.statistics.gov.uk
For any other use of this material please apply for a Click-Use Licence
for core material at www.opsi.gov.uk/click-use/system/online/pLogin.
asp or by writing to:
Office of Public Sector Information
Information Policy Team
St Clements House
2–16 Colegate
Norwich NR3 1BQ
Fax: 01603 723000
E-mail: hmsolicensing@cabinet-office.x.gsi.gov.uk
ISBN 0-230-00315-X
ISSN 1465-1645
2
in brief
H e a l t h S t a t i s t i cs Q u a r t e r ly 1 3 0
Leading causes of
death in England and
Wales – response to
the consultation
ONS published a consultation document on ranking leading causes of death in England and
Wales on 31 January 2006. Users were invited to comment on the proposals put forward
for future routine tabulation of the leading causes of death. There was a six-week period of
consultation for comments, which ended on 13 March 2006.
ONS proposed in its consultation document
to use a ranking list developed by the World
Health Organization, which split cancers by site
and accidents by mechanism. This list has been
PRGL¿HGVOLJKWO\IRUXVHLQ(QJODQGDQG:DOHV
The responses were on the whole in agreement
with the proposals. Accordingly ONS decided
to continue with its proposal to provide routine
tabulations of the leading causes of death in
England and Wales according to the WHO
proposed ranking list which splits cancers
by site and accidents by mechanism. In the
annual report on death registrations by cause of
death in 2005 (see page 46), this tabulation is
SURYLGHGIRUWKH¿UVWWLPH
Summer 2006
Revision of
stillbirths in
England and
Wales in 2004
It has recently come to light that some register
RI¿FHVLQ(QJODQGDQG:DOHVIDLOHGWRQRWLI\
ONS, in line with regulations, of some
stillbirths that occurred in 2004. The result is
WKDWWKHSHULQDWDOPRUWDOLW\¿JXUHVQXPEHUV
and rates) for 2004 given in reference tables
2.1 and 6.2 in +HDOWK6WDWLVWLFV4XDUWHUO\ (and
in 3RSXODWLRQ7UHQGV) are undercounts. In
addition, the stillbirth and perinatal mortality
¿JXUHVIRUVRPHDUHDVSUHVHQWHGLQWKH5HSRUW
on Infant and perinatal mortality, 2004: health
areas, which was published in +HDOWK6WDWLVWLFV
4XDUWHUO\ 27, Autumn 2005 edition, are
undercounts.
Similarly, the stillbirth and perinatal
PRUWDOLW\¿JXUHVIRUJLYHQLQRWKHU216
publications are also undercounts. These
publications include 0RUWDOLW\VWDWLVWLFV
&KLOGKRRGLQIDQWDQGSHULQDWDO(series
DH3 no.37) published on 28 March 2006, .H\
3RSXODWLRQDQG9LWDO6WDWLVWLFV(series VS
no.31, PP1 no. 27), published on 27 April 2006,
and %LUWKVWDWLVWLFV (series FM1 no. 33)
published on 15 December 2005.
Work is currently underway to ensure all
stillbirths that occurred in both 2004 and
DUHFRUUHFWO\LGHQWL¿HGIRULQFOXVLRQLQ
SXEOLVKHG¿JXUHV216DLPVWRSXEOLVKUHYLVHG
VWLOOELUWKDQGSHULQDWDOPRUWDOLW\¿JXUHVIRU
ZLWKWKHQHZ¿JXUHVIRUDVSDUW
of the report on Infant and perinatal mortality,
2005, scheduled for publication in +HDOWK
6WDWLVWLFV4XDUWHUO\ 31 in August 2006.
3
N a t i o n a l S t a t i s t i cs
He al th Stati sti cs Q u a r t e rly 1 3 0
Summer 2006
Recent publications
Key Population and Vital Statistics, 2004 Series VS No. 31, PP1 No. 27 Regional Trends 39 3DOJUDYH0DFPLOODQ…0D\,6%1
3DOJUDYH0DFPLOODQ…$SULO,6%1
Mortality statistics: childhood, infant and perinatal, England and
Wales, 2004. Series DH3 No. 37 0DUFKDYDLODEOHDW www.statistics.gov.
uk/statbase/Product.asp?vlnk=160).
Standardised Mortality Ratios for deaths under 85 years in wards in
England and Wales, 1999–2003 $SULODYDLODEOHDW www.statistics.gov.
uk/statbase/Product.asp?vlnk=14359).
Population Trends 123 3DOJUDYH0DFPLOODQ…0DUFK,6%1
To order any of the above publications from Palgrave Macmillan please
contact www.palgrave.com/ons
All publications are also available free of charge at www.statistics.gov.uk
Nati o n a l S t a t ist ic s
4
Summer 2006
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Health indicators
Figure A
England and Wales
Population change (mid-year to mid-year)
Thousands
300
Natural change
Total change
200
100
0
19
71
−
72 72
−7
3
73
−7
74 4
−7
5
75
−7
76 6
−7
77 7
−7
78 8
−7
79 9
−8
80 0
−8
81 1
−8
2
82
−8
83 3
−8
84 4
−8
85 5
−8
86 6
−8
87 7
−8
8
88
−8
89 9
−9
90 0
−9
91 1
−9
92 2
−9
93 3
−9
94 4
−9
95 5
−9
6
96
−9
97 7
−9
98 8
−
99 99
−2
20 000
00
−
20 01
01
2 0 −0 2
02
2 0 −0
03 3
−0
4
−100
Mid−year
Figure B
Age-standardised mortality rate
1
Rate per million population
20,000
15,000
10,000
5,000
0
1971
1973
Figure C
1975
1977
1979
1981
1983
1985
1987
1989
Year
1991
1993
1995
1997
1999
2001
2003
2005
Infant mortality (under 1 year)
Rate per 1,000 live births
20
15
10
5
0
1971
Figure D
1973
1975
1977
1979
1981
1983
2
1987
1989
Year
1991
1993
1995
1997
1999
2001
2003
2005
Age-standardised quarterly abortion rates – residents2
Age standardised rate per 1,000 women 15–44
20
19
18
17
16
15
14
13
12
11
ASR Abortion rate
10
9
1985 1986 1987 1988 1989 1990 1991 1992
1
1985
Provisional rate
1993
Moving average rate
1994
1995 1996 1997 1998 1999
Year
The age-standardised mortality rate for 2004 is based on mid 2004 population estimates published on the 25 August 2005.
Rates for 2004 and March quarter 2005 are based on 2004 population projections.
2000
5
2001
2002
2003
N a t i o n a l S t a t i s t i cs
2004
2005
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Trends in mortality from
Alzheimer’s disease,
Parkinson’s disease and
dementia, England and
Wales, 1979–2004
Clare Griffiths and Cleo Rooney
Office for National Statistics
INTRODUCTION
In this article we present trends in
mortality from Alzheimer’s
disease, Parkinson’s disease and
dementia in England and Wales
from 1979 to 2004. We describe
the impact of mortality coding
changes on the underlying cause of
death, particularly the introduction
of ICD-10 in 2001. We present
rates for all mentions of the
conditions on death certificates to
interpret trends better. Mortality
rates for the three conditions
showed varying trends over the
time period examined. Between
1985 and 2004, Alzheimer’s
disease showed a dramatic
increase.Trends in mentions of
dementia differed between males
and females, with rates being
relatively stable among males, but
increasing among females. Rates
for Parkinson’s disease declined
over this period.
Nati
Nation
onaal l SSt taat tist
isticicss
Dementia is the loss of intellectual ability. People with dementia may
become confused and unable to remember things or lose skills they once
had, including the ability to perform normal daily activities. Eventually, they may not recognise family members or friends and may show
agitated behaviour. Although dementia is more common in older adults,
LWLVQRWDQRUPDOFRQVHTXHQFHRIDJHLQJ1 Dementia may be the result of
a range of diseases and pathological processes, the commonest of which
DUHGHVFULEHGEULHÀ\EHORZ+RZHYHULWVKRXOGEHQRWHGWKDWLWLVQRW
always possible to draw a clear distinction between different dementing
illnesses clinically during life or pathologically post mortem.2
Alzheimer’s disease is the single most common cause of dementia in the
developed world. People with Alzheimer’s disease lose functioning nerve
cells in areas of the brain that deal with intellectual ability and memory.
Alzheimer’s disease usually affects older adults but can sometimes
begin in younger individuals.1 The causes of Alzheimer’s disease are
not known, but risk factors include family history of the disease and
advanced age.1
Vascular dementia is usually caused by cumulated cerebral damage from
YHU\VPDOOµVWURNHV¶RYHUDORQJWLPHWKDWDIIHFWEORRGÀRZWRDUHDVRIWKH
brain related to memory and thinking. Some neurological diseases, such
as Parkinson’s disease, which is a brain disease that causes tremors and
muscle stiffness, can cause dementia because of their effects on brain
tissue. Parkinson’s disease is less common as a cause of dementia than
Alzheimer’s disease or vascular dementia. Infections that can cause dementia include HIV, tuberculosis, syphilis, meningitis and encephalitis.1
6
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
It is important to examine trends in mortality from dementia, Alzheimer’s
disease and Parkinson’s disease, as mortality represents an important
aspect of the public health burden of these conditions. In addition, as
the population ages, and mortality from circulatory diseases and cancer
declines, these conditions are likely to increase both in prevalence and
LQFRQWULEXWLRQWRPRUWDOLW\(TXDOO\FRUUHFWLQWHUSUHWDWLRQRIFKDQJHVLQ
mortality rates over time is vital to understanding the underlying trends
in mortality. Previous analysis of trends in dementing illnesses showed a
dramatic increase in mortality from Alzheimer’s disease, over the period
1979 to 1996,3 and an increase in mortality from dementias from 1993 to
1996.4 Analyses of mortality from Parkinson’s disease showed that rates
fell between 1960 and 1980, with an increase from 1980 to 1989. Part
of the increase in the 1980s was due to changes in coding practices in
England and Wales (described in this article).5
In this article we present trends in dementia, Alzheimer’s disease and
Parkinson’s disease in England and Wales from 1979 to 2004, updating
previous analyses and including revised population estimates. Because
RIWKHGLI¿FXOW\LQGLVWLQJXLVKLQJEHWZHHQ$O]KHLPHU¶VGLVHDVHDQGRWKHU
forms of dementia in some cases, and because the use of these terms
by doctors certifying the cause of death may have changed over the
period studied, we have also presented trends for these two categories
combined. We describe the impact of past mortality coding changes on
trends in the underlying cause of death for each of the three conditions,
SDUWLFXODUO\IRFXVVLQJRQWKHLQWURGXFWLRQRIWKH,QWHUQDWLRQDO&ODVVL¿FDWLRQRI'LVHDVHV7HQWK5HYLVLRQ,&'LQ
METHODS
We have examined mortality from three conditions – Alzheimer’s
GLVHDVH3DUNLQVRQ¶VGLVHDVHDQGGHPHQWLD±GH¿QHGDVYDVFXODUDQG
XQVSHFL¿HGGHPHQWLDXVLQJ,&'DQGDVGHPHQWLDDQGSV\FKRVLVXVLQJ
ICD-9. Mortality data for each of the three conditions examined were
H[WUDFWHGIURPWKHGHDWKVGDWDEDVHVKHOGE\WKH2I¿FHIRU1DWLRQDO
Statistics (ONS). The codes from ICD-10 and ICD-9 used to select each
condition are shown in Box One. 1979 was chosen as the start year for
DQDO\VLVEHFDXVHWKLVZDVWKH¿UVW\HDUWKDW,&'FRGLQJZDVXVHGLQ
England and Wales. ICD-10 was introduced in 2001.
Box one
ICD codes used to define specific conditions
Dementia
Alzheimer’s disease
Parkinson’s disease
ICD-10
F01, F03
G30
G20
ICD-9
290, 294.9, 298.9
331.0
332.0
Changes in the rules used by ONS and its predecessors to select the
underlying cause of death from all of the conditions mentioned on the
GHDWKFHUWL¿FDWHFDQKDYHDGUDPDWLFLPSDFWRQPRUWDOLW\UDWHVIRUSDUticular conditions. Previous analysis has shown that the three conditions
H[DPLQHGKHUHDUHSDUWLFXODUO\DIIHFWHG%HORZZHGHVFULEHWKHPDMRU
changes in mortality coding that have taken place during the time period
1979 to 2004.
For this reason, we have also examined trends in mortality rates for the
WKUHHFRQGLWLRQVZKHUHWKH\ZHUHPHQWLRQHGRQWKHGHDWKFHUWL¿FDWHDV
well as rates for the underlying cause of death. This allows us to see the
underlying trend, regardless of changes to coding rules, for chronic
conditions such as these. This type of analysis has been used for other
conditions such as diabetes, and chronic obstructive pulmonary disease.6,7
Data on ‘mentions’ are available for 1985, 1986 and 1993 onwards.
Summer 2006
In order to examine changes occurring as a result of the introduction of
ICD-10 we used data from the bridge coding study carried out by
ONS.8-10 Box Two describes the methods used in this study.
Box two
Bridge coding study: methods
To understand trends in cause-specific mortality spanning
the change from ICD-9 to ICD-10, we need to measure the
effect of this change on the proportion of deaths attributed
to different causes of death. This is done using bridge coding,
that is coding a sample of death certificates independently to
both ICD-9 and ICD-10, and comparing the resulting underlying causes of death. ONS bridge-coded mortality data for all
deaths registered in 1999. The first step in this process is to
identify equivalent codes or code groups in the two revisions
which represent the same causes. In most cases this is not
contentious, and the same groupings have been used by various
authors and national statistics offices.
The results can then be presented as comparability ratios of
the numbers of deaths assigned to a given disease or group of
diseases in the two revisions. These are simply the ratio of the
number of deaths coded to a cause in ICD-10 to the number
coded to the equivalent cause in ICD-9. They measure the net
effect of all changes to a particular cause of death. Analysis
can also be carried out of reassignments of conditions from
one code to another between ICD-9 and ICD-10, to look at
changes in more detail. This type of analysis is presented in this
paper. Comparability ratios for the conditions examined have
been published elsewhere, for males and females separately, 8,10
and are presented here for persons.
To take into account differences in age/sex distributions over time, we
calculated directly age-standardised mortality rates for males and females
VHSDUDWHO\XVLQJWKH(XURSHDQ6WDQGDUG3RSXODWLRQ5HYLVHGPLG\HDU
population estimates based on the 2001 Census were used to calculate
WKHUDWHVIRUWR)RUWRWKHVHZHUH¿QDOUHYLVHG
populations published in Autumn 2004. For 1982 to 1991, these were
¿QDOUHYLVHGSRSXODWLRQVSXEOLVKHGLQ6SULQJ3RSXODWLRQVSULRUWR
1981 were not revised following the 2001 Census.
CHANGES TO MORTALITY CODING, 1979–2004
Introduction of ICD-9 – 1979
ICD-9 was introduced in 1979 in England and Wales. It was structurally
very similar to its predecessor, ICD-8. However, Alzheimer’s disease was
VHSDUDWHGIURPGHPHQWLDLQWKHFODVVL¿FDWLRQVRWKDWWKHGLVHDVHSURFHVV
FRXOGEHLGHQWL¿HGVHSDUDWHO\IURPWKHUHVXOWLQJGHPHQWLD11 In ICD-8
it had been grouped with pre-senile dementia. This meant that trends in
Alzheimer’s disease could be examined separately from 1979 onwards.
ICD-9 Rule 3 – 1984
$GHOLEHUDWHEURDGHQLQJRIWKHDSSOLFDWLRQRI,&'VHOHFWLRQ5XOHE\
WKH2I¿FHRI3RSXODWLRQ&HQVXVHVDQG6XUYH\V23&6QRZ216IURP
1984 to 1992 also had an impact on mortality statistics.12 This rule allows
DFRQGLWLRQZKLFKLVUHSRUWHGLQHLWKHU3DUW,RU,,RIWKHGHDWKFHUWL¿FDWH
to be selected as the underlying cause over the condition selected using
WKHRWKHUFRGLQJUXOHVLIWKHODWWHULVREYLRXVO\DGLUHFWFRQVHTXHQFHRI
WKHIRUPHUFRQGLWLRQ%HWZHHQDQGWKHYHUVLRQRI5XOHXVHG
by OPCS meant that when the underlying cause as recorded on Part I
RIWKHFHUWL¿FDWHZDVFODVVL¿DEOHWRRQHRIWKHFRQGLWLRQVOLVWHGLQ%R[
7
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Box three
conditions.12 In addition, at the same time OPCS suspended its system of
PHGLFDOHQTXLULHVKRZHYHUWKLVKDGDOPRVWQRLPSDFWRQPRUWDOLW\IURP
dementia, Alzheimer’s disease or Parkinson’s disease.14
Conditions to which Rule 3 was applied during
1984 to 1992
Introduction of ICD-10 – 2001
ICD-9
415.1
427.5
428
451.1
451.2
451.9
453.9
485
486
514
572.8
Condition
Pulmonary embolism
Cardiac arrest
Heart failure
Phlebitis and thrombophlebitis of deep vessels of
lower extremities
Phlebitis and thrombophlebitis of lower
extremities, unspecified
Phlebitis and thrombophlebitis of unspecified sites
Venous embolism or thrombosis of unspecified site
Bronchopneumonia, unspecified
Pneumonia, unspecified
Pulmonary congestion or hypostasis
Hepatic failure or liver failure
7KUHHLIWKHUHZDVDPDMRUFRQGLWLRQPHQWLRQHGHOVHZKHUHRQWKH
FHUWL¿FDWHWKHPDMRUFRQGLWLRQZDVVHOHFWHGLQVWHDGZKHWKHURUQRWD
FDXVDOVHTXHQFHFRXOGEHSUHVXPHG13
This had the effect of increasing the number of deaths assigned to chronic
debilitating conditions like dementia, Alzheimer’s disease and Parkinson’s disease as the underlying cause.
Introduction of automatic cause coding and
suspension of medical enquiries – 1993
In 1993, OPCS introduced automatic cause coding, meaning that 80
SHUFHQWRIGHDWKFHUWL¿FDWHVZHUHFRGHGE\FRPSXWHUVRIWZDUH$&&6
supplied by the National Centre for Health Statistics (NCHS) in the US,
instead of being coded manually by cause of death coders. This software
XVHGWKHLQWHUQDWLRQDOLQWHUSUHWDWLRQRI5XOHXVHGLQ(QJODQGDQG:DOHV
between 1979 and 1983. The effect of introducing automatic cause
coding was to reverse the changes seen between 1984 and 1992, causing
a substantial drop in the number of deaths assigned to chronic debilitating
Figure 1
The introduction of ICD-10 in 2001 represented the greatest change
in the ICD in over 50 years. There were three main types of change.
7KH¿UVWFKDUDFWHURIHDFKFRGHEHFDPHDOSKDEHWLFUDWKHUWKDQQXPHULF
– enabling the expansion of the number of codes to provide for recently
recognised conditions and more detail about common diseases. Some
GLVHDVHVDQGJURXSVRIFRQGLWLRQVPRYHGEHWZHHQ,&'&KDSWHUVWRUHÀHFW
current ideas of aetiology and pathology. There were several changes to
the rules governing selection of the underlying cause of death, including
a reduction in the number of rules from 9 to 5.15 The changes in the
DSSOLFDWLRQRI5XOHKDGWKHELJJHVWLPSDFW,Q,&'WKHOLVWRI
FRQGLWLRQVDIIHFWHGE\5XOHLVPRUHFOHDUO\GH¿QHGWKDQLQ,&'DQG
broader in scope. This internationally agreed interpretation is used in the
automated coding software produced by NCHS. The impact of this was
to reduce the number of deaths assigned to conditions such as pneumonia
and to increase the number of deaths assigned to chronic debilitating
diseases, in a similar but less marked way to that seen between 1984 and
1992. There has also been a change in the coding of Alzheimer’s disease
depending on the exact terminology used. In ICD-9, if dementia (unVSHFL¿HGRUVSHFL¿HGDVVHQLOHSUHVHQLOHDQG$O]KHLPHU¶VGLVHDVHZHUH
ERWKPHQWLRQHGRQWKHFHUWL¿FDWHZKHWKHULQDµGXHWR¶VHTXHQFHRUQRW
the code for the dementia was usually selected as the underlying cause.
In ICD-10, such combinations will usually result in Alzheimer’s disease
being coded as the underlying cause. 9, 16
PATTERNS OF MORTALITY AND INTERPRETATION OF
TRENDS, 1979–2004
Alzheimer’s disease
Between 1985 and 2004, the age-standardised mortality rate for any mention of Alzheimer’s disease increased from a very low level of less than
1 per 100,000 in both sexes in 1985 to 6.8 per 100,000 for males and 7.9
per 100,000 for females in 2004; an eight-fold increase for males and a
12-fold increase for females (Figure 1).
Directly age-standardised mortality rates for Alzheimer’s disease, Parkinson’s disease and dementia, all
mentions, 1979–2004
England and Wales
Females
35
30
30
25
25
Rate per 100,000
Rate per 100,000
Males
35
20
15
20
15
10
10
5
5
0
1979
1982
1985
1988
1991 1994
Year
1997
2000
2003 2004
Parkinson’s disease
Nati on a l S t a t ist ic s
8
0
1979
1982
Alzheimer’s disease
1985
1988
Dementia
1991 1994
Year
1997
2000
2003 2004
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Figure 2 shows the effects of the changes in selection rules on deaths
ZKHUH$O]KHLPHU¶VGLVHDVHZDVWKHXQGHUO\LQJFDXVHRIGHDWK5DWHV
were very low up to 1984, with a steady increase from then until 1992,
followed by a drop in 1993, with the introduction of automatic cause codLQJWKHQDELJMXPSLQZKHQ,&'ZDVLQWURGXFHG7KLVLQFUHDVH
in 2001 brings rates in line with what might have been expected if the
rates from 1984 to 1992 had continued their increase (Figure 2). In 1985
and 1986 and from 2001 onwards about 65 per cent of all mentions of
$O]KHLPHU¶VGLVHDVHRQWKHGHDWKFHUWL¿FDWHZHUHVHOHFWHGDVWKHXQGHUO\ing cause of death, compared with between 35 and 45 per cent between
Figure 2
Summer 2006
1993 and 2000. This percentage was generally higher for females than
for males (Table 1).
/RRNLQJDWDJHVSHFL¿FSDWWHUQVUDWHVLQFUHDVHGPDUNHGO\ZLWKDJHDV
ZRXOGEHH[SHFWHG5DWHVIRUIHPDOHVDJHG±LQFUHDVHGWKHPRVW
over time (Figure 3). Before 1999, rates for males and females were
fairly similar in each age group examined, but from 1999 onwards, rates
have been consistently higher among females, ranging from 4 per cent
higher in the 65–74 age group to 24 per cent higher in the 90 and over
age group in 2004.
Directly age-standardised mortality rates for Alzheimer’s disease, Parkinson’s disease and dementia, underlying
cause, 1979–2004
England and Wales
Males
18
18
16
16
14
14
12
12
10
8
10
8
6
6
4
4
2
2
0
1979
1982
1985
1988
1991
1994
Year
1997
2000
2003 2004
Parkinson’s disease
Table 1
0
1979
1982
Alzheimer’s disease
1985
1988
1994
1991
Year
1997
2000
2003 2004
Dementia
Percentage of mentions of dementia, Alzheimer’s disease or Parkinson’s disease selected as the underlying cause
of death, 1985–1986, 1993–2004
Males
1985
1986
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
ICD−10
ACCS
OPCS Rule 3
ICD−10
Rate per 100,000
Rate per 100,000
Females
ACCS
OPCS Rule 3
Females
Parkinson’s disease
Alzheimer’s disease
Dementia
Parkinson’s disease
Alzheimer’s disease
Dementia
55
55
33
35
34
36
36
36
37
36
53
55
57
55
66
62
35
34
38
37
38
39
39
38
62
63
60
63
56
54
25
26
28
29
29
30
30
28
40
38
36
35
52
55
35
35
35
37
36
38
37
40
56
59
57
56
64
64
37
40
43
44
43
45
45
46
68
67
67
67
58
59
31
33
33
34
35
37
37
38
49
47
46
45
9
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Figure 3
Summer 2006
Age-specific mortality rates, Alzheimer’s disease mentions, 1979–2004
England and Wales
Females
600
600
500
500
400
400
Rate per 100,000
Rate per 100,000
Males
300
200
300
200
100
100
0
0
1979
1982
1985
1988
1991 1994
Year
1997
65−74
Parkinson’s disease
The mortality rate for mentions of Parkinson’s disease declined between
1985 and 2004, by 22 per cent for males (from 14.9 per 100,000 to 11.6
per 100,000) and 32 per cent for females (from 7.3 per 100,000 to 5.0
SHU5DWHVZHUHKLJKHUIRUPDOHVWKDQIRUIHPDOHV)LJXUH
Looking at deaths where Parkinson’s disease was the underlying cause
of death, the trends are strongly affected by the changes in coding rules
LQDQG5DWHVZHUHDJDLQKLJKHUIRUPDOHVWKDQIHPDOHV
(Figure 2). The percentage of mentions selected as the underlying cause
was about 55 per cent in 1985, 1986 and 2001 onwards, compared with
Figure 4
1979
2003 2004
2000
75−84
1982
1985
85−89
1988
1991 1994
Year
1997
2000
2003 2004
90 and over
about 35 to 40 per cent between 1993 and 2000. As for Alzheimer’s disease this percentage was generally, though not always, higher for females
than for males (Table 1).
Mortality from Parkinson’s disease showed the same relationship with
age as that for Alzheimer’s disease, with rates being much higher in the
ROGHUDJHJURXSV)LJXUH5DWHVIRUPDOHVZHUHPRUHWKDQWZLFHDV
KLJKDVUDWHVIRUIHPDOHVLQHDFKDJHJURXS5DWHVGHFUHDVHGLQHDFKDJH
group between 1985 and 2004. The declines were greater at younger
ages, with a decline of 31 per cent among males and 45 per cent among
females aged 65–74.
Age-specific mortality rates, Parkinson’s disease mentions, 1979–2004
England and Wales
Females
700
600
600
500
500
Rate per 100,000
Rate per 100,000
Males
700
400
300
400
300
200
200
100
100
0
1979
1982
1985
1988
1991 1994
Year
1997
2000
65−74
Nati on a l S t a t ist ic s
10
0
2003 2004
1979
75−84
1982
85−89
1985
1988
90 and over
1991 1994
Year
1997
2000
2003 2004
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Between 1993 and 2004 mortality rates for mentions of dementia
remained steady among males. Among females, rates increased steadily
between 1993 and 2004 (Figure 1). For both sexes, rates were higher in
2004 than in 1985, 5 per cent higher for males and 23 per cent higher for
females.
Figure 2 shows that underlying cause mortality rates for dementia were
strongly affected by changes to the coding rules, with trends in seemingly
different directions in 1984 to 1992 compared to the other time periods
– rates being fairly stable or decreasing during this period compared to
increases at other times for females. This unusual pattern of mortality
trends may be explained by a combination of gradual drift in the terminology used by doctors certifying the cause of death and abrupt changes
LQWKH,&'FRGLQJDQGFODVVL¿FDWLRQUXOHVDVDSSOLHGWRLQGLYLGXDOWHUPV
DQGFRPELQDWLRQVRIWHUPVRQWKHFHUWL¿FDWHV$QHDUOLHUDQDO\VLVXSWR
1996,3 suggested that the pattern seen for dementia between 1984 and
1992 was due to diagnostic transfer rather than a true decline. This means
that deaths that would in the past have been recorded as dementia would
be recorded as Alzheimer’s disease, leading to an apparent decline in
dementia mortality. Looking at mortality rates for both dementia and
Alzheimer’s disease using the underlying cause of death (as this shows
the full time period under consideration) shows that this does indeed
appear to be the case in the 1984 to 1992 period, with rates for
Alzheimer’s disease and dementia combined increasing, but rates for
dementia declining or remaining steady (Figure 5). An examination of the
ratio of dementia mortality rates to Alzheimer’s disease mortality rates
from 1984 onwards suggests that diagnostic transfer was occurring most
markedly in the 1980s and early 1990s. In the mid to late 1990s, the ratio
of dementia to Alzheimer’s was fairly constant. This ratio was also fairly
stable, though at a different level, from 2001 onwards (Figure 6). The
GLIIHUHQFHLQWKHOHYHORIWKHUDWLRVLQWKHVHWZRODWHUWLPHSHULRGVUHÀHFWV
coding changes that occurred when ICD-10 was introduced, described
above.
Figure 5
Figure 6
Ratio of mortality rates for dementia to rates
for Alzheimer’s disease, by sex, 1984–2004
England and Wales
ACCS
ICD−10
100
Males
Females
Ratio (log scale)
Dementia
Summer 2006
10
1
1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
The percentage of dementia mentions selected as the underlying cause
varied from about 55–60 per cent in 1985 to 1986, between 25 and 38 per
cent between 1993 and 2000 and 35–40 per cent for males and 45–49 per
cent for females between 2001 and 2004 (Table 1).
Mortality from dementia showed the same relationship with age as that
for Alzheimer’s and Parkinson’s disease, with rates being much higher in
WKHROGHUDJHJURXSV)LJXUH5DWHVZHUHKLJKHUIRUPDOHVWKDQIHPDOHV
Directly age-standardised mortality rates for Alzheimer’s disease and dementia, underlying cause, 1979–2004
England and Wales
Males
ACCS
ICD−10
ACCS
OPCS Rule 3
25
25
20
20
Rate per 100,000
Rate per 100,000
OPCS Rule 3
Females
15
10
ICD−10
15
10
5
5
0
1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 20012003 2004
Year
0
1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2004
Year
Alzheimer’s disease
Dementia
11
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Figure 7
Age-specific mortality rates, dementia mentions, 1979–2004
England and Wales
Males
Females
3,000
3,000
2,500
2,500
2,000
2,000
Rate per 100,000
Rate per 100,000
Summer 2006
1,500
1,500
1,000
1,000
500
500
0
1979
0
1979
1982
1985
19 88
1991
1994
Year
1997
2000
2003 2004
65−74
75−84
in the younger age groups, but in the 90 and over age group, rates for
IHPDOHVZHUHKLJKHU5DWHVLQWKH±DJHJURXSZHUHVLPLODUEHWZHHQ
the sexes. It is likely that the higher rates for females aged 90 and over
UHÀHFWVWKHIDFWWKDWSRSXODWLRQRIZRPHQDJHGDQGRYHULVOLNHO\
to have an older age structure (and therefore higher mortality) than the
population of men aged 90 and over.
Table 2
Alzheimer’s disease, ICD-9 and ICD-10 coding,
1999
(a) Number of deaths coded as due to Alzheimer’s disease in ICD-9 by their
underlying cause of death in ICD-10
ICD-10 code
Number of deaths
G30
G00–G99 excluding
G30
J00–J99
Total
1988
1991
Year
1994
1997
2000
2003 2004
90 and over
CHANGES RESULTING FROM THE INTRODUCTION OF
ICD-10 IN 2001
/RRNLQJVSHFL¿FDOO\DWWKHFKDQJHVLQ,&'7DEOHVKRZVWKDWWKHUH
was very little transfer of deaths away from Alzheimer’s disease as the
underlying cause of death between ICD-9 and ICD-10. Gains were seen
from deaths previously coded as bronchopneumonia (33 per cent of
deaths coded to Alzheimer’s disease in ICD-10) and dementia (16 per
cent). Only half of those deaths attributed to Alzheimer’s disease in ICD10 would have been coded as such in ICD-9. Two-thirds of the overall
Table 3
Parkinson’s disease, ICD–9 and ICD–10 coding,
1999
ICD-9 code
2,369
17
98.2
0.7
14
13
2,413
0.6
0.5
Number of deaths
331.0
485–486
290
390–459
E800–E999
2,369
1,545
733
17
6
8
4,679
Total
Comparability ratio
Nati on a l S t a t ist ic s
12
1.94
(a) Number of deaths coded as due to Parkinson’s disease in ICD-9 by their
underlying cause of death in ICD-10
ICD-10 code
%
(b) Number of deaths coded as due to Alzheimer’s disease in ICD-10 by their
underlying cause of death in ICD-9
Alzheimer’s disease
Bronchopneumonia
Dementia
Circulatory diseases
External causes
Other causes
85−89
1985
England and Wales
England and Wales
Alzheimer’s disease
Other diseases of
nervous system
Respiratory diseases
Other causes
1982
%
50.7
33.0
15.7
0.4
0.1
0.2
Parkinson’s disease
Respiratory diseases
Circulatory diseases
Other causes
G20
J00-–J99
I00–I99
Total
Number of deaths
2,689
37
23
22
2,771
%
97.0
1.3
0.8
0.8
(b) Number of deaths coded as due to Parkinson’s disease in ICD-10 by their
underlying cause of death in ICD-9
ICD-9 code
Parkinson’s disease
Bronchopneumonia
Dementia
Circulatory diseases
External causes
Other diseases of
nervous system
Other causes
332.0
485–486
290
390–459
E800–E999
320–359 excluding
332.0
Total
Comparability ratio
Number of deaths
%
2,689
1,261
137
24
7
6
65.0
30.5
3.3
0.6
0.2
0.1
10
4,134
0.2
1.49
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
increase was from deaths previously coded as bronchopneumonia, and
RQHWKLUGIURPWKHOHVVVSHFL¿FGHPHQWLDV±DOUHDG\GHVFULEHGDERYH
For Parkinson’s disease (Table 3), there was very little transfer of deaths
away from Parkinson’s disease as the underlying cause of death between
ICD-9 and ICD-10. Gains were seen from deaths previously coded as
bronchopneumonia (30 per cent of deaths coded to Parkinson’s disease in
ICD-10) and dementia (3 per cent). Two-thirds of the deaths coded as due
to Parkinson’s disease in ICD-10 were coded as such in ICD-9. Around
90 per cent of the overall gain came from bronchopneumonia.
The changes resulting from the introduction of ICD-10 for dementia are
complex, with transfers in and out of the dementia group contributing to
the net changes in the underlying cause. Losses to circulatory diseases,
due to the change in indexing of multi-infarct dementia17 (17 per cent),
Alzheimer’s disease (10 per cent) and Parkinson’s disease (2 per cent)
and a variety of other conditions were offset by gains from bronchopneumonia (38 per cent) (Table 4).
Table 4
Dementia, ICD-9 and ICD-10 coding, 1999
England and Wales
(a) Number of deaths coded as due to dementia in ICD-9 by their underlying
cause of death in ICD-10
ICD-10 code
Vascular and
unspecified dementia
Circulatory diseases
Alzheimer’s disease
Parkinson’s disease
Respiratory diseases
Endocrine, nutritional
and metabolic diseases
Other diseases of
nervous system
Neoplasms
Diseases of the
genitourinary system
Other mental and
behavioural disorders
Diseases of the
musculoskeletal system
Symptoms, signs and
ill-defined conditions
External causes
Other causes
F01, F03
I00-I99
G30
G20
J00-J99
Number of deaths
%
5,161
1,323
733
134
69
67.9
17.4
9.6
1.8
0.9
E00-E90
G00-G99 excluding
G20 and G30
44
0.6
34
0.4
C00-D48
26
0.3
N00-N99
F00-F99 excluding
F01 and F03
18
0.2
12
0.2
M00-M99
12
0.2
12
12
15
7,605
0.2
0.2
0.2
R00-R99
V01-Y89
Total
(b) Number of deaths coded as due to dementia in ICD-10 by their
underlying cause of death in ICD-9
ICD-9 code
Senile and presenile organic
psychotic conditions
Bronchopneumonia
Unspecified psychosis
Circulatory diseases
Other respiratory diseases
Other mental and
behavioural disorders
Unspecified chronic organic
psychotic conditions
External causes
Endocrine, nutritional and
metabolic diseases
Diseases of nervous system
Other causes
290
485–486
298.9
390–459
460–519 excluding
485–486
Number of deaths
%
5,161
4,542
1,806
120
43.4
38.2
15.2
1.0
93
0.8
290–319 excluding
290, 294.9 and 298.9
78
0.7
294.9
E800–E999
32
25
0.3
0.2
13
11
13
11,894
0.1
0.1
0.1
DISCUSSION
Mortality rates for the three conditions examined in this article showed
varying trends over the time period examined. Alzheimer’s disease
showed the largest increase. This is in part due to an increasing tendency
to record Alzheimer’s disease (as the cause of dementia) on death cerWL¿FDWHVIROORZLQJIURPDQLQFUHDVLQJUHFRJQLWLRQRI$O]KHLPHU¶VDVWKH
disease process underlying much dementia. Dementia mortality
patterns were complex, with the unusual pattern for the underlying cause
of dementia seen in the 1980s and 1990s appearing to be due to diagnostic transfer to Alzheimer’s disease. Despite this gradual drift toward the
use of ‘Alzheimer’s disease’ rather than terms such as senile or pre-senile
dementia, more than two and a half times as many deaths are still attributed to ‘dementia’ as to Alzheimer’s disease.
Studies in the UK have suggested varying patterns of reporting of demenWLDDQG$O]KHLPHU¶VGLVHDVHRQWKHGHDWKFHUWL¿FDWHVRISDWLHQWVZLWKWKH
conditions. Two recent studies suggested reporting rates of over 70 per
cent for both dementia and Alzheimer’s disease.18,19 Older studies from
Scotland and northern England have reported variations according to
whether the patient had Alzheimer’s disease or vascular dementia, with
reporting being as high as between 75 and 90 per cent for patients with
Alzheimer’s disease compared to 50 per cent for vascular dementia.20, 21
Prevalence surveys for dementia and Alzheimer’s disease are costly and
GLI¿FXOWWRFDUU\RXWZLWKUHVXOWVYDU\LQJDFFRUGLQJWRWKHGLDJQRVWLF
criteria used. A Delphi consensus study, which looked at all the available estimates from prevalence studies, concluded that prevalence in
those aged 60 and over in Western Europe was around 5 per cent, with an
estimated annual incidence of nearly 9 per 1,000 population. The study
also predicted that the number of adults in Western Europe with dementia
would almost double between 2001 and 2040.22
Mortality rates for mentions of Parkinson’s disease declined over the
period examined. A study of people with Parkinson’s disease in the south
of England found that of those who died between 1966 and 1997, 76 per
FHQWKDG3DUNLQVRQ¶VGLVHDVHUHFRUGHGRQWKHGHDWKFHUWL¿FDWH23 Two reFHQWVWXGLHVRIGHDWKFHUWL¿FDWLRQLQ6FDQGLQDYLDKRZHYHUIRXQGWKDWRQO\
around half of patients with Parkinson’s disease had the condition written
RQWKHLUGHDWKFHUWL¿FDWH24, 25 but a slightly older study showed a reporting
rate of over 70 per cent. 26
As for dementia and Alzheimer’s disease, studies of prevalence of
3DUNLQVRQ¶VGLVHDVHLQWKH8.DUHOLPLWHG7KHUHKDYHEHHQ¿YHVWXGLHV
examining the prevalence of Parkinson’s disease over a 40 year period in
WKH8.5HVXOWVRIWKHVHVWXGLHVVXJJHVWVWDEOHSUHYDOHQFH27-31 This could
imply a decline in incidence, but an increasing mean duration of disease,
perhaps due to better disease management, which would lead to constant
prevalence with declining mortality. Prevalence of Parkinson’s disease
is higher among men than women, which matches the pattern seen for
mortality.
Key findings
M
240–279
320–359
Total
Comparability ratio
Summer 2006
M
M
Mortality rates based on mentions of Alzheimer’s disease
increased dramatically over the period 1985 to 2004 by 8 times
for males and 12 times for females.
Mortality rates based on mentions of Parkinson’s disease
declined over the same time period, by 22 per cent for males and
32 per cent for females.
Between 1985 and 2004, trends in mentions of dementia at
death differed between males and females, with rates remaining
relatively stable among males, but increasing among females.
1.56
13
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Mortality rates using the underlying cause of death for dementia,
Alzheimer’s disease and Parkinson’s disease are strongly affected by
changes to coding rules and therefore trends should also be examined
XVLQJGDWDRQDOOPHQWLRQVRIWKHVHFRQGLWLRQVRQGHDWKFHUWL¿FDWHVWR
improve interpretation of the underlying trend.
ACKNOWLEDGEMENTS
The authors thank Allan Baker and Anita Brock (ONS) for their invaluable help on a number of aspects of the article. In addition, we thank
the team in Vital Events and Morbidity Processing, led by Elaine Tower
(ONS), for their help in interpreting coding changes as a result of the
introduction of ICD-10. Without the help of all these colleagues it would
not have been possible to produce this article.
REFERENCES
7RUS\-0/\QP&DQG*ODVV50'HPHQWLDJAMA 292,
1514.
1HXURSDWKRORJ\*URXSRIWKH0HGLFDO5HVHDUFK&RXQFLO
Cognitive Function and Ageing Study (2001) Pathological correlates
of late-onset dementia in a multicentre, community-based population
in England and Wales. /DQFHW 357, 169–175.
.LUE\//HKPDQQ3DQG0DMHHG$'HPHQWLDLQSHRSOHDJHG
65 and over: a growing problem? 3RSXODWLRQ7UHQGV92, 23–28.
0DMHHG$/HKPDQQ3.LUE\/DQG&ROHPDQ03
Mortality from dementias and neurodegenerative disorders in people
aged 15–64 in England and Wales in 1979-96. %ULWLVK0HGLFDO
-RXUQDO 317, 320–321.
5. Clarke C E (1993) Mortality from Parkinson’s disease in England
and Wales, 1921-1989. -RXUQDORI1HXURORJ\1HXURVXUJHU\DQG
3V\FKLDWU\ 56, 690–693.
6. Fuller JH, Elford J, Goldblatt P and Adelstein A M (1983) Diabetes
mortality: new light on an underestimated public health problem.
'LDEHWRORJLD 24, 336–341.
*ROGDFUH0-'XQFDQ0&RRN0R]DIIDUL3DQG*ULI¿WK0
Mortality rates for common respiratory diseases in an English
population 1979-1998: artefact and substantive trends. -RXUQDORI
3XEOLF+HDOWK 26, 8–12.
8. www.statistics.gov.uk/icd10mortality. Accessed 25 April 2006.
5RRQH\&*ULI¿WKV&DQG&RRN/7KHLPSOHPHQWDWLRQRI
ICD-10 for cause of death coding – some preliminary results from
the bridge coding study. +HDOWK6WDWLVWLFV4XDUWHUO\ 13, 31–41.
2I¿FHIRU1DWLRQDO6WDWLVWLFV5HSRUW5HVXOWVRIWKH,&'
bridge coding study, England and Wales 1999. +HDOWK6WDWLVWLFV
4XDUWHUO\14, 75–83.
2I¿FHRI3RSXODWLRQ&HQVXVHVDQG6XUYH\V0RUWDOLW\
6WDWLVWLFVFRPSDULVRQRIWKHWKDQGWKUHYLVLRQVRIWKH
,QWHUQDWLRQDO&ODVVL¿FDWLRQRI'LVHDVHV. Series DH1. No. 10,
HMSO: London.
5RRQH\&DQG'HYLV70RUWDOLW\WUHQGVE\FDXVHRIGHDWKLQ
England and Wales 1980-94: the impact of introducing automated
cause coding and related changes in 1993. 3RSXODWLRQ7UHQGV 86,
29–35.
2I¿FHRI3RSXODWLRQ&HQVXVHVDQG6XUYH\V0RUWDOLW\
6WDWLVWLFV&DXVH. Series DH2. No. 11, HMSO: London.
2I¿FHRI3RSXODWLRQ&HQVXVHVDQG6XUYH\V0RUWDOLW\
6WDWLVWLFV&DXVHUHYLVHGDQG. Series DH2. No. 21,
HMSO: London.
15. World Health Organization (1993) ,QWHUQDWLRQDO6WDWLVWLFDO
&ODVVL¿FDWLRQRI'LVHDVHVDQG5HODWHG+HDOWK3UREOHPV7HQWK
5HYLVLRQ9ROXPH,QVWUXFWLRQ0DQXDO, World Health Organization:
Geneva.
$QGHUVRQ510LQLxR$0+R\HUW'/DQG5RVHQEHUJ+0
(2001) Comparability of cause of death between ICD-9 and ICD-10:
Nati on a l S t a t ist ic s
14
preliminary estimates. 1DWLRQDO9LWDO6WDWLVWLFV5HSRUWV 49 (2) 1–32.
www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_02.pdf. Accessed 25
April 2006.
*ULI¿WKV&%URFN$DQG5RRQH\&7KHLPSDFWRILQWURducing ICD-10 on trends in mortality from circulatory diseases in
England and Wales. +HDOWK6WDWLVWLFV4XDUWHUO\ 22, 14–20.
.HHQH-+RSH7)DLUEXUQ&*DQG-DFRE\5'HDWKDQG
dementia. ,QWHUQDWLRQDO-RXUQDORI*HULDWULF3V\FKLDWU\ 16, 969–974.
19. Kay D W, Forster D P and Newens A J (2000) Long-term survival,
SODFHRIGHDWKDQGGHDWKFHUWL¿FDWLRQLQFOLQLFDOO\GLDJQRVHGSUH
senile dementia in northern England. Follow-up after 8-12 years.
%ULWLVK-RXUQDORI3V\FKLDWU\ 177, 156–162.
7KRPDV%06WDUU-0DQG:KDOOH\/-'HDWKFHUWL¿FDWLRQ
in treated cases of presenile Alzheimer’s disease and vascular dementia in Scotland. $JHDQG$JHLQJ 26, 401–406.
1HZHQV$-)RUVWHU'3DQG.D\':'HDWKFHUWL¿FDWLRQ
after a diagnosis of presenile dementia. -RXUQDORI(SLGHPLRORJ\DQG
&RPPXQLW\+HDOWK 47, 293–297.
22. Ferri CP, Prince M, Brayne C HWDO (2005) Global prevalence of
dementia: a Delphi consensus study. /DQFHW 366, 2112–2117.
3KLOOLSV1-5HD\-DQG0DUW\Q&19DOLGLW\RIPRUWDOLW\GDWD
for Parkinson’s disease. -RXUQDORI(SLGHPLRORJ\DQG&RPPXQLW\
+HDOWK 53, 587–588.
24. Beyer M K, Herlofson K, Årsland D and Larsen J P (2001) Causes
of death in a community-based study of Parkinson’s disease. $FWD
QHXURORJLFD6FDQGLQDYLFD 103, 7–11.
25. Fall P A, Saleh A, Fredrickson M HWDO (2003) Survival time,
mortality, and cause of death in elderly patients with Parkinson’s
disease. A 9-year follow-up. 0RYHPHQWGLVRUGHUV 18, 1312–1316.
26. Wermuth L, Stenager E N, Stenager E and Boldsen J (1995)
Mortality in patients with Parkinson’s disease. AFWDQHXURORJLFD
6FDQGLQDYLFD 92, 55–58.
%UHZLV03RVNDQ]HU'&5ROODQG&DQG0LOOHU+1HXURlogical disease in an English city. $FWDQHXURORJLFD6FDQGLQDYLFD 42,
1–89.
6XWFOLIIH5/*3ULRU50DZE\%DQG0F4XLOODQ:-
Parkinson’s disease in the district of the Northampton Health
Authority, United Kingdom. A study of prevalence and disability.
$FWDQHXURORJLFD6FDQGLQDYLFD 72, 363–379.
29. Mutch W J, Dingwall-Fordyce I, Downie AW HWDO (1986) Parkinson’s disease in a Scottish city. %ULWLVK0HGLFDO-RXUQDO 292,
534–536.
6XWFOLIIH5/*DQG0HDUD-53DUNLQVRQ¶VGLVHDVHHSLGHPLology in the Northampton district, England, 1992. AFWDQHXURORJLFD
6FDQGLQDYLFD 92, 443–450.
6FKUDJ$%HQ6KORPR<DQG4XLQQ13&URVVVHFWLRQDO
prevalence survey of idiopathic Parkinson’s disease and Parkinsonism in London. %ULWLVK0HGLFDO-RXUQDO 321, 21–22.
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Summer 2006
Risk factors for low
birthweight based on
birth registration and
census information,
England and Wales,
1981–2000
Aleks Collingwood Bakeo
Office for National Statistics
Lynda Clarke
Department of Epidemiology and
Population Health, London School of
Hygiene and Tropical Medicine
INTRODUCTION
This study examines whether
there are socio-demographic
factors (collected at census)
that are not routinely available
at birth registration that help
to explain low birthweight in
England and Wales in the 1980s
and 1990s. Maternal age and
marital status at the time of
birth are known to affect the risk
of low birthweight.The article
looks at whether the additional
socio-demographic information
about the mother that is
collected at Census modifies
our understanding. It identifies
specific groups at high risk of this
negative birth outcome – being a
mother from a non-White ethnic
group, having a long-standing
illness and living in a deprived
area.
Birthweight is a strong predictor of neonatal and infant mortality and
of health outcomes in childhood and adulthood.1 Sixty-four per cent of
infant deaths in England and Wales in 2003 were of babies weighing less
than 2,500g (low birthweight).2 Low birthweight is associated with poor
outcomes in child health and, in particular, the development of cognitive
skills.3 It is also related to illness in adult life, such as diabetes, stroke
and lung disease.4,5 There has been a continuing rise in the proportion of
low birthweight babies in the late 1980s and 1990s from 6.7 per cent in
1989 to 7.6 per cent in 1999.2 Most of this increase is explained by the
increased number of multiple births and the increased survival rates of
lighter babies due to improved technical advances.6
,QUHVSRQVHWRFRQFHUQVRYHUKHDOWKLQHTXDOLWLHVLQWKH'HSDUWPHQW
RI+HDOWKLGHQWL¿HGLQWKH1+63ODQIRU(QJODQG7 national targets
to reduce the gap in infant mortality between manual groups and the
population as a whole and to reduce the gap in life expectancy between
areas with the lowest levels and the population as a whole.8 Birthweight
is a key indicator for both of these targets, given its association with both
infant mortality and life expectancy.
Most analyses examining determinants of low birthweight have focused
on information collected at birth registration. Strong relationships are
known to exist between mother’s marital status at the time of the birth
and birthweight. For example, sole registered births registered by mother
alone are much more likely to be of low birthweight.2 Lone mothers
are younger and more disadvantaged in general compared to married
15
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
mothers and mothers cohabiting with their partners.9 Lone mothers are
more likely to be poor, unemployed, have no car and have no educational
TXDOL¿FDWLRQV9 Infant mortality rates are higher among lone mothers.2
Many of these adverse characteristics are inter-related. Age of the mother
at birth is closely associated with low birthweight; very young and older
mothers have lighter babies.10 Deprivation has also been linked to infant
mortality and low birthweight.11, 12 For example, there is a social gradient
in low birthweight with higher proportions in manual compared to nonmanual groups.13,14 However, since the 1980s, no further analysis has
been undertaken looking at the relationship between socio-demographic
information available from the census and birthweight of babies in
England and Wales except for an unpublished analysis of the relationship
between ethnic ancestry and birthweight in babies born to South Asian
and White women.15
of the parents’ legal marital status. Births are coded as being within
marriage (child born to parents who were lawfully married to one another
either at the date of the child’s birth or when the child was conceived,
even if they later divorced or the father died before the child’s birth),
RXWVLGHPDUULDJHMRLQWO\UHJLVWHUHGUHTXLUHVERWKSDUHQWVWREHSUHVHQWDW
registration) or as a sole registration.2
Census characteristics
Census socio-demographic characteristics used as explanatory variables
in the analysis are:
M
M
M
This study focuses on singleton births to women for whom census
information was available. It examines whether there are sociodemographic factors (collected at census) that are not routinely available
at birth registration that help to explain low birthweight in England
and Wales in the 1980s and 1990s. It seeks to establish how much
the effects of maternal age or marital status at the time of birth on the
ULVNRIORZELUWKZHLJKWDUHPRGL¿HGE\DGGLWLRQDOVRFLRGHPRJUDSKLF
factors collected at Census. It will also examine whether these census
characteristics can independently identify groups at high risk of this
negative birth outcome.
METHODS
Sample
M
M
M
M
M
M
Economic activity
Number of people in the household
Number of rooms in the household
Household access to a car
Housing tenure
5HJLRQRIXVXDOUHVLGHQFH
&DUVWDLUVGHSULYDWLRQTXLQWLOH
Ethnicity (available for 1991 only)
Limiting long term illness status (available for 1991 only).
Carstairs deprivation score is used as a measure of socio-economic
deprivation and is based on four census variables (unemployment among
men, domestic overcrowding, household access to a car and low social
status). It was developed by Carstairs and Morris19 and is available for LS
Census samples since 1981.17&DUVWDLUVVFRUHVZHUHJURXSHGLQWRTXLQWLOHV
E\216ZKHUHTXLQWLOHLVPRVWDIÀXHQWDQGLVWKHPRVWGHSULYHG
Statistical analysis
This study uses data from the ONS Longitudinal Study (LS). The LS
contains linked census and vital event data for one per cent of the
population of England and Wales from 1971. It is the largest longitudinal
data resource in England and Wales, including records for almost a
million study members. New LS members enter the study through
birth and immigration and existing members leave through death
and emigration. Thus, the LS represents a continuous sample of the
population of England and Wales and at any point in time it is largely
representative of the population as a whole. Information on vital events
such as births, deaths and cancer occurring to study members is also
included in the LS, and updated annually.16, 17 This study analyses live
born babies to LS sample mothers in the 1980s and 1990s according to
birth registration information and their mother’s census characteristics at
a census prior to the birth
A total of 65,666 live births to LS sample mothers occurred in the
1980s and 68,333 occurred in the 1990s. Births with no prior census
information were excluded from the study (8 per cent in 1980s, 12
per cent in 1990s). For all birthweight analysis, births with a missing
birthweight, or births weighing less than 500 grams or more than 6000
grams were excluded because of the possibility of incorrect recording
(2 per cent in 1980s, 1 per cent in 1990s). Multiple births are in general
lighter than singleton births therefore they were also not included in the
birthweight analysis to eliminate bias (1 per cent in 1980s, 2 per cent in
1990s).
/RJLVWLFUHJUHVVLRQZDVXVHGWRHVWLPDWHRGGVUDWLRV25VDVDPHDVXUH
of association between the outcome and explanatory variables. The
analyses were run for each decade of births separately. For each model to
include the same number of cases and be comparable, mothers with any
missing explanatory census variable information were not included in the
multivariate analysis. Because the regression analysis relies so heavily
on Census characteristics collected every ten years, the analysis was
controlled for the number of births born to each mother in each decade.
This was done to avoid overstating associations where a mother’s census
FKDUDFWHULVWLFZDVWKHVDPHIRUDOOKHUELUWKVLQRQHGHFDGH6LJQL¿FDQFH
WHVWVIRUWUHQGZHUHFDUULHGRXWRQ&DUVWDLUVTXLQWLOH
RESULTS
Tables 1 and 2 show the distribution of low birthweight babies in the
1980s and 1990s by registration characteristics and mother’s prior census
characteristics and the odds ratios for each variable without controlling
IRURWKHUFKDUDFWHULVWLFV)LJXUHVDQGVKRZWKHUHVXOWVZKHQDGMXVWLQJ
for the registration variables and all census variables. The likelihood
ratio test showed that mother’s region of usual residence did not make
DVLJQL¿FDQWFRQWULEXWLRQWRWKHPXOWLYDULDWHPRGHOVRWKLVYDULDEOHZDV
removed from the model.
Birth registration characteristics
In the 1980s, female babies, having a young mother and being registered
RXWVLGHPDUULDJHZHUHVLJQL¿FDQWO\DVVRFLDWHGZLWKORZELUWKZHLJKW7KH
information from the 1981 Census showed that living in a deprived area
FDUULHGWKHKLJKHVWULVNRIORZELUWKZHLJKW25IRUORZHVWTXLQWLOH
IROORZHGE\VPDOOQXPEHURIURRPVLQWKHKRXVHKROG25KDYLQJD
PRWKHUZKRZDVXQHPSOR\HG25DQGOLYLQJLQDFRXQFLOKRXVHRU
KRXVLQJDVVRFLDWLRQ25DQGOLYLQJLQDKRXVHKROGZLWKRXWDFFHVV
WRDFDU25
Birth registration characteristics used in the analyses are gender of baby,
mother’s age at birth and registration status at birth. The age of mother in
years at time of the baby’s birth is derived by ONS from her date of birth
DQGWKHEDE\¶VGDWHRIELUWK5HJLVWUDWLRQVWDWXVDWELUWKLVDQLQGLFDWRU
In the 1990s, many of the associations with low birthweight show the
same pattern as found for births in the 1980s. From birth registration
data, the highest likelihood of low birthweight is seen amongst mothers
ZKRUHJLVWHUWKHELUWKDORQH25DVZHOODVIRU\RXQJPRWKHUV
Birthweight
7KH:RUOG+HDOWK2UJDQL]DWLRQ:+2GH¿QLWLRQRIORZELUWKZHLJKWRI
less than 2,500 grams is used in routine statistics and in this article.18
Nati on a l S t a t ist ic s
16
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 1
Summer 2006
Distribution of low birthweight babies and odds ratios by birth registration characteristics
Births in the 1980s
Birth registration characteristics
Births in the 1990s
Live
births
%
LBW 95% CI
OR
LBW 95% CI
Live
births
Sex of baby
Male
Female
29,976
28,226
5.2 (4.9, 5.4)
6.3 (6.1, 6.6)
1.00
1.24 (1.15, 1.33)
29,585
28,474
Mothers age at birth
15–24
25–34
35–44
45 and over
21,809
31,932
4,420
41
6.5
5.2
5.6
7.3
(6.2, 6.9)
(5.0, 5.5)
(4.9, 6.3)
(1.0, 15.6)
1.27 (1.18, 1.37)
1.00
1.08 (0.94, 1.24)
1.36 (0.42, 4.41)
16,121
34,621
7,277
40
46,117
12,085
5.2 (5.0, 5.4)
7.9 (7.4, 8.4)
1.00
1.58 (1.46, 1.71)
37,622
5.0
4,411
11,983
4,043
9.4 (8.6, 10.3)
6.6 (6.1, 7.0)
7.5 (6.7, 8.3)
Marital status at birth
Within marriage
Outside marriage
Sole registration
Joint registration (same add)
Joint registration (diff add)
%
LBW 95% CI
5.4
6.3
OR
LBW 95% CI
(5.1, 5.6)
(6.0, 6.6)
1.00
1.19 (1.11, 1.28)
7.1 (6.7, 7.5)
5.1 (4.9, 5.4)
6.4 (5.8, 7.0)
12.5 (1.5, 23.5)
1.42 (1.31, 1.54)
1.00
1.26 (1.13, 1.41)
2.43 (0.95, 6.23)
(4.8, 5.2)
1.00
-
1.97 (1.76, 2.21)
1.33 (1.22, 1.46)
1.54 (1.35, 1.75)
Table excludes any missing registration data.
Source: ONS Longitudinal Study
25,QIRUPDWLRQIURPWKH&HQVXVDJDLQLQGLFDWHVWKHKLJKHVW
likelihood for mothers living in a deprived area (1.78 for the lowest
&DUVWDLUVTXLQWLOHIROORZHGE\OLYLQJLQDFRXQFLOKRXVHRUKRXVLQJ
DVVRFLDWLRQ25KDYLQJDPRWKHUZKRZDVXQHPSOR\HG25
or living in a household with no access to a car (1.44). The number of
URRPVSHUKRXVHKROGZDVQRWVLJQL¿FDQWO\UHODWHGWRELUWKZHLJKWIRU
births in the 1990s as it was for those in the 1980s. Mothers who were
FODVVL¿HGDVIURPDQRQ:KLWHHWKQLFJURXSZHUHPXFKPRUHOLNHO\WR
KDYHDORZELUWKZHLJKWEDE\WKDQWKRVHIURPD:KLWHJURXS25IRU
QRQ:KLWHDVZHUHPRWKHUVZLWKDORQJWHUPKHDOWKSUREOHP25
MULTIVARIATE ANALYSIS
Multivariate models allow estimates to be made of the contribution of
HDFKFKDUDFWHULVWLFWRYDULDWLRQVLQORZELUWKZHLJKWZKLOHDGMXVWLQJIRU
all other characteristics included in the model. Figure 1 shows a logistic
Figure 1
PRGHORIORZELUWKZHLJKWEDELHVLQWKHVDQGVDGMXVWHGIRUWKH
information available from birth registration records. In Figure 2 this
LVDGMXVWHGIRUERWKWKLVLQIRUPDWLRQDQGLQIRUPDWLRQIURPWKHFHQVXV
7KHVH¿JXUHVVKRZWKDWLQERWKGHFDGHVELUWKVRXWVLGHPDUULDJHFDUULHG
a higher risk of low birthweight than those inside marriage. In the 1990s
it became possible to distinguish whether births outside marriage were
UHJLVWHUHGMRLQWO\E\WZRSDUHQWVDWWKHVDPHDGGUHVVGLIIHUHQWDGGUHVVHV
or solely by the mother alone. The odds of low birthweight in the 1990s
were highest for those births outside marriage registered solely by one
SDUHQWLQWKH¿QDOPRGHOVHH)LJXUH$OWKRXJKPDULWDOVWDWXV
UHPDLQHGVLJQL¿FDQWZKHQWKHFHQVXVLQIRUPDWLRQZDVLQFOXGHGLQWKH
model the effect decreased in both decades. For births in the 1980s, the
25GHFUHDVHGIURPUHJLVWUDWLRQYDULDEOHVRQO\WRFHQVXV
YDULDEOHVLQFOXGHG6LPLODUO\IRUELUWKVLQWKHVWKH25GHFUHDVHG
from 1.98 (registration variables only) to 1.70 (census variables
included).
Multivariate logistic analysis: odds ratios of low birthweight adjusted from birth registration charactistics
2.5
2
1.5
1
0.5
0
Female
Mother
15−24
Births in the 1980s
Outside
marriage
Female
Mother
15−24
Mother
35−44
Sole
registration
Births in the 1990s
Joint
registration
(same address)
Source: ONS Longitudinal Study
17
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Table 2
Summer 2006
Distribution of low birthweight babies and odds ratios by mother’s prior census characteristics
Births in the 1980s
Mother’s prior census characteristics
Births in the 1990s
Live
births
%
LBW 95% CI
OR
LBW 95% CI
Live
births
%
LBW 95% CI
Economic Activity
Employed
Unemployed*
Inactive
At school/student
27,871
4,095
13,713
3,533
5.5
7.8
5.0
5.0
(5.2, 5.8)
(7.0, 8.6)
(4.7, 5.4)
(4.2, 5.7)
1.00
1.45 (1.3,1.7)
0.91 (0.8, 1.0)
0.90 (0.8, 1.1)
31,777
3,926
13,485
2,680
5.3
7.5
5.7
6.3
(5.0, 5.5)
(6.6, 8.3)
(5.3, 6.1)
(5.4, 7.3)
1.00
1.45 (1.27, 1.67)
1.09 (0.99, 1.20)
1.22 (1.02, 1.45)
Number of people in the household
1 or 2
3 or 4
5 and over
15,292
25,215
16,481
5.5 (5.2, 5.9)
5.2 (5.0, 5.4)
6.7 (6.3, 7.1)
1.06 (1.0,1.2)
1.00
1.29 (1.2,1.4)
19,209
26,278
11,355
5.5
5.4
7.2
(5.2, 5.8)
(5.1, 5.7)
(6.7, 7.7)
1.02 (0.94, 1.11)
1.00
1.35 (1.23, 1.49)
Number of rooms
1 or 2
3 or 4
5 and over
1,542
13,226
42,361
7.9 (6.6, 9.3)
6.0 (5.6, 6.5)
5.6 (5.3, 5.8)
1.46 (1.2,1.8)
1.09 (1.0,1.2)
1.00
-
1,946
14,724
40,422
6.1
5.7
5.8
(5.0, 7.1)
(5.3, 6.1)
(5.6, 6.0)
1.04 (0.85, 1.28)
0.97 (0.89, 1.06)
1.00
-
Number of cars
No cars
1 car
more than 1 car
17,138
28,452
11,539
6.9 (6.5, 7.3)
5.3 (5.1, 5.6)
5.0 (4.6, 5.4)
1.31 (1.2,1.4)
1.00
0.93 (0.8,1.0)
13,682
25,498
17,912
7.8
5.5
4.7
(7.3, 8.2)
(5.2, 5.8)
(4.4, 5.0)
1.44 (1.32, 1.57)
1.00
0.84 (0.77, 0.92)
Tenure
Owner
Council/housing association
renting other
31,765
19,502
5,860
5.1 (4.8, 5.3)
6.9 (6.5, 7.2)
5.5 (5.0, 6.1)
1.00
1.39(1.28,1.50)
1.10(0.97, 1.25)
36,776
13,755
6,311
5.1
7.9
5.5
(4.8, 5.3)
(7.4, 8.3)
(4.9, 6.0)
1.00
1.60
1.08
Usual residence
North
Yorkshire and humberside
North West
East Midlands
West Midlands
East Anglia
South East
South West
Wales
3,630
5,986
7,992
4,608
6,421
2,136
20,395
4,603
3,326
5.2
5.7
6.1
6.1
6.6
5.2
5.2
5.4
5.7
(4.4, 5.9)
(5.2, 6.3)
(5.6, 6.7)
(5.4, 6.8)
(6.0, 7.2)
(4.3, 6.1)
(4.9, 5.5)
(4.8, 6.1)
(4.9, 6.5)
0.94(0.79,1.10)
1.05(0.92,1.20)
1.13(1.00,1.27)
1.11(0.97,1.28)
1.21(1.07,1.38)
0.94(0.77,1.17)
1.00
0.99(0.85,1.15)
1.04(0.88,1.24)
3,439
5,765
4,473
2,196
20,378
4,894
6,250
7,431
3,228
6.2
6.1
6.5
4.7
5.3
5.4
7.0
6.1
6.4
(5.4, 7.0)
(5.5,6.7)
(5.8, 7.2)
(3.8, 5.6)
(4.9, 5.6)
(4.8, 6.0)
(6.3, 7.6)
(5.6, 6.7)
(5.6, 7.3)
1.20 (1.02,1.41)
1.17 (1.02,1.34)
1.26 (1.09,1.45)
0.90 (0.73,1.11)
1.00
1.03 (0.88, 1.20)
1.35 (1.20,1.53)
1.18 (1.04,1.33)
1.24 (1.05,1.47)
Carstairs quintile
1
2
3
4
5
7,085
8,055
10,106
13,568
19,280
4.1
4.9
5.3
6.0
6.8
(3.7, 4.6)
(4.4, 5.3)
(4.9, 5.8)
(5.6, 6.4)
(6.4, 7.1)
1.00
1.19(1.01,1.40)
1.31(1.12,1.53)
1.49(1.29,1.72)
1.69(1.47,1.94)
6,139
8,259
10,133
13,922
19,570
4.2
4.9
5.2
5.7
7.2
(3.7, 4.7)
(4.5, 5.4)
(4.8, 5.6)
(5.3, 6.1)
(6.8, 7.6)
1.00
1.19
1.26
1.39
1.78
(1.01,1.41)
(1.07,1.48)
(1.19,1.61)
(1.54,2.05)
Long-term illness
Health problem
No health problem
1,617
56,440
9.5 (8.0, 10.9)
5.7 (5.5, 5.9)
1.71
1.00
(1.43,2.06)
-
Ethnicity
White
non-White
52,530
5,529
5.5 (5.3, 5.7)
9.3 (8.5, 10.1)
1.00
1.77 (1.59, 1.97)
*
Includes temporarily unemployed.
Table excludes missing census characteristic data.
Source: ONS Longitudinal Study
Nati on a l S t a t ist ic s
18
OR
LBW 95% CI
(1.48,1.74)
(0.95,1.23)
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Figure 2
Summer 2006
Multivariate logistic analysis: odds ratios of low birthweight adjusted for birth registration charactistics and
mother’s prior census information
2.5
2
1.5
1
Living in a deprived area carried a high risk of having a low birthweight
baby; for births in the 1980s the odds were 39 per cent higher for mothers
OLYLQJLQWKHORZHVWTXLQWLOHPRVWGLVDGYDQWDJHGDUHDVFRPSDUHGZLWK
mothers in the highest (most advantaged) areas. This was still true for
births in the 1990s but the risk had decreased to a 29 per cent excess
for those in the lowest 20 per cent of areas. Living in a council house
or housing association accommodation also carried a higher risk for
babies born in the 1990s (32 per cent higher) but this relationship with
KRXVLQJWHQXUHZDVQRWVLJQL¿FDQWIRUEDELHVERUQLQWKHVZKHQ
controlling for other variables. The associations between car access
and low birthweight, observed in the individual analysis for births in
the 1980s, disappear when controlling for all the other characteristics.
+RZHYHUIRUELUWKVLQWKHVWKLVUHPDLQHGDVLJQL¿FDQWDVVRFLDWLRQ
after controlling for other factors.
The effect of young motherhood disappears when census information
is in the model showing that other characteristics can explain the
association between young motherhood and low birthweight. The model
based on registration information only (Figure 1) shows an increased
ULVNDPRQJPRWKHUVDJHG±WLPHVKLJKHU25WKDQIRUPRWKHUV
aged 25–33 for the 1980s and 1.13 times higher for the 1990s). In both
GHFDGHVWKLVDJHJURXSQRORQJHUKDGDVLJQL¿FDQWO\UDLVHGOHYHORIULVN
after controlling for all the variables mainly as a result of the poverty of
these mothers measured by the Carstairs Deprivation Index.
ness
m ill
−ter
Long
4
3
5
tairs
Cars
tairs
Cars
tairs
Cars
no
car
cou
n
asso cil/hou
ciati sing
on
ople
Births in the 1990s
Births in the 1980s
Source: ONS Longitudinal Study
The next highest likelihood of low birthweight in the 1990s was
associated with mothers from a non-White ethnic group: non-White
ethnic group mothers had a 62 per cent increased risk of low birthweight
compared with White mothers. A high risk of having a low weight baby
was also experienced by mothers with a long term illness in the 1990
Census (1.55). Ethnic group and long-term illness were not asked in the
1981 Census so this information was not available for births in the 1980s.
2 pe
1 or
regis
tra
tion
Join
(samt registr
e ad atio
dres n
Join
s)
(diff t registr
addr atio
ess) n
Eco
nom
inac ically
tive
Sole
ale
Mot
35− her
44
Fem
4
3
2
5
tairs
Cars
tairs
Cars
tairs
Cars
tairs
Cars
e
2 ro
oms
eopl
1 or
5+ p
Une
mplo
yed
ale
Fem
O ut
mar side
riag
e
0
non
ethn −Whte
icity
0.5
DISCUSSION
This study shows that when explaining low birthweight, lone parenthood
remains important after accounting for all other factors considered
in this analysis (e.g. deprivation, ethnicity, tenure and limiting longWHUPLOOQHVV7KHRQO\VLJQL¿FDQWDVVRFLDWLRQZLWKPRWKHU¶VDJHDIWHU
including the census factors was seen in the 1990s for women having a
baby at age 35–44.
It has been shown from previous analysis of birth records that the risk
of having a baby of low birthweight is increased if it is born outside
marriage.207KHVHUHVXOWVFRQ¿UPWKDWVROHUHJLVWUDWLRQLVWKHFDWHJRU\
most at risk when controlling for the birth registration variables only.
These mothers were twice as likely to have a low birthweight baby
25WKDQPDUULHGFRXSOHVLQWKHV%\FRPSDULVRQEDELHV
MRLQWO\UHJLVWHUHGE\DPRWKHUDQGIDWKHUOLYLQJDWWKHVDPHDGGUHVV
in other words a cohabiting couple, carried a 33 per cent higher risk.
The increased prevalence of births to cohabiting couples might suggest
that this might be an alternative to marriage in the 1990s but the birth
outcomes for such couples are not as favourable. In interpreting the
different results between the 1980s and 1990s, account needs to be taken
both of changes in patterns of marriage (more births outside marriage)
and mother’s age at childbirth (increasing). It is also important to
recognise that none of these risk factors can be singled out as the only or
primary cause of low birthweight.
When additional information is available for mothers from the ONS LS,
the multivariate models show that marital status remains an important
indicator of higher risk of low birthweight but the risk is decreased,
indicating that these other characteristics account for some of this effect.
$OWKRXJKPDULWDOVWDWXVUHPDLQHGVLJQL¿FDQWZKHQWKHFHQVXVLQIRUPDWLRQ
was included in the model the effect decreased in both decades. For
ELUWKVLQWKHVWKH25GHFUHDVHGIURPUHJLVWUDWLRQYDULDEOHV
only) to 1.40 (census variables included). Similarly for births in the
VWKH25GHFUHDVHGIURPUHJLVWUDWLRQYDULDEOHVRQO\WR
1.70 (census variables included). The risk for young mothers shown
with analysis of the birth registration data disappears when the census
19
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
information is included in models (Figure 2), which indicates that the
additional characteristics in the model, mainly social housing, car access
and deprivation as measured by the Carstairs Index account for, or
H[SODLQWKHHIIHFWRI\RXQJPRWKHUKRRGEHLQJLGHQWL¿HGDVDULVNIDFWRU
for low birthweight.
There are certain characteristics available from the census that
additionally identify certain groups of women at risk of these negative
birth outcomes. Ethnicity is known to be associated with the risk of low
birthweight and this is evident in the results for the 1990s births. It is
known that mothers born in India, Pakistan, Bangladesh and East Africa
have the highest proportions of low birthweight babies in the UK.21
Indicators of socio-economic disadvantage, as opposed to sociodemographic characteristics, were generally more important in
identifying an adverse birth outcome but the individual measures
varied in their usefulness as predictors of low birthweight. The most
notable predictors were tenure, car access and the Carstairs index of
deprivation. Living in a disadvantaged area increased the likelihood of
ORZELUWKZHLJKWVLJQL¿FDQWO\:KHWKHUDIDPLO\KDVDFFHVVWRDFDURUQRW
is an important poverty indicator, which is included in the calculations of
Carstairs deprivation score, but by itself not having access to a car was
RQO\VLJQL¿FDQWIRUORZELUWKZHLJKWEDELHVLQWKHV/LYLQJLQORFDO
authority or housing association accommodation in 1991 increased the
risk of the mother having a low birthweight baby in the 1990s. This may
be related to the increasing proportion of lone mothers throughout the
1980s and 1990s. The proportion of dependent children living in lone
parent households in Great Britain increased from 12 per cent in 1981, to
18 per cent in 1992 and 22 per cent in 2001 (lone mothers head around
nine out of ten lone parent families).22 A study of births in the LS sample
between 1981 to 1994 showed that low birthweight babies with mothers
in privately rented accommodation at the time of the 1981 Census were
less likely to die before the age of one than those whose mothers lived in
local authority housing.6
The relationship between the number of people in the household and low
birthweight differed between the 1980s and 1990s. In the 1980s, there
was an effect of household size. In the 1990s the risk was higher for 1
to 2 people in the household than for larger households. This category
includes lone mother households and, as mentioned previously, the
proportion of lone mother households was much higher in the 1990s than
in the 1980s. A study using historical data for the cities of Glasgow and
(GLQEXUJKVKRZHGWKDWRYHUFURZGLQJZDVDVLJQL¿FDQWFDXVHRILQIDQW
mortality.23
A higher proportion of female babies than male babies are of low
birthweight (under 2,500g), however, the stillbirth rate and infant
mortality rate for low birthweight babies is higher for male than female
babies (Table 3). The higher risk of low birthweight amongst female
EDELHVLVFRQ¿UPHGLQPXOWLYDULDWHDQDO\VLV7DEOH'HSULYDWLRQ
ZDVDOVRDNH\ULVNIDFWRULQWKH¿QDOPRGHOZLWKWKHULVN25RIORZ
ELUWKZHLJKWLQFUHDVLQJDVDIÀXHQFHGHFUHDVHV%HLQJDQROGHUPRWKHU
Table 3
Birthweight (grams)
Under 2,500
2,500–3,499
3,500–4,499
Over 4,500
Not stated
All
DJHG±ZDVRQO\VLJQL¿FDQWDVDULVNRIORZELUWKZHLJKWLQWKH
1990s, as it was for infant mortality.24 As explained earlier, this is likely
to be due in part to the mean age of mothers increasing over time.
Increased age is also associated with gestational diabetes, multiple births
(more older mothers undergoing IVF treatment), and genetic defects.
This risk of low birthweight associated with older mothers cannot
however be attributed to the increase in multiple births in this study as
the analysis is for singleton births only (multiple births are generally
lighter as they are more likely to be preterm births).6
A number of limitations in the information available for analysis in
the current study can be addressed in the future. In particular, limited
information on educational level was collected in the 1981 and
1991 Censuses. Greater detail is available from the 2001 Census for
VXEVHTXHQWDQDO\VLV,QDUHFHQWVWXG\LQ5XVVLDORRNLQJDWWKHHIIHFWRI
various socio-demographic and lifestyle factors on pregnancy outcomes,
maternal education was found to be the most important social factor
LQÀXHQFLQJELUWKZHLJKW25 No information on gestational age was
available in this study as it is not routinely collected by birth registration
(it is only collected for stillbirths) so it was not possible to compare risk
factors for preterm births with low birthweight full-term births. A study
carried out in Spain looking at low birthweight associated with socioGHPRJUDSKLFIDFWRUVIRXQGVLJQL¿FDQWGLIIHUHQFHVLQWKHUHODWLRQVKLS
between maternal age and low birthweight in preterm births (those during
WKH¿UVWZHHNVRIJHVWDWLRQFRPSDUHGWRIXOOWHUPELUWKV26
&KDUDFWHULVWLFVRIWKHPRWKHUVLGHQWL¿HGDWWKH&HQVXVPD\KDYHFKDQJHG
by the time of the birth. A previous study with the LS has shown that
among women who were married in the 1971 Census but were divorced
at the time of the 1981 Census, there were pronounced changes in their
housing tenure.27 This study did not examine changing status between
censuses. Future analysis examining changes in family type between
Censuses, for example, would make it possible to examine whether
mothers that have recently separated are more likely to have a low
birthweight baby than those who had been lone mothers for a longer
period. Exploring the effect of region of residence or whether the mother
lives in an urban or rural area or examining the effect of including
RFFXSDWLRQDOFODVVL¿FDWLRQVVRFLDOFODVVDYDLODEOHWRDQG166(&
1DWLRQDO6WDWLVWLFV(FRQRPLFDQG6RFLDO&ODVVL¿FDWLRQ±DYDLODEOHIRU
1991 and 2001 Census records) might also prove productive. In the
current analysis tenure and employment status were used as an alternative
for social class indicators. Analyses similar to those presented in this
article have been undertaken with infant mortality as the birth outcome
rather than low birthweight. However the numbers of events available for
analysis were too small to allow any conclusions to be drawn.24
CONCLUSION
This analysis has shown that demographic factors collected at birth
registration (particularly lone parenthood) are undoubtedly important
for identifying groups at risk of low birthweight babies. However other
socio-economic factors available from the Census further identify groups
Distribution of live births, stillbirths and infant deaths by birthweight category, 2000–2004
Live births
Stillbirths
Infant deaths
Stillbirth rates
Infant death rates
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
110,862
758,603
659,936
35,144
2,546
122,123
849,177
499,497
16,163
2,336
5,996
1,882
718
89
319
5,290
1,784
466
60
247
5,675
2,204
832
54
183
4,481
1,840
554
44
110
51.3
2.5
1.1
2.5
111.3
41.5
2.1
0.9
3.7
95.6
51.2
2.9
1.3
1.5
71.9
36.7
2.2
1.1
2.7
47.1
1,567,091
1,489,296
9,004
7,847
8,948
7,029
5.7
5.2
5.7
4.7
Nati on a l S t a t ist ic s
20
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
at risk and explain some of the variation associated with demographic
characteristics at birth, namely lone motherhood and young motherhood.
Being a mother from a non-White ethnic group, with a long-standing
LOOQHVVRUOLYLQJLQDGHSULYHGDUHDZHUHWKHNH\FKDUDFWHULVWLFVLGHQWL¿HG
from additional Census information as being a risk factors for low
birthweight.
Part of the association between mother’s age and marital status for this
adverse birth outcome is because these mothers are more likely to be
poor and disadvantaged. The results indicate that there is a higher risk
for mothers registering births outside marriage than for those registering
births inside marriage, particularly for mothers registering babies
alone. This higher risk persists even when their economic situation
is taken into consideration, although this risk is lowered when other
socio-demographic factors are included in multivariate analysis. The
higher risk of lower birthweight for young mothers shown by birth
registration statistics disappears once other socio-economic information
(primarily tenure, car access and Carstairs Deprivation Index) is included
in the analyses, which indicates that this effect can be explained by
the disadvantaged situation of these mothers. The effect of young
motherhood can be seen to be related to their adverse socio-economic
conditions.
In terms of identifying groups for policy or intervention purposes,
the groups at higher risk of low birthweight remain lone mothers,
particularly mothers registering their children alone, young mothers
and the oldest mothers. The current analyses show that the higher
risk of this adverse birth outcome for these mothers is related to their
economic circumstances and that the increased risk for young mothers is
entirely accounted for by their deprived socio-economic circumstances.
$GGLWLRQDOO\RWKHUJURXSVKDYHEHHQLGHQWL¿HGDVEHLQJZRUWK\IRU
attention, namely people of non-White ethnic groups and mothers with a
limiting long-term illness or in deprived circumstances.
Key findings
In the 1990s, the factor most strongly associated with low
birthweight was being born outside marriage, where the birth
was registered by the mother alone. This was the case even
after taking account of the mother’s socio-economic status.
M Mothers from non-White ethnic groups had a 62 per cent increased risk of having a low birthweight baby when compared
with White mothers, after taking account of their age at the
time of the birth, household and area characteristics..
M Mothers living in the most deprived areas had a higher risk of
having a low birthweight baby compared with mothers living in
the least deprived area (39 per cent in the 1980s and 29 per
cent in the 1990s), after taking account of their age at the time
of the birth, ethnicity and limiting long-term illness.
M
REFERENCE
1. Spencer N (2003) :HLJKLQJWKHHYLGHQFH+RZLVELUWKZHLJKW
GHWHUPLQHG"5DGFOLIIH0HGLFDO3UHVV/WG2[IRUG8.
2I¿FHIRU1DWLRQDO6WDWLVWLFV±0RUWDOLW\6WDWLVWLFV
FKLOGKRRGLQIDQWDQGSHULQDWDO(QJODQGDQG:DOHV, Series DH3.
HMSO/TSO: London.
3. Jefferis B, Power C and Hertzman C (2002) Birth weight, childhood
socioeconomic environment, and cognitive development in the 1958
British birth cohort study. %0- 325, 305.
5LFK(GZDUGV-:&ROGLW]*$6WDPSIHU0-HWDO (1999) Birthweight and the risk for type 2 diabetes mellitus in adult women. $QQ
,QWHUQ0HG. 130, 278–284.
Summer 2006
5LFK(GZDUGV-.OHLQPDQ.0LFKHOV.HWDO (2005) Longitudinal
study of birth weight and adult body mass index in predicting risk
of coronary heart disease and stroke in women. %0- 330:1115,
278–284.
6. Macfarlane A and Mugford M ( 2000) %LUWK&RXQWV6WDWLVWLFVRI
3UHJQDQF\DQG&KLOGELUWK. Volume 1, TSO: London.
7. Department of Health (2000) 7KH1+63ODQ$SODQIRULQYHVWPHQW
$SODQIRUUHIRUP, HMSO: London.
'HSDUWPHQWRI+HDOWK7DFNOLQJKHDOWKLQHTXDOLWLHV$SURJUDPPH
for Action. Available from: www.dh.gov.uk/PolicyAndGuidance/
+HDOWK$QG6RFLDO&DUH7RSLFV+HDOWK,QHTXDOLWLHV3URJUDP)RU$FWLRQ
fs/en
9. Shouls S, Whitehead M, Burstrom B HWDO (1999) The health and
socio-economic circumstances of British lone mothers over the last
two decades. 3RSXODWLRQ7UHQGV 95, 41–46.
10. Youngest Mothers’ infants having greatly elevated risk of dying by
age one (2003) Digests. 3HUVSHFWLYHVRQ6H[XDODQG5HSURGXFWLYH
+HDOWK 2003;35
3DWWHQGHQ6'RON+DQG9ULMKHLG0,QHTXDOLWLHVLQORZ
birthweight: parental social class, area deprivation and ‘lone mother’
status. JRXUQDORI(SLGHPLRORJ\DQG&RPPXQWL\+HDOWK 53, 355–358.
12. Fitzpatrick J and Cooper N (2001) Patterns and trends in stillbirths
DQGLQIDQWPRUWDOLW\LQ*ULI¿WKV&DQG)LW]SDWULFN-HGV
*HRJUDSKLF9DULDWLRQVLQ+HDOWK. Decennial Supplements No.16,
TSO: London.
0DKHU-DQG0DFIDUODQH$,QHTXDOLWLHVLQLQIDQWPRUWDOLW\
trends by social class, registration status, mother’s age and birthweight, England and Wales, 1976–2000. +HDOWK6WDWLVWLFV4XDUWHUO\
24, 14–22.
0RVHU./L/DQG3RZHU&6RFLDOLQHTXDOLWLHVLQORZELUWK
weight in England and Wales: trends and implications for future
population health. -RXUQDORI(SLGHPLRO&RPP+HDOWK 57, 687–691.
5RQDOGV*DQG/HRQG6WXG\RIWKHUHODWLRQVKLSEHWZHHQHWKQLF
ancestry and birth weight in babies born to South Asian and White
parents in England and Wales.
$YDLODEOHIURPKWWSZZZFHOVLXVOVKWPDFXNSURMHFWVURQDOGVKWPO
16. The ONS Longitudinal study at www.statistics.gov.uk Cited
15 August 2005.
17. Centre for Longitudinal Study Information and Support at
www.celsius.lshtm.ac.uk Cited 15 August 2005.
18. United Nations Childrens Fund and World Health Association (2004)
/RZELUWKZHLJKW&RXQWU\UHJLRQDODQGJOREDOHVWLPDWHV, UNICEF:
New York.
&DUVWDLUV9DQG0RUULV5'HSULYDWLRQDQG0RUWDOLW\DQDOWHUnative to social class? &RPPXQLW\0HGLFLQH 11, 213–219.
20. Maher J and Macfarlane A (2004) Trends in live births and birthweight by social class, marital status and mother’s age, 1976–2000.
+HDOWK6WDWLVWLFV4XDUWHUO\ 23, 34–43.
21. Davey-Smith G, Chaturvedi N, Harding S HWDO (2000) Ethnic
LQHTXDOLWLHVLQKHDOWKDUHYLHZRI8.HSLGHPLRORJLFDOHYLGHQFH
&ULWLFDO3XEOLF+HDOWK 10(4), 375–408.
2I¿FHIRU1DWLRQDO6WDWLVWLFV6RFLDO7UHQGV . &K
+RXVHKROGVDQG)DPLOLHV, Palgrave Macmillan: Basingstoke, pg 24.
23. Foster J (2002) Overcrowding and Infant mortality: a tale of two
cities. 6FRWWLVK-RXUQDORI3ROLWLFDO(FRQRP\ 49, 129–149.
24. Collingwood Bakeo A M (2005).Birthweight and infant
PRUWDOLW\ULVNIDFWRUVLGHQWL¿HGIURPELUWKUHJLVWUDWLRQDQGFHQVXV
data, England and Wales 1981 to 2000. MSc Thesis. London School
of Hygiene and Tropical Medicine.
*UMLERYVNL$%\JUHQ/2DQG6YDUWER%6RFLRGHPRJUDSKLF
GHWHUPLQDQWVRISRRULQIDQWRXWFRPHLQQRUWKZHVW5XVVLD3DHGLDWULF
and Perinatal Epidemiology 16(3), 255–262.
5RGULJXH]&5HJLGRU(DQG*XWLHUUH])LVDF-/RZELUWK
weight in Spain associated with sociodemographic factors. -RXUQDORI
(SLGHPLRORJ\DQG&RPPXQLW\+HDOWK 49, 38–42.
27. Grundy E (1989) :RPHQ¶VPLJUDWLRQPDUULDJHIHUWLOLW\DQGGLYRUFH.
Series LS no.4, HMSO: London.
21
N a t i o n a l S t a t i s t i cs
Tables
Page
Notes to tables
1.1
1.2
1.3
1.4
1.5
2.1
2.2
3.1
3.2
23
Population
International ........................................................................................Selected countries
National ...............................................................................................Constituent countries of
the United Kingdom
SXEQDWLRQDO*RYHUQPHQW2I¿FH5HJLRQV
of England
Age and sex .........................................................................................Constituent countries of
the United Kingdom
Age, sex and legal marital status ........................................................England and Wales
Summary .............................................................................................Constituent countries of
the United Kingdom
Key demographic and health indicators .............................................Constituent countries of
the United Kingdom
Age of mother .....................................................................................England and Wales
Outside marriage: age of mother and type of registration .................England and Wales
(In years) at birth and selected age .....................................................Constituent countries of
the United Kingdom
36
37
38
39
40
Expectation of life
Deaths
Age and sex .........................................................................................England and Wales
Subnational..........................................................................................+HDOWK5HJLRQDO2I¿FHDUHDV
of England
Selected causes and sex ......................................................................England and Wales
StatBase®
+HDOWK6WDWLVWLFV4XDUWHUO\WDEOHVDUHQRZDYDLODEOHRQ6WDW%DVH® which can be accessed
via our website www.statistics.gov.uk
Symbols
Nati o n a l S t a t ist ic s
34
Conceptions and abortions
5.1
29
32
Live births
Age of women at conception ..............................................................England and Wales (residents)
Abortions: age and gestation. ............................................................England and Wales
6.3
28
Vital statistics
4.1
4.2
6.1
6.2
24
27
..
not available
:
not applicable
QLORUOHVVWKDQKDOIWKH¿QDOGLJLWVKRZQ
blank not yet available
22
22
N a t i o n a l S t a t i s t i cs
41
42
43
44
H e a l t h S t a t i s t i cs Q u a r t e r l y 3 0
Summer 2006
Notes to tables
Time series
For most tables, years start at 1971 and then
FRQWLQXHDW¿YH\HDULQWHUYDOVXQWLO
Individual years are shown thereafter. If a year
is not present the data are not available.
United Kingdom
The United Kingdom comprises England,
Wales, Scotland and Northern Ireland. The
Channel Islands and the Isle of Man are not part
of the United Kingdom.
Population
The estimated resident population of an area
includes all people who usually live there,
whatever their nationality. Members of HM
and US Armed Forces in England and Wales
are included on residential basis wherever
possible. HM Forces stationed outside England
and Wales are not included. Students are taken
to be resident at their term time addresses.
Further information on population estimates can
be found on the National Statistics website at
www.statistics.gov.uk/popest
Live births
)RU(QJODQGDQG:DOHV¿JXUHVUHODWHWR
numbers occurring in a period; for Scotland
DQG1RUWKHUQ,UHODQG¿JXUHVUHODWHWRWKRVH
registered in a period. See also Note on page 63
of 3RSXODWLRQ7UHQGV67.
Perinatal mortality
,Q2FWREHUWKHOHJDOGH¿QLWLRQRID
stillbirth was changed, from a baby born dead
after 28 completed weeks of gestation or more,
to one born dead after 24 completed weeks of
gestation or more.
Expectation of life
The life tables on which these expectations
are based use current death rates to describe
mortality levels for each year. Each individual
year shown is based on a three-year period,
so that for instance 1986 represents 1985–87.
More details can be found in 3RSXODWLRQ7UHQGV
60, page 23.
Deaths
Figures for England and Wales relate to the
number of deaths registered in each year up
to 1992, and the number occurring in each
\HDUIURPWKRXJKSURYLVLRQDO¿JXUHVDUH
registrations. Figures for both Scotland and
Northern Ireland relate to the number of deaths
registered in each year.
Since +HDOWK6WDWLVWLFV4XDUWHUO\ 15, Table 6.2
SUHVHQWVGHDWKVIRU*RYHUQPHQW2I¿FHVIRUWKH
5HJLRQVUDWKHUWKDQ+HDOWK5HJLRQDO2I¿FH
areas in England. More details can be found in
+HDOWK6WDWLVWLFV4XDUWHUO\ 15, page 2.
Age-standardised mortality
Directly age-standardised rates make allowances
for changes in the age structure of the population.
The age-standardised rate for a particular
condition is that which would have occurred if
WKHREVHUYHGDJHVSHFL¿FUDWHVIRUWKHFRQGLWLRQ
had applied in a given standard population.
Tables 2.2 and 6.3 use the European Standard
Population. This is a hypothetical population
standard which is the same for both males
and females allowing standardised rates to be
compared for each sex, and between males and
females.
Rounding
$OO¿JXUHVDUHURXQGHGLQGHSHQGHQWO\
constituent parts may not add to totals.
Generally numbers and rates per 1,000
population are rounded to one decimal place
HJZKHUHDSSURSULDWHIRUVPDOO¿JXUHV
(below 10.0), two decimal places are given
(eg 7.62). Figures which are provisional or
estimated are given in less detail (eg 123 or
7.6 respectively) if their reliability does not
MXVWLI\JLYLQJWKHVWDQGDUGDPRXQWRIGHWDLO
:KHUH¿JXUHVQHHGWREHWUHDWHGZLWKSDUWLFXODU
caution, an explanation is given as a footnote.
Abortions
Figures relate to numbers occurring in a period.
Latest figures
)LJXUHVIRUWKHODWHVWTXDUWHUVDQG\HDUVPD\EH
provisional and will be updated in future issues
when later information becomes available.
:KHUH¿JXUHVDUHQRW\HWDYDLODEOHFHOOVDUH
left blank.
Improvements to National Statistics on
abortions performed in England and Wales
were published in +HDOWK6WDWLVWLFV4XDUWHUO\
7KHUHYLVHG¿JXUHVDUHSUHVHQWHGLQ7DEOH
4.2. These changes include an improvement
LQWKHFDOFXODWLRQRITXDUWHUO\DERUWLRQUDWHV
7KHPLGTXDUWHUSRSXODWLRQHVWLPDWHVXVHGWR
calculate these rates, were produced by linear
interpolation as follows:
0DUFKTXDUWHU
-XQHTXDUWHU
6HSWHPEHUTXDUWHU
'HFHPEHUTXDUWHU
333
333
333
333
Shaded background
$VKDGHGEDFNJURXQGLQGLFDWHV¿JXUHVWKDW
DUHRUPD\EHVXEMHFWWRFKDQJHWKHJUH\
VKDGLQJVLJQL¿HVWKDWWKHXQGHUO\LQJSRSXODWLRQ
estimates relate to those originally published;
the coloured shading indicates estimates that
have already been revised from the original, but
ZLOORUPD\EHVXEMHFWWRIXUWKHUUHYLVLRQ
Where P1 = mid-year population estimate
of previous year;
P2 = mid-year population estimate
of year being calculated;
3 SRSXODWLRQSURMHFWLRQIRUQH[W
year.
For example
0DUFKTXDUWHU SRS
SRSSRS
6HSWHPEHUTXDUWHU SRS
SRSSRS
Marriages and divorces
Marriages are tabulated according to date of
solemnisation. Divorces are tabulated according
to date of decree absolute. In Scotland a small
number of late divorces from previous years are
added to the current year. The term ‘divorces’
includes decrees of nullity. The fact that a
marriage or divorce has taken place in England,
Wales, Scotland or Northern Ireland does not
necessarily mean that either of the parties is
resident there.
Sources
Figures for Scotland and Northern Ireland have
EHHQSURYLGHGE\WKH*HQHUDO5HJLVWHU2I¿FH
for Scotland and the Northern Ireland Statistics
DQG5HVHDUFK$JHQF\UHVSHFWLYHO\
23
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Population and vital rates: international
Table 1.1
Selected countries
Year
Numbers (thousands)/Rates per thousand
United
Kingdom
Austria
Belgium
Cyprus1,3
Czech
Republic3
Denmark
Estonia3
Finland
France
Germany2
Greece
Hungary3
Irish
Republic
Population (thousands)
1971
55,928
1976
56,216
1981
56,357
1986
56,684
1991
57,439
7,501
7,566
7,569
7,588
7,813
9,673
9,818
9,859
9,862
9,979
..
498
515
545
587
9,810
10,094
10,293
10,340
10,309
4,963
5,073
5,121
5,120
5,154
1,369
1,435
1,482
1,534
1,566
4,612
4,726
4,800
4,918
5,014
51,251
52,909
54,182
55,547
57,055
78,313
78,337
78,408
77,720
79,984
8,831
9,167
9,729
9,967
10,247
10,370
10,590
10,712
10,631
10,346
2,992
3,238
3,443
3,543
3,526
1996
1997
1998
1999
2000
58,164
58,314
58,475
58,684
58,886
7,953
7,965
7,980
7,990
8,010
10,160
10,180
10,200
10,230
10,250
750 10
760 10
770 10
770 10
780 10
10,321
10,300
10,290
10,280
10,270
5,260
5,275
5,295
5,330
5,340
1,470
1,460
1,450
1,440
1,372
5,117
5,140
5,147
5,170
5,180
58,030
58,610
58,400
58,620
58,900
81,900
82,060
82,030
82,060
82,180
10,480
10,500
10,520
10,530
10,010
10,190
10,150
10,110
10,070
10,020
3,630
3,660
3,700
3,740
3,790
2001
2002
2003
2004
2005
59,113
59,322
59,554
59,834 11
..
8,040
8,080
8,120
8,170
8,20613p
10,290
10,330
10.380
10,396
10,44613p
790 10
800 10
810 10
..
..
10,220
10,206
10,203
10,212
10,22113p
5,360
5,370
5,390
5,400
5,41113p
1,360
1,361
1,350
1,351 P
1,34713p
5,190
5,200
5,210
5,230
5,23713p
59,190
59,490
59,770
60,200
60,56113p
82,350
82,490
82,530
82,500
82,50113p
10,020
10,988
11,018
11,041
11,07613p
10,190
10,160
10,130
10,117
10,09713p
3,840
3,920
3,980
4,028
4,10913p
Population changes (per 1,000 per annum)
1971–76
1.0
1.7
3.0
1976–81
0.5
0.1
0.8
1981–86
1.2
0.5
0.1
1986–91
2.7
5.9
2.4
3.6
3.6
1991–96
2.5
..
6.8
11.7
15.4
55.5
5.8
3.9
0.9
–0.6
0.1
4.4
1.9
0.0
1.3
4.1
9.6
6.6
7.0
4.2
–12.4
4.9
3.1
4.9
3.9
3.8
6.5
4.8
5.0
5.4
3.4
0.1
0.2
–1.8
5.8
4.8
7.6
12.3
4.9
5.6
4.5
4.2
2.3
–1.5
–5.4
–3.0
16.4
12.7
5.8
–1.0
4.3
1997–98
1998–99
1999–2000
2000–01
2001–02
2002–03
2003–04
2004–05
2.0
2.9
2.0
3.9
3.9
4.8
1.5
4.8
13.2
10.0
13.0
12.8
12.7
12.5
..
..
–1.0
–1.0
–1.0
–4.9
–2.0
0.0
1.2
0.9
3.8
6.6
1.9
3.7
1.9
3.7
1.9
2.0
–6.8
–16.9
–47.2
–8.7
0.0
–7.4
0.7
–3.0
1.4
4.5
1.9
1.9
1.9
1.9
3.8
1.3
–3.6
3.8
4.8
4.9
5.1
4.7
7.2
6.0
–0.4
–0.4
1.5
2.1
1.7
0.5
–0.4
0.0
1.9
1.0
–49.4
1.0
96.8
2.7
1.9
3.2
–3.9
–4.0
–5.0
17.0
–2.9
–3.0
–1.3
–2.0
10.9
10.8
13.4
13.2
20.8
15.3
12.1
20.1
Live birth rate (per 1,000 per annum)
1971–75
14.1
13.3
1976–80
12.5
11.5
1981–85
12.9
12.0
1986–90
13.7
11.6
1991–95
13.2
11.8
13.4
12.5
12.0
12.1
12.0
17.7
19.0
20.2
18.8
16.9
17.8
17.1
13.5
12.7
11.1
14.6
12.0
10.2
11.5
13.1
15.4
15.0
15.6
15.5
10.7
13.1
13.6
13.4
12.7
12.9
16.0
14.1
14.2
13.8
12.7
10.5
10.5
10.7
9.8
10.9
15.8
15.6
13.3
10.6
9.9
16.1
15.8
12.3
11.8
11.7
22.2
21.3
19.2
15.8
14.0
1996
1997
1998
1999
2000
12.6
12.5
12.3
11.9
11.5
11.0
10.4
10.1
9.7
9.7
11.5
11.4
11.2
11.1
11.2
14.5
13.9
13.1
12.4
12.2
8.8
8.8
8.8
8.7
8.8
12.9
12.8
12.5
12.4
12.6
9.0
8.7
8.4
8.7
9.6
11.8
11.5
11.1
11.1
11.0
12.6
12.4
12.6
12.6
13.2
9.7
9.9
9.7
9.4
9.3
9.6
9.7
9.6
11.0
11.7
10.3
9.9
9.6
9.4
9.7
13.9
14.4
14.5
14.2
14.3
2001
2002
2003
2004
11.3
11.3
11.7
12.1
9.3
9.7
9.4
9.7
11.1
..
..
11.2
11.6
11.1
..
..
8.9
9.1
9.2
9.6
12.2
11.9
12.0
11.9
9.3
9.6
..
10.4
10.8
10.7
10.9
11.4
13.1
12.8
12.7
..
9.0
8.7
8.6
8.6
10.2
..
9.5
..
9.7
9.5
9.3
..
15.1
15.5
15.7
15.3
Death rate (per 1,000 per annum)
1971–75
11.8
12.6
1976–80
11.9
12.3
1981–85
11.7
12.0
1986–90
11.4
11.1
1991–95
11.1
10.4
12.1
11.6
11.4
10.8
10.4
9.9
10.4
10.0
10.2
9.0
12.4
12.5
12.8
12.4
11.6
10.1
10.5
11.1
11.5
11.9
11.1
12.1
12.3
11.9
13.9
9.5
9.3
9.3
9.8
9.8
10.7
10.2
10.1
9.5
9.1
12.3
12.2
12.0
11.6
10.8
8.6
8.8
9.0
9.3
9.5
11.9
12.9
13.7
13.5
14.3
11.0
10.2
9.4
9.1
8.8
1996
1997
1998
1999
2000
10.9
10.8
10.8
10.8
10.3
10.0
9.8
9.7
9.7
9.5
10.3
10.2
10.3
10.3
10.2
8.5
8.8
8.0
7.4
7.7
10.9
10.9
10.6
10.7
10.6
11.6
11.3
11.0
11.1
10.9
12.9
12.7
13.4
12.8
13.4
9.6
9.6
9.6
9.5
9.5
9.2
9.0
9.2
9.2
9.1
10.8
10.5
10.4
10.4
10.2
9.6
9.5
9.8
9.9
10.5
14.0
13.7
13.9
14.2
13.5
8.7
8.6
8.5
8.5
8.2
2001
2002
2003
2004
2005P
10.2
10.2
10.3
9.7
9.7
9.2
9.5
9.5
9.1
..
10.1
..
..
9.8
..
6.9
7.3
..
..
..
10.5
10.6
10.9
10.5
..
10.9
10.9
10.7
10.3
..
13.6
13.5
..
13.2
..
9.4
9.5
9.4
9.1
..
9.0
9.0
9.2
..
..
10.0
10.2
10.3
10.0
..
10.2
..
9.6
..
..
13.0
13.1
13.4
..
..
7.8
7.5
7.4
7.0
..
2.8
3.6
3.4
3.9
3.5
3.9
4.7
..
1.9
1.3
2.5
3.7
5.0
5.0
6.2
4.4
12
12
14
Note:
Estimated population (mid-year), live birth and death rates up to the latest available date, as
given in the United Nations Monthly Bulletin of Statistics (November 2005), the United Nations
Demographic Yearbook (2000 Edn), Eurostat Yearbook 2004 and the Eurostat website (April 2006).
1 Republic of Cyprus - Greek Cypriot controlled area only
2 Including former GDR throughout.
3 The European Union consists of 25 member countries (EU25) - 1 May 2004 (10 new
member countries).
4 Including the Indian held part of Jammu and Kashmir, the final status of which has not yet
been determined.
5 Rates are based on births to or deaths of Japanese nationals only.
National Statistics
24
6
7
8
9
10
11
12
13
14
p
Excludes Hong Kong.
Estimate prepared by the Population Division of the United Nations.
Includes Hong Kong.
Rate is for 1990–1995.
Indicates population estimates of uncertain reliability.
Data for mid-2004 for the United Kingdom, Great Britain, England and Wales and England
were revised due to the Harrow correction that was published on 20 December 2005.
Birth and death rates for 2004 have been calculated using the revised mid-2004
population estimates published on 20 December 2005.
As at 1 January.
Death rates for 2005 are based on the 2004 based Population Projections for 2005.
Provisional
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Summer 2006
Nether–
lands
Poland3
Portugal
Slovakia3
Slovenia3
Spain
Sweden
Population and vital rates: international
Table 1.1
continued
Selected countries
Year
Numbers (thousands)/Rates per thousand
United
Kingdom
Italy
Latvia3
Lithuania3
Luxem–
bourg
Malta3
Population (thousands)
1971
55,928
1976
56,216
1981
56,357
1986
56,684
1991
57,439
54,073
55,718
56,502
56,596
56,751
2,366
2,465
2,515
2,588
2,662
3,160
3,315
3,422
3,560
3,742
342
361
365
368
387
330
330
322
344
358
13,194
13,774
14,247
14,572
15,070
32,800
34,360
35,902
37,456
38,245
8,644
9,356
9,851
10,011
9,871
4,540
4,764
4,996
5,179
5,283
1,732
1,809
1,910
1,975
2,002
34,216
36,118
37,741
38,536
38,920
8,098
8,222
8,320
8,370
8,617
..
420,258
428,563
433,555
440,927
1996
1997
1998
1999
2000
58,164
58,314
58,475
58,684
58,886
57,380
57,520
57,590
57,650
57,760
2,460
2,430
2,410
2,390
2,370
3,615
3,580
3,550
3,520
3,512
420
416
430
427
440
380
380
390
390
389
15,530
15,610
15,710
15,810
15,910
38,620
38,650
38,670
38,650
38,260
10,060
10,090
10,130
10,170
10,230
5,368
5,379
5,388
5,393
5,399
1,990
1,987
1,985
1,978
1,988
39,430
39,520
39,650
39,840
40,170
8,838
8,845
8,848
8,860
8,870
447,522
448,785
449,121
449,994
450,287
2001
2002
2003
2004
2005
59,113
59,322
59,554
59,834 11
..
57,950
57,160
57.610
58,170
58,46213p
2,364
2,340
2,332
2,310
2,30613p
3,480
3,470
3,460
3,440
3,42513p
440
450
450
450
45513p
390
390
400
400
40313p
16,050
16,150
16,220
16,270
16,30513p
38,250
38,230
38,200
38,180
38,17413p
10,290
10,370
10,440
10,500 P
10,52913p
5,379
5,379
5,379
5,380
5,38513p
1,990
2,000
2,000
2,000
1,99813p
40,610
41,200
41,870 P
42,345
43,03813p
8,900
8,920
8,960
8,990
9,01113p
452,043
453,772
455,764
457,645
..
9.8
6.5
8.1
10.2
–1.7
10.7
2.5
1.8
10.2
17.0
0.0
–4.8
13.7
8.1
8.4
8.8
6.9
4.6
6.8
4.6
9.5
9.0
8.7
4.2
2.0
16.5
10.6
3.2
–2.8
3.8
9.9
9.7
7.3
4.0
3.4
8.9
11.2
6.8
2.7
–1.1
11.1
9.0
4.2
2.0
2.6
3.1
2.4
1.2
5.9
1.2
..
4.0
2.3
3.4
3.0
–8.2
–8.3
–8.4
–4.2
–8.5
–4.3
–8.6
–1.7
–8.4
–8.5
–2.3
–9.1
–2.9
–2.9
–5.8
–4.4
33.7
–0.7
30.4
0.0
22.7
0.0
0.0
11.1
26.3
0.0
–2.6
2.6
0.0
25.6
0.0
7.5
6.4
6.4
6.3
8.8
6.2
4.3
3.1
2.2
0.5
–0.5
–10.1
–0.3
–0.5
–0.8
–0.5
–0.2
4.0
3.9
5.9
5.9
–7.8
6.8
5.7
2.8
1.5
0.7
0.9
–3.7
0.0
0.0
0.0
0.9
–1.0
–3.5
5.1
1.0
5.0
0.0
0.0
–1.0
3.3
4.8
8.3
11.0
14.5
16.3
11.3
16.4
0.3
1.4
1.1
3.4
2.2
4.5
3.3
2.3
0.7
1.9
0.7
3.9
3.8
4.4
2.5
..
Live birth rate (per 1,000 per annum)
1971–75
14.1
16.0
14.4
1976–80
12.5
12.6
13.9
1981–85
12.9
10.6
15.2
1986–90
13.7
9.8
15.3
1991–95
13.2
9.6
10.8
16.4
15.4
16.0
15.8
13.1
11.6
11.2
11.6
12.2
13.3
17.5
17.0
15.3
16.0
14.0
14.9
12.6
12.2
12.8
12.8
17.9
19.3
19.0
15.5
12.9
20.3
17.9
14.5
11.9
11.4
19.7
20.3
18.0
15.8
13.3
16.4
16.3
14.2
12.3
10.0
19.2
17.1
12.8
10.8
9.8
13.5
11.6
11.3
13.2
13.3
..
..
..
..
..
1996
1997
1998
1999
2000
12.6
12.5
12.3
11.9
11.5
9.2
9.4
9.3
9.3
9.4
7.9
7.6
7.5
8.0
8.3
10.5
10.2
10.4
10.3
9.8
13.7
13.1
12.7
13.0
13.1
13.5
13.1
12.2
11.4
10.8
12.2
12.3
12.7
12.7
13.0
11.1
10.7
10.2
9.9
9.8
11.1
11.4
11.4
11.6
11.8
11.2
11.0
10.7
10.4
10.2
9.4
9.1
9.0
8.8
9.1
9.2
9.4
9.3
9.6
9.8
10.8
10.2
10.1
10.0
10.2
10.8
10.7
10.5
10.5
10.6
2001
2002
2003
2004
11.3
11.3
11.7
12.1
9.3
9.3
9.4
..
8.3
8.6
..
..
9.1
8.7
8.9
8.9
12.4
12.0
11.5
12.1
..
..
..
..
12.6
12.6
12.4
11.9
9.5
9.2
9.2
9.3
10.8
11.0
11.2
10.4
9.5
9.5
9.7
10.0
8.8
8.8
8.7
9.0
..
..
..
..
10.3
10.7
11.1
11.2
10.4
10.3
..
..
Death rate (per 1,000 per annum)
1971–75
11.8
9.8
1976–80
11.9
9.7
1981–85
11.7
9.5
1986–90
11.4
9.4
1991–95
11.1
9.7
11.6
12.6
12.8
12.4
14.8
9.0
10.1
10.6
10.3
12.0
12.2
11.5
11.2
10.5
9.8
9.0
9.0
8.2
7.4
7.6
8.3
8.1
8.3
8.5
8.8
8.4
9.2
9.6
10.0
10.2
11.0
10.1
9.6
9.6
10.4
9.4
9.8
10.1
10.1
9.9
10.0
9.8
10.3
9.6
9.7
8.5
8.0
7.7
8.2
8.7
10.5
10.9
11.0
11.1
10.9
..
..
..
..
..
1996
1997
1998
1999
2000
10.9
10.8
10.8
10.8
10.3
9.6
9.8
10.0
9.9
9.7
13.8
13.8
14.2
13.7
13.2
11.6
11.1
11.5
11.4
11.1
9.4
9.4
9.2
8.8
8.6
7.4
7.7
8.1
8.2
7.6
8.9
8.7
8.8
8.9
8.8
10.0
9.8
9.7
9.9
9.5
10.8
10.6
10.7
10.8
10.6
9.8
9.7
9.9
9.7
9.8
9.4
9.5
9.6
9.5
9.3
8.9
8.9
9.2
9.1
9.1
10.6
10.5
10.5
10.7
10.5
10.1
10.0
10.0
10.0
9.8
2001
2002
2003
2004
2005P
10.2
10.2
10.3
9.7
9.7
9.6
9.7
10.8
..
..
14.0
13.9
..
..
..
11.6
11.8
11.9
12.0
..
8.4
8.4
8.6
7.9
..
..
..
..
..
..
8.8
8.9
8.7
8.4
..
9.4
9.4
9.6
..
..
10.4
10.2
10.9
9.7
..
9.6
9.6
9.7
9.6
..
9.3
9.3
9.7
9.3
..
8.9
..
..
..
..
10.5
10.7
10.4
10.1
..
9.7
9.8
..
..
..
Population changes (per 1,000 per annum)
1971–76
1.0
6.1
8.4
1976–81
0.5
2.8
4.1
1981–86
1.2
0.3
5.8
1986–91
2.7
0.5
5.7
2.2
–12.8
1991–96
2.5
1997–98
1998–99
1999–2000
2000–01
2001–02
2002–03
2003–04
2004–05
1.2
1.0
1.9
3.3
–13.6
7.9
9.7
5.0
2.8
3.6
3.4
3.9
3.5
3.9
4.7
..
12
12
14
See notes on first page of table.
25
National Statistics
EU–253
Heal th Stati sti cs Q u a r t e rly 3 0
Table 1.1
continued
Summer 2006
Population and vital rates: international
Selected countries
Numbers (thousands)/Rates per thousand
Year
United
Kingdom
EU–25
3
Russian
Federation
Australia
Canada
New
Zealand
China
India4
Population (thousands)
1971
1976
1981
1986
1991
55,928
56,216
56,357
56,684
57,439
..
420,258
428,563
433,555
440,927
130,934
135,027
139,225
144,154
148,245
13,067
14,033
14,923
16,018
17,284
22,026
23,517
24,900
26,204
28,031
2,899
3,163
3,195
3,317
3,477
852,290
937,170
1,008,460
1,086,733
1,170,100
1996
1997
1998
1999
2000
58,164
58,314
58,475
58,684
58,886
447,552
448,785
449,121
449,994
450,287
147,739
147,105
146,540
145,940
145,560
18,311
18,524
18,710
18,930
19,150
29,610
29,910
30,160
30,490
30,770
3,730
3,780
3,820
3,840
3,860
1,223,890 6,10
1,236,260 6,10
1,248,100 6,10
1,259,090 6,10
1,275,130 7,8,10
2001
2002
2003
2004
2005
59,113
59,322
59,554
59,834 11
..
452,043
453,772
455,764
457,645
..
145,980
145,310
144,570
143,820
..
19,410
19,640
19,870
20,110
..
31,110
31,410
31,630
31,950
..
3,850
3,940
4,010
4,060
..
..
..
..
..
..
6
6
6
6
6
Japan5
USA
105,145
113,094
117,902
121,672
123,964
207,661
218,035
229,958
240,680
252,639
125,761
126,065
126,400
126,630
126,840
265,463
268,008
270,300
272,691
275,260
127,130
127,400
127,650
126,670
..
284,800
288,370
290,810
291,685
..
23.9
18.8
27.3
22.1
21.1
15.1
8.5
6.4
3.8
2.9
10.0
10.9
9.3
9.9
10.2
19.0
18.8
18.5
18.2
16.8
16.7
16.3
2.7
1.8
1.7
2.3
2.1
2.0
0.2
8.6
8.8
9.4
34.7
12.5
8.5
3.0
551,311
617,248
675,185
767,199
851,897
941,580
959,800
978,080
996,430
1,014,820
10
10
10
10
10
1,033,325 10
1,050,640 10
1,068.210 10
1,085,600 10
..
Population changes (per 1,000 per annum)
1971–76
1.0
1976–81
0.5
1981–86
1.2
1986–91
2.6
1991–96
2.5
..
4.0
2.3
3.4
3.0
6.3
6.2
7.1
5.7
–0.7
14.8
12.7
14.7
15.8
11.9
13.5
11.8
10.5
13.9
11.3
18.2
2.0
7.6
9.6
15.1
19.9
15.2
15.5
15.3
9.2
6
1997–98
1998–99
1999–2000
2000–01
2001–02
2002–03
2003–04
0.7
1.9
0.7
3.9
3.8
4.4
2.5
–3.8
–4.1
–2.6
2.9
–4.6
–5.1
–5.2
10.0
11.8
11.6
13.6
11.8
11.7
12.1
8.4
10.9
9.2
11.0
9.6
7.0
10.1
10.6
5.2
5.2
–2.6
23.4
17.8
12.5
9.6
8.8
12.7
..
..
..
..
6
..
..
..
..
..
..
..
..
..
10.2
18.8
15.7
15.6
15.1
..
15.9
15.5
15.1
14.8
..
20.4
16.8
15.8
17.1
..
27.2 6
18.6 6
19.2 6
..
18.5 6,9
35.6
33.4
..
..
..
18.6
14.9
12.6
10.6
..
15.3
15.2
15.7
16.0
..
27.3
..
26.2
..
..
9.6
9.5
9.5
9.3
9.4
14.7
14.5
14.6
14.5
14.7
..
..
..
..
9.2
9.1
8.8
..
14.1
13.9
14.1
..
15.5
13.8
..
..
..
6.4
6.1
6.1
6.4
..
9.1
8.7
8.6
8.7
..
8.9
..
9.0
..
..
7.1
7.2
7.4
7.8
7.6
8.7
8.6
8.6
8.8
8.7
..
..
..
..
..
7.6
7.7
7.9
..
..
8.5
8.5
8.4
..
..
2.8
3.6
3.4
3.9
3.5
3.9
4.7
Live birth rate (per 1,000 per annum)
1971–75
14.1
1976–80
12.5
1981–85
12.9
1986–90
13.7
1991–95
13.2
P
6
6
6
6
6
8
1996
1997
1998
1999
2000
12.6
12.5
12.3
11.9
11.5
10.8
10.7
10.5
10.5
10.6
8.8
8.6
8.7
8.3
8.6
13.9
13.6
13.3
13.1
13.0
12.3
11.6
11.3
11.0
10.8
15.4
15.4
14.5
14.9
14.7
9.8
9.1
8.1
7.8
8.1
6
2001
2002
2003
2004
11.3
11.3
11.7
12.1
10.4
10.3
..
..
9.0
9.6
10.2
10.5
12.7
12.8
12.6
12.7
..
..
..
..
14.4
13.7
14.0
14.3
7.2
7.1
6.9
7.2
8
..
..
..
..
..
..
..
..
..
13.7
8.2
7.6
7.3
7.2
..
7.4
7.2
7.0
7.3
..
8.4
8.2
8.1
8.2
..
7.3
6.6
6.7
..
..
6
12
Death rate (per 1,000 per annum)
1971–75
11.8
1976–80
11.9
1981–85
11.7
1986–90
11.4
1991–95
11.1
8
8
8
8
8
8
8
6
6
1996
1997
1998
1999
2000
10.9
10.8
10.8
10.8
10.3
10.1
10.0
10.0
10.0
9.8
14.1
13.7
13.6
14.7
15.3
7.0
7.0
6.8
6.8
6.7
7.2
7.2
7.2
7.4
7.5
7.6
7.3
6.9
7.3
6.9
5.0
4.9
5.0
5.0
5.1
6
2001
2002
2003
2004
2005P
10.2
10.2
10.3
9.7
9.7
9.7
9.8
..
..
..
15.6
..
..
..
..
6.6
6.8
6.6
6.6
..
..
..
..
..
..
7.2
7.1
7.0
7.0
..
5.0
5.0
5.4
5.3
..
8
12
14
See notes on first page of table.
National Statistics
26
8
8
8
8
8
8
8
P
P
P
P
7
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 1.2
Summer 2006
Population: national
Constituent countries of the United Kingdom
Mid-year
Numbers (thousands) and percentage age distribution
United
Kingdom
Great
Britain
England
and Wales
England
Wales
Scotland
Northern
Ireland
Estimates
1971
1976
1981
1986
1991
55,928
56,216
56,357
56,684
57,439
54,388
54,693
54,815
55,110
55,831
49,152
49,459
49,634
49,999
50,748
46,412
46,660
46,821
47,188
47,875
2,740
2,799
2,813
2,811
2,873
5,236
5,233
5,180
5,112
5,083
1,540
1,524
1,543
1,574
1,607
19933
19943
19953
19963
19973
57,714
57,862
58,025
58,164
58,314
56,078
56,218
56,376
56,503
56,643
50,986
51,116
51,272
51,410
51,560
48,102
48,229
48,383
48,519
48,665
2,884
2,887
2,889
2,891
2,895
5,092
5,102
5,104
5,092
5,083
1,636
1,644
1,649
1,662
1,671
19983
19993
20003
20013
20023
2003
20044
58,475
58,684
58,886
59,113
59,322
59,554
59,834
56,797
57,005
57,203
57,424
57,625
57,851
58,124
51,720
51,933
52,140
52,360
52,570
52,794
53,046
48,821
49,033
49,233
49,450
49,647
49,856
50,093
2,900
2,901
2,907
2,910
2,923
2,938
2,952
5,077
5,072
5,063
5,064
5,055
5,057
5,078
1,678
1,679
1,683
1,689
1,697
1,703
1,710
5.7
13.8
40.2
21.7
11.0
7.6
5.6
13.7
40.2
21.8
11.0
7.6
5.7
13.8
40.2
21.7
11.0
7.7
5.7
13.8
40.4
21.6
10.9
7.6
5.4
14.0
37.5
22.7
12.0
8.4
5.2
13.2
39.8
22.7
11.7
7.3
6.4
16.0
41.4
20.1
9.9
6.2
60,533
61,892
63,304
64,727
58,800
60,124
61,504
62,897
53,691
55,005
56,378
57,770
50,714
51,967
53,276
54,605
2,977
3,037
3,102
3,165
5,108
5,120
5,126
5,127
1,733
1,767
1,800
1,830
5.6
12.0
36.8
25.9
10.2
9.5
5.6
12.0
36.8
25.9
10.2
9.5
5.6
12.1
36.9
25.8
10.1
9.5
5.6
12.1
37.1
25.8
10.0
9.4
5.3
11.8
34.7
25.9
11.6
10.6
5.0
11.2
35.0
27.6
11.3
10.0
5.9
13.0
37.2
25.6
9.5
8.6
of which (percentages)
0–4
5–15
16–44
45–64M/59F
65M/60F–74
75 and over
Projections1
2006
2011
2016
2021
of which (percentages)
0–4
5–15
16–44
45–642
65–742
75 and over
Note: Figures may not add exactly due to rounding.
1 National projections based on mid-2004 population estimates.
2 Between 2010 and 2020, state retirement age will change from 65 years for men and 60 years for women to 65 years for both sexes.
3 These revised population estimates were published on 9 September 2004 (for mid-2001 and mid-2002) and 7 October 2004 (for mid-1992 to mid-2000), following the local authority
population studies, and replace all earlier versions. All figures shown on this table are now therefore on a consistent basis.
4 Data for mid-2004 for the United Kingdom, Great Britain, England and Wales and England were revised due to the Harrow correction that was published on 20 December 2005.
Tel no. for all queries relating to population estimates - 01329 813318
27
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 1.3
Summer 2006
Population: subnational
Government Office Regions of England1
Mid-year
Numbers (thousands) and percentage age distribution
North
East
North
West
Yorkshire
and the
Humber
East
Midlands
West
Midlands
East
London
South
East
South
West
Estimates
1971
1976
1981
1986
1991
2,679
2,671
2,636
2,594
2,587
7,108
7,043
6,940
6,833
6,843
4,902
4,924
4,918
4,884
4,936
3,652
3,774
3,853
3,908
4,011
5,146
5,178
5,187
5,180
5,230
4,454
4,672
4,854
4,999
5,121
7,529
7,089
6,806
6,774
6,829
6,830
7,029
7,245
7,468
7,629
4,112
4,280
4,381
4,548
4,688
19934
19944
19954
19964
19974
2,594
2,589
2,583
2,576
2,568
6,847
6,839
6,828
6,810
6,794
4,954
4,960
4,961
4,961
4,958
4,056
4,072
4,092
4,108
4,120
5,246
5,249
5,257
5,263
5,262
5,154
5,178
5,206
5,233
5,267
6,844
6,874
6,913
6,974
7,015
7,673
7,712
7,763
7,800
7,853
4,734
4,757
4,782
4,793
4,827
19984
19994
20004
20014
20024
2003
2004
2,561
2,550
2,543
2,540
2,538
2,539
2,545
6,792
6,773
6,774
6,773
6,783
6,805
6,827
4,958
4,956
4,959
4,977
4,993
5,009
5,039
4,133
4,152
4,168
4,190
4,223
4,252
4,280
5,271
5,272
5,270
5,281
5,304
5,320
5,334
5,302
5,339
5,375
5,400
5,422
5,463
5,491
7,065
7,154
7,237
7,322
7,371
7,388
7,4295
7,889
7,955
7,991
8,023
8,044
8,080
8,110
4,849
4,881
4,917
4,943
4,968
4,999
5,038
5.3
13.6
39.1
22.6
11.8
7.7
5.6
14.2
39.5
22.0
11.3
7.5
5.6
14.0
39.7
21.9
11.1
7.6
5.5
13.9
39.3
22.5
11.2
7.7
5.8
14.3
39.3
21.8
11.3
7.6
5.7
13.9
38.6
22.4
11.4
8.0
6.5
12.9
48.7
18.0
8.2
5.7
5.6
13.9
39.1
22.3
11.0
8.1
5.1
13.3
36.9
22.9
12.3
9.4
2,535
2,525
2,516
2,510
2,502
2,489
6,811
6,852
6,914
6,987
7,057
7,107
5,022
5,079
5,154
5,234
5,313
5,379
4,275
4,366
4,479
4,594
4,706
4,804
5,330
5,380
5,451
5,531
5,609
5,672
5,499
5,646
5,833
6,025
6,212
6,380
7,431
7,614
7,858
8,105
8,331
8,523
8,122
8,300
8,527
8,765
9,005
9,222
5,031
5,163
5,328
5,498
5,668
5,823
4.7
11.2
33.7
25.3
12.7
12.3
5.3
12.1
35.4
24.9
11.1
11.2
5.4
12.1
35.7
24.6
11.0
11.3
5.1
11.9
33.9
25.6
11.5
12.1
5.6
12.5
34.7
25.1
10.7
11.4
5.4
12.3
34.0
25.0
11.2
12.2
6.3
11.7
43.8
24.2
7.4
6.6
5.4
12.1
35.0
25.1
10.8
11.7
4.8
11.3
32.8
25.3
12.1
13.7
of which (percentages)
0–4
5–15
16–44
45–64M/59F
65M/60F–74
75 and over
Projections2
2004
2008
2013
2018
2023
2028
of which (percentages)
0–4
5–15
16–44
45–643
65–743
75 and over
Note: Figures may not add exactly due to rounding.
1 From 1 April 2002 there are four Directorates of Health and Social Care (DHSCs) within the Department of Health. The GORs sit within the DHSCs as follows: North East, North West,
Yorkshire and the Humber GORs are within North DHSC, East Midlands, West Midlands and East GORs are within Midlands and Eastern DHSC, London GOR equates to London DHSC
and South East and South West GORs are within South DHSC. See ‘In brief’ Health Statistics Quarterly 15 for further details of changes to Health Areas.
2 These projections are based on the mid-2003 population estimates and are consistent with the 2003-based national projections produced by the Government Actuary’s Department and
presented in Table 1.2 in Health Statistics Quarterly nos 25 to 28.
3 Between 2010 and 2020, state retirement age will change from 65 years for men and 60 years for women to 65 years for both sexes.
4 These revised population estimates were published on 9 September 2004 (for mid-2001 and mid-2002) and 7 October 2004 (for mid-1992 to mid-2000), following the local authority
population studies, and replace all earlier versions. All figures shown on this table are now therefore on a consistent basis.
5 Data for mid-2004 for London were revised due to the Harrow correction that was published on 20 December 2005.
National Statistics
28
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 1.4
Summer 2006
Population: age and sex
Constituent countries of the United Kingdom
Numbers (thousands)
Age group
Mid-year
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–59
60–64
65–74
75–84
85–89
90 and
over
United Kingdom
Persons
1976
1981
1986
1991
19961
56,216
56,357
56,684
57,439
58,164
19981
19991
20001
20011
20021
Under
16
16–
64/59
65/60
and over
677
730
748
790
719
3,043
2,726
2,886
3,077
3,019
9.176
8,147
7,143
7,141
7,544
8.126
9,019
9,200
8,168
7,231
7,868
8,010
8,007
8,898
9,131
6,361
6,774
7,711
7,918
7,958
9,836
9,540
9,212
9,500
10,553
3,131
2,935
3,069
2,888
2,785
5,112
5,195
5,020
5,067
5,066
2,348
2,677
2,971
3,119
3,129
390
..
716
626
711
147
..
..
248
317
13,797
12,543
11,645
11,685
12,018
32,757
33,780
34,725
35,197
35,498
9,663
10,035
10,313
10,557
10,649
58,475
58,684
58,886
59,113
59,322
713
704
682
663
661
2,930
2,896
2,869
2,819
2,753
7,649
7,684
7,652
7,624
7,601
7,079
7,090
7,139
7,261
7,403
8,948
8,795
8,646
8,475
8,256
8,285
8,474
8,678
8,846
9,002
10,767
10,887
11,011
11,168
11,316
2,835
2,877
2,900
2,884
2,890
4,979
4,948
4,940
4,947
4,969
3,211
3,230
3,249
3,296
3,345
736
746
755
753
739
344
354
364
377
388
12,013
12,011
11,959
11,863
11,783
35,746
35,928
36,138
36,406
36,622
10,717
10,745
10,788
10,845
10,916
2003
20042
59,554
59,834
679
705
2,703
2,684
7,542
7,477
7,575
7,720
8,070
7,937
9,108
9,192
11,424
11,517
2,943
3,021
5,005
5,033
3,401
3,435
706
703
399
409
11,712
11,646
36,828
37,064
11,014
11,125
Males
1976
1981
1986
1991
19961
27,360
27.412
27,542
27,909
28,287
348
374
384
403
369
1,564
1,400
1,478
1,572
1,547
4,711
4,184
3,664
3,655
3,857
4,145
4,596
4,663
4,146
3,652
3,981
4,035
4,022
4,432
4,540
3,214
3,409
3,864
3,949
3,954
4,820
4,711
4,572
4,732
5,244
1,466
1,376
1,463
1,390
1,360
2,204
2,264
2,206
2,272
2,311
775
922
1,060
1,146
1,187
101
..
166
166
201
31
..
..
46
65
7,083
6,439
5,968
5,976
6,148
17.167
17,646
18,142
18,303
18,375
3,111
3,327
3,432
3,630
3,764
19981
19991
20001
20011
20021
28,458
28,578
28,690
28,832
28,963
365
361
350
338
339
1,503
1,485
1,469
1,445
1,409
3,916
3,934
3,920
3,906
3,895
3,570
3,577
3,606
3,672
3,754
4,444
4,367
4,292
4,215
4,107
4,109
4,200
4,298
4,382
4,460
5,342
5,400
5,457
5,534
5,604
1,388
1,409
1,420
1,412
1,414
2,293
2,289
2,294
2,308
2,327
1,240
1,259
1,278
1,308
1,339
215
221
225
227
226
73
77
81
85
89
6,151
6,152
6,128
6,077
6,037
18,486
18,582
18,685
18,827
18,945
3,821
3,845
3,878
3,928
3,982
2003
2004
29,108
29,271
349
361
1,384
1,375
3,864
3,833
3,850
3,933
4,018
3,954
4,514
4,553
5,653
5,694
1,439
1,476
2,354
2,374
1,371
1,394
219
224
94
99
6,002
5,970
19,068
19,210
4,038
4,091
Females
1976
1981
1986
1991
19961
28,856
28,946
29,142
29,530
29,877
330
356
364
387
350
1,479
1,327
1,408
1,505
1,472
4,465
3,963
3,480
3,487
3,687
3,980
4,423
4,538
4,021
3,579
3,887
3,975
3,985
4,466
4,591
3,147
3,365
3,847
3,968
4,005
5,015
4,829
4,639
4,769
5,309
1,665
1,559
1,606
1,498
1,426
2,908
2,931
2,814
2,795
2,755
1,573
1,756
1,911
1,972
1,942
289
..
550
460
509
116
..
..
202
252
6,714
6,104
5,678
5,709
5,870
15,590
16,134
16,583
16,894
17,123
6,552
6,708
6,881
6,927
6,885
19981
19991
20001
20011
20021
30,017
30,106
30,196
30,281
30,359
348
343
333
324
323
1,427
1,412
1,399
1,375
1,344
3,733
3,750
3,732
3,718
3,706
3,509
3,513
3,533
3,589
3,649
4,504
4,428
4,353
4,260
4,149
4,176
4,273
4,380
4,465
4,542
5,425
5,487
5,554
5,634
5,712
1,447
1,468
1,481
1,473
1,476
2,686
2,659
2,646
2,640
2,641
1,971
1,971
1,971
1,987
2,006
521
525
530
526
512
271
277
283
292
299
5,861
5,859
5,832
5,786
5,747
17,260
17,346
17,453
17,579
17,677
6,895
6,900
6,911
6,917
6,934
2003
20042
30,446
30,563
331
343
1,319
1,309
3,677
3,644
3,725
3,787
4,052
3,983
4,594
4,640
5,771
5,823
1,504
1,545
2,651
2,659
2,030
2,041
486
478
305
310
5,710
5,676
17,760
17,854
6,976
7,034
England and Wales
Persons
1976
49,459
1981
49,634
1986
49,999
1991
50,748
19961
51,410
585
634
654
698
637
2,642
2,372
2,522
2,713
2,668
7,967
7,085
6,226
6,248
6,636
7,077
7,873
8,061
7,165
6,336
6,979
7,086
7,052
7,862
8,076
5,608
5,996
6,856
7,022
7,017
8,707
8,433
8,136
8,407
9,363
2,777
2,607
2,725
2,553
2,457
4,540
4,619
4,470
4,506
4,496
2,093
2,388
2,655
2,790
2,801
351
383
461
561
639
135
157
182
223
285
11,973
10,910
10,161
10,247
10,584
28,894
29,796
30,647
31,100
31,353
8,593
8,928
9,190
9,400
9,474
19981
19991
20001
20011
20021
51,720
51,933
52,140
52,360
52,570
631
625
607
589
589
2,594
2,566
2,544
2,502
2,445
6,740
6,779
6,757
6,740
6,726
6,212
6,228
6,275
6,387
6,520
7,925
7,800
7,682
7,536
7,349
7,304
7,475
7,661
7,816
7,962
9,552
9,656
9,764
9,898
10,027
2,503
2,542
2,564
2,549
2,553
4,411
4,381
4,372
4,377
4,395
2,875
2,891
2,907
2,947
2,990
661
671
680
677
664
311
319
328
340
351
10,599
10,608
10,572
10,495
10,435
31,591
31,771
31,977
32,226
32,435
9,530
9,554
9,591
9,639
9,700
2003
20042
52,794
53,046
606
629
2,402
2,388
6,677
6,621
6,681
6,817
7,190
7,073
8,062
8,140
10,116
10,188
2,599
2,669
4,427
4,451
3,039
3,067
634
633
360
370
10,381
10,327
32,627
32,837
9,786
9,882
Males
1976
1981
1986
1991
19961
24,089
24,160
24,311
24,681
25,030
300
324
335
356
327
1,358
1,218
1,292
1,385
1,368
4,091
3,639
3,194
3,198
3,393
3,610
4,011
4,083
3,638
3,202
3,532
3,569
3,542
3,920
4,020
2,843
3,024
3,438
3,504
3,489
4,280
4,178
4,053
4,199
4,659
1,304
1,227
1,302
1,234
1,205
1,963
2,020
1,972
2,027
2,059
690
825
951
1,029
1,067
91
94
115
150
182
29
32
35
42
59
6,148
5,601
5,208
5,240
5,416
15,169
15,589
16,031
16,193
16,247
2,773
2,970
3,072
3,248
3,367
19981
19991
20001
20011
20021
25,201
25,323
25,438
25,574
25,702
323
321
311
301
302
1,331
1,315
1,303
1,281
1,251
3,451
3,471
3,462
3,453
3,446
3,135
3,144
3,172
3,231
3,307
3,942
3,880
3,823
3,758
3,664
3,627
3,711
3,802
3,881
3,955
4,744
4,793
4,842
4,907
4,967
1,230
1,250
1,259
1,252
1,253
2,041
2,036
2,040
2,052
2,069
1,115
1,132
1,148
1,175
1,203
194
200
204
206
205
66
70
73
77
81
5,428
5,434
5,416
5,376
5,346
16,355
16,452
16,556
16,688
16,799
3,417
3,437
3,466
3,510
3,557
2003
2004
25,841
25,988
311
322
1,230
1,223
3,422
3,395
3,394
3,473
3,588
3,531
4,006
4,043
5,008
5,040
1,274
1,307
2,092
2,109
1,231
1,251
199
203
85
90
5,320
5,294
16,914
17,041
3,607
3,653
Females
1976
1981
1986
1991
19961
25,370
25,474
25,687
26,067
26,381
285
310
319
342
310
1,284
1,154
1,231
1,328
1,300
3,876
3,446
3,032
3,050
3,243
3,467
3,863
3,978
3,527
3,134
3,447
3,517
3,509
3,943
4,056
2,765
2,972
3,418
3,517
3,528
4,428
4,255
4,083
4,208
4,704
1,473
1,380
1,422
1,319
1,252
2,577
2,599
2,498
2,479
2,437
1,403
1,564
1,704
1,761
1,734
261
289
346
411
457
106
126
148
181
227
5,826
5,309
4,953
5,007
5,168
13,725
14,207
14,616
14,908
15,106
5,820
5,958
6,118
6,152
6,107
19981
19991
20001
20011
20021
26,519
26,610
26,702
26,786
26,868
308
305
296
288
287
1,264
1,251
1,241
1,220
1,194
3,289
3,308
3,296
3,287
3,280
3,077
3,083
3,103
3,156
3,214
3,983
3,920
3,859
3,778
3,684
3,677
3,763
3,859
3,935
4,007
4,808
4,863
4,923
4,992
5,059
1,272
1,292
1,304
1,297
1,300
2,370
2,345
2,332
2,326
2,326
1,760
1,759
1,758
1,771
1,787
467
472
476
471
460
244
249
255
263
270
5,171
5,175
5,155
5,119
5,090
15,235
15,318
15,421
15,538
15,635
6,113
6,117
6,126
6,129
6,143
2003
20042
26,953
27,057
295
307
1,172
1,164
3,256
3,226
3,287
3,344
3,602
3,542
4,056
4,098
5,108
5,148
1,325
1,362
2,335
2,341
1,808
1,816
436
429
275
280
5,061
5,033
15,714
15,796
6,179
6,229
Note: Figures may not add exactly due to rounding.
1 These revised population estimates were published on 9 September 2004 (for mid-2001 and mid-2002) and 7 October 2004 (for mid-1992 to mid-2000), following the local authority
population studies, and replace all earlier versions. All figures shown on this table are now therefore on a consistent basis.
2 Data for mid-2004 for the United Kingdom, Great Britain, England and Wales and England were revised due to the Harrow correction that was published on 20 December 2005.
Tel no. for all enquiries relating to population estimates:- 01329 813318
29
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 1.4
continued
Summer 2006
Population: age and sex
Constituent countries of the United Kingdom
Numbers (thousands)
Age group
Mid-year
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–59
60–64
65–74
75–84
85–89
90 and
over
Under
16
16–
64/59
65/60
and over
England
Persons
1976
1981
1986
1991
19961
46,660
46,821
47,188
47,875
48,519
551
598
618
660
603
2,491
2,235
2,380
2,560
2,523
7,513
6,678
5,869
5,885
6,255
6,688
7,440
7,623
6,772
5,985
6,599
6,703
6,682
7,460
7,667
5,298
5,663
6,478
6,633
6,638
8,199
7,948
7,672
7,920
8,822
2,616
2,449
2,559
2,399
2,310
4,274
4,347
4,199
4,222
4,217
1,972
2,249
2,501
2,626
2,631
332
362
435
529
602
127
149
172
210
269
11,293
10,285
9,583
9,658
9,985
27,275
28,133
28,962
29,390
29,639
8,092
8,403
8,643
8,827
8,895
19981
19991
20001
20011
20021
48,821
49,033
49,233
49,450
49,647
598
592
575
558
558
2,453
2,427
2,406
2,366
2,312
6,356
6,394
6,375
6,359
6,345
5,869
5,881
5,923
6,032
6,155
7,524
7,412
7,304
7,171
6,993
6,915
7,079
7,257
7,407
7,548
8,999
9,097
9,199
9,327
9,448
2,353
2,391
2,411
2,395
2,397
4,140
4,114
4,107
4,113
4,130
2,698
2,713
2,727
2,764
2,804
623
632
641
638
625
293
301
309
321
331
10,003
10,014
9,980
9,908
9,853
29,868
30,044
30,243
30,487
30,683
8,950
8,975
9,010
9,055
9,111
2003
20042
49,856
50,093
575
597
2,273
2,260
6,300
6,247
6,304
6,432
6,843
6,732
7,643
7,718
9,533
9,600
2,438
2,503
4,159
4,181
2,852
2,879
596
594
340
349
9,804
9,754
30,862
31,059
9,190
9,280
Males
1976
1981
1986
1991
19961
22,728
22,795
22,949
23,291
23,629
283
306
317
336
309
1,280
1,147
1,219
1,307
1,294
3,858
3,430
3,010
3,011
3,198
3,413
3,790
3,862
3,439
3,023
3,339
3,377
3,357
3,721
3,818
2,686
2,856
3,249
3,311
3,302
4,031
3,938
3,822
3,957
4,390
1,228
1,154
1,224
1,159
1,133
1,849
1,902
1,853
1,900
1,932
649
777
897
970
1,003
85
89
108
141
172
27
30
33
39
55
5,798
5,280
4,911
4,938
5,110
14,320
14,717
15,147
15,302
15,358
2,610
2,798
2,891
3,050
3,161
19981
19991
20001
20011
20021
23,794
23,916
24,030
24,166
24,288
306
304
294
285
286
1,258
1,243
1,232
1,212
1,183
3,254
3,274
3,266
3,257
3,251
2,960
2,969
2,995
3,053
3,123
3,743
3,689
3,638
3,580
3,492
3,436
3,517
3,604
3,681
3,753
4,470
4,516
4,562
4,624
4,682
1,157
1,176
1,184
1,176
1,176
1,916
1,913
1,917
1,928
1,944
1,047
1,063
1,078
1,103
1,128
183
188
192
194
193
62
66
69
73
77
5,123
5,129
5,113
5,075
5,047
15,462
15,558
15,661
15,793
15,899
3,209
3,229
3,256
3,298
3,342
2003
2004
24,415
24,554
295
306
1,164
1,158
3,228
3,203
3,204
3,278
3,418
3,364
3,802
3,837
4,721
4,752
1,195
1,225
1,965
1,981
1,156
1,175
187
191
80
85
5,024
5,000
16,003
16.122
3,388
3,431
Females
1976
1981
1986
1991
19961
23,932
24,026
24,239
24,584
24,890
269
292
301
324
293
1,211
1,088
1,161
1,253
1,229
3,656
3,248
2,859
2,873
3,056
3,275
3,650
3,761
3,333
2,961
3,260
3,327
3,325
3,739
3,849
2,612
2,807
3,229
3,322
3,336
4,168
4,009
3,850
3,964
4,432
1,387
1,295
1,335
1,239
1,177
2,425
2,445
2,346
2,323
2,286
1,323
1,472
1,604
1,656
1,628
246
273
326
388
430
100
119
140
171
214
5,495
5,004
4,672
4,720
4,876
14,968
13,416
13,815
14,088
14,281
5,481
5,605
5,752
5,777
5,734
19981
19991
20001
20011
20021
25,027
25,117
25,203
25,284
25,358
292
288
281
273
272
1,195
1,183
1,174
1,154
1,129
3,102
3,121
3,109
3,102
3,095
2,908
2,912
2,928
2,979
3,031
3,781
3,724
3,667
3,591
3,501
3,479
3,562
3,653
3,726
3,795
4,529
4,581
4,637
4,702
4,766
1,196
1,215
1,227
1,219
1,220
2,224
2,201
2,190
2,185
2,186
1,651
1,650
1,649
1,661
1,676
440
444
448
444
433
230
235
240
248
254
4,880
4,885
4,867
4,834
4,806
14,406
14,486
14,582
14,694
14,783
5,741
5,746
5,755
5,757
5,769
2003
20042
25,441
25,539
280
291
1,109
1,103
3,072
3,044
3,100
3,155
3,424
3,368
3,841
3,881
4,812
4,849
1,243
1,278
2,194
2,200
1,696
1,704
409
403
260
264
4,780
4,754
14,859
14,936
5,802
5,849
Wales
Persons
1976
1981
1986
1991
19961
2,799
2,813
2,811
2,873
2,891
33
36
37
38
34
151
136
143
153
146
453
407
357
363
381
388
434
438
393
352
379
383
369
402
409
309
333
378
389
379
509
485
464
486
541
161
158
166
154
147
267
272
271
284
279
121
139
154
164
170
19
21
26
32
37
7
8
10
13
17
680
626
578
589
598
1,618
1,663
1,686
1,711
1,714
501
525
547
573
578
19981
19991
20001
20011
20021
2,900
2,901
2,907
2,910
2,923
34
33
32
32
30
141
139
138
136
132
384
385
383
382
380
343
347
352
356
366
401
388
378
365
356
390
395
403
409
415
553
559
565
572
579
150
151
152
154
156
271
267
265
264
265
177
178
180
183
185
38
39
39
39
39
18
18
19
20
20
596
594
591
587
582
1,723
1,727
1,734
1,739
1,752
581
580
581
584
589
2003
2004
2,938
2,952
31
32
129
127
377
374
377
385
347
341
418
422
583
588
161
166
268
270
187
188
38
39
20
21
577
572
1,765
1,778
596
602
Males
1976
1981
1986
1991
19961
1,361
1,365
1,362
1,391
1,401
17
18
19
20
17
78
70
73
78
74
233
209
184
186
195
197
221
221
199
179
193
193
186
199
203
157
168
190
194
187
249
240
231
242
269
75
73
79
74
72
114
118
119
128
128
41
48
54
60
64
5
5
7
8
10
2
2
2
2
3
350
321
297
302
306
849
871
885
891
890
162
173
181
198
206
19981
19991
20001
20011
20021
1,407
1,408
1,408
1,409
1,414
17
17
16
16
16
72
72
71
69
68
197
198
196
196
195
174
176
177
179
183
199
192
185
178
172
192
194
198
200
202
274
277
280
283
286
73
74
75
75
77
125
124
124
124
125
68
69
71
73
74
11
11
12
12
12
4
4
4
4
5
305
305
303
301
299
894
895
895
895
900
208
208
210
212
215
2003
2004
1,426
1,434
16
16
66
66
194
192
191
196
170
167
204
206
287
289
79
82
127
128
75
76
12
12
5
5
297
294
911
918
219
222
Females
1976
1981
1986
1991
19961
1,438
1,448
1,449
1,482
1,490
16
18
18
19
16
73
66
70
75
71
220
199
173
177
186
191
213
217
194
173
187
190
184
203
206
153
165
188
195
192
260
246
233
244
272
86
85
87
80
75
152
154
152
156
151
80
91
100
104
106
14
16
20
24
27
6
6
8
10
13
330
305
282
288
293
770
791
801
820
825
339
352
366
375
373
19981
19991
20001
20011
20021
1,492
1,493
1,499
1,502
1,509
16
16
15
15
15
69
68
67
66
65
187
187
186
186
185
169
171
175
177
182
202
196
192
187
183
198
201
206
209
212
278
282
285
289
293
76
77
77
78
80
146
144
142
141
140
109
109
109
110
111
27
27
28
27
27
14
15
15
15
16
290
289
288
286
283
829
832
840
844
852
373
371
371
372
374
2003
2004
1,512
1,518
15
15
63
62
184
182
186
189
178
174
214
216
296
299
82
85
141
142
112
112
26
26
16
16
281
278
855
859
377
380
National Statistics
30
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 1.4
continued
Summer 2006
Population: age and sex
Constituent countries of the United Kingdom
Numbers (thousands)
Age group
Mid-year
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–59
60–64
65–74
75–84
85–89
90 and
over
Under
16
16–
64/59
65/60
and over
Scotland
Persons
1976
1981
1986
1991
1996
5,233
5,180
5,112
5,083
5,092
67
69
66
66
59
291
249
257
258
252
904
780
656
634
643
806
875
863
746
651
692
724
739
795
798
591
603
665
696
722
897
880
849
853
925
282
260
273
265
259
460
460
435
441
448
202
232
252
259
256
31
35
42
51
57
11
14
15
19
24
1,352
1,188
1,061
1,021
1,019
3,023
3,110
3,161
3,151
3,151
858
882
890
912
922
1998
1999
2000
2001
2002
5,077
5,072
5,063
5,064
5,055
58
56
53
52
51
239
234
230
224
217
644
643
636
629
622
628
625
628
633
639
766
743
717
696
669
749
762
774
782
788
941
951
962
979
993
261
262
263
262
262
445
444
445
447
449
262
265
267
272
276
59
59
59
59
58
26
27
28
29
30
1,003
995
985
970
955
3,145
3,144
3,141
3,150
3,150
929
933
937
944
950
2003
2004
5,057
5,078
52
54
212
210
614
609
648
653
648
635
793
796
1,008
1,025
265
270
452
455
281
286
55
54
31
31
943
935
3,156
3,175
958
968
Males
1976
1981
1986
1991
1996
2,517
2,495
2,462
2,445
2,447
34
35
34
34
30
149
128
131
132
128
463
400
336
324
328
408
445
438
377
327
347
364
371
394
392
290
298
331
345
355
429
424
410
415
454
128
118
127
124
122
193
194
184
192
198
65
77
86
91
93
8
8
10
13
15
2
3
3
3
5
693
610
543
522
521
1,556
1,603
1,636
1,623
1,616
269
282
283
299
310
1998
1999
2000
2001
2002
2,439
2,437
2,432
2,434
2,432
30
29
28
26
26
122
120
118
115
111
329
329
326
322
319
315
313
315
319
324
374
362
347
337
325
367
372
377
379
382
463
469
474
483
490
124
125
125
125
125
198
198
199
200
202
96
98
100
103
106
16
16
17
17
17
5
6
6
6
7
513
510
505
497
489
1,610
1,609
1,606
1,610
1,612
316
318
322
327
331
2003
2004
2,435
2,446
26
28
108
107
314
312
329
332
315
310
383
384
496
503
126
129
204
207
108
111
16
16
7
7
483
479
1,616
1,627
336
341
Females
1976
1981
1986
1991
1996
2,716
2,685
2,649
2,639
2,645
32
33
32
32
28
142
121
126
126
123
440
380
320
309
315
398
430
424
369
324
345
359
368
402
406
301
305
334
351
367
468
456
439
437
470
154
142
146
141
137
267
265
250
249
250
137
155
166
168
164
23
27
32
38
42
8
11
12
16
20
659
579
518
499
498
1,468
1,506
1,525
1,528
1,535
589
600
606
612
612
1998
1999
2000
2001
2002
2,638
2,635
2,631
2,630
2,623
28
27
26
26
25
116
114
112
109
106
315
314
310
307
303
313
312
313
314
315
392
381
369
359
344
382
390
397
403
406
478
483
488
496
504
137
138
138
137
137
248
246
246
246
247
166
166
166
169
171
43
43
43
43
41
21
22
22
23
23
490
486
480
473
466
1,535
1,535
1,535
1,540
1,538
614
614
616
617
619
2003
2004
2,623
2,632
25
26
104
103
300
297
318
321
332
325
410
412
512
521
139
141
248
248
173
175
39
38
24
24
460
457
1,540
1,549
622
627
Northern Ireland
Persons
1976
1981
1986
1991
1996
1,524
1,543
1,574
1,607
1,662
26
27
28
26
24
111
106
107
106
99
306
282
261
260
266
243
271
277
256
244
198
200
217
240
257
163
175
190
200
220
231
227
227
241
266
73
68
71
70
70
111
116
115
121
123
53
57
64
69
72
8
..
16
14
15
2
..
..
6
7
471
444
423
417
415
840
874
917
945
993
212
224
234
246
253
1998
1999
2000
2001
2002
1,678
1,679
1,683
1,689
1,697
24
23
22
22
22
97
96
95
93
91
264
262
259
255
253
239
237
237
240
243
257
252
247
243
238
231
237
243
248
251
275
279
284
290
296
71
73
73
74
75
122
122
123
123
125
74
75
75
77
79
16
16
16
16
16
7
7
7
7
7
411
408
403
397
393
1,010
1,014
1,020
1,030
1,037
257
258
259
262
266
2003
2004
1,703
1,710
21
22
89
87
251
248
246
250
233
229
254
256
301
305
78
81
126
127
81
82
16
16
8
8
388
383
1,044
1,052
271
275
Males
1976
1981
1986
1991
1996
754
757
768
783
810
13
14
14
13
12
58
54
55
54
51
157
145
134
133
136
127
140
142
131
124
102
102
109
119
128
81
87
95
100
109
111
109
110
118
131
34
32
33
32
33
47
50
50
53
54
19
21
23
26
27
3
..
4
4
4
..
..
1
1
242
228
217
213
212
442
454
474
487
511
70
75
77
83
87
1998
1999
2000
2001
2002
819
818
820
824
829
12
12
11
11
11
50
49
49
48
47
135
134
133
131
130
121
119
120
122
124
128
125
122
120
117
114
117
119
122
123
135
138
141
144
147
34
35
35
35
36
54
54
55
56
56
28
29
29
30
31
5
5
5
5
5
2
2
2
2
2
211
209
207
204
202
520
521
524
529
534
89
89
90
92
94
2003
2004
833
836
11
11
46
45
129
127
126
128
115
113
124
125
149
151
38
39
58
58
31
32
5
5
2
2
199
197
538
542
95
97
Females
1976
1981
1986
1991
1996
769
786
805
824
851
13
13
13
13
11
53
52
52
52
49
149
137
127
127
130
116
130
135
125
120
96
98
107
121
129
81
88
96
100
110
120
118
118
123
135
38
37
38
38
37
64
66
65
67
69
33
37
41
44
45
6
..
12
10
11
2
..
..
4
6
229
216
206
203
203
398
420
442
458
482
143
150
157
163
167
1998
1999
2000
2001
2002
859
861
862
865
868
12
11
11
10
11
47
47
46
45
44
129
128
126
124
123
118
117
118
119
119
129
127
125
123
120
117
120
124
126
128
139
141
143
146
149
37
38
38
38
39
68
68
68
68
68
46
46
46
47
48
11
11
11
11
11
6
6
6
6
6
201
199
196
193
191
490
493
497
501
504
168
169
169
170
173
2003
2004
870
874
10
11
43
42
122
121
120
122
118
116
129
130
152
154
40
42
68
69
49
50
11
11
6
6
189
187
506
509
175
178
31
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 1.5
Summer 2006
Population: age, sex and legal marital status1
England and Wales
Mid-year
Numbers (thousands)
Total
population
Males
Single
Married
Divorced
Females
Widowed
Total
Single
Married
Divorced
Widowed
Total
Aged
16 and over
1971
1976
1981
1986
1991
36,818
37,486
38,724
39,837
40,501
4,173
4,369
5,013
5,625
5,891
12,522
12,511
12,238
11,867
11,636
187
376
611
917
1,187
682
686
698
695
727
17,563
17,941
18,559
19,103
19,441
3,583
3,597
4,114
4,617
4,817
12,566
12,538
12,284
12,000
11,833
296
533
828
1,165
1,459
2,810
2,877
2,939
2,953
2,951
19,255
19,545
20,165
20,734
21,060
1996
1997
1998
1999
40,827
40,966
41,121
41,325
6,225
6,337
6,450
6,582
11,310
11,240
11,183
11,143
1,346
1,379
1,405
1,433
733
734
735
732
19,614
19,690
19,773
19,890
5,168
5,288
5,406
5,526
11,433
11,353
11,284
11,235
1,730
1,781
1,827
1,875
2,881
2,855
2,832
2,800
21,212
21,276
21,349
21,435
2000
2001
2002
2003
2004
41,569
41,865
42,135
42,413
42,719
6,721
6,894
7,076
7,261
7,461
11,113
11,090
11,015
10,940
10,863
1,456
1,482
1,535
1,590
1,644
731
733
731
728
726
20,022
20,198
20,357
20,520
20,694
5,650
5,798
5,961
6,128
6,306
11,199
11,150
11,073
11,000
10,935
1,927
1,975
2,035
2,096
2,156
2,772
2,745
2,709
2,668
2,628
21,547
21,667
21,778
21,892
22,025
16–19
1971
1976
1981
1986
1991
2,666
2,901
3,310
3,131
2,665
1,327
1,454
1,675
1,587
1,358
34
28
20
10
8
0
0
0
0
0
0
0
0
0
0
1,362
1,482
1,694
1,596
1,366
1,163
1,289
1,523
1,484
1,267
142
129
93
49
32
0
0
0
1
0
0
0
0
0
0
1,305
1,419
1,616
1,535
1,300
1996
1997
1998
1999
2,402
2,478
2,532
2,543
1,209
1,246
1,274
1,280
6
6
6
6
0
0
1
1
0
0
0
1
1,216
1,253
1,281
1,288
1,164
1,203
1,230
1,234
21
20
20
20
0
1
1
1
0
1
1
1
1,186
1,225
1,251
1,255
2000
2001
2002
2003
2004
2,523
2,567
2,633
2,702
2,770
1,276
1,304
1,347
1,386
1,423
6
5
4
4
3
1
1
1
1
0
1
1
1
1
0
1,283
1,312
1,353
1,391
1,427
1,221
1,237
1,266
1,299
1,332
18
16
13
12
11
1
1
1
0
0
1
1
1
1
0
1,240
1,255
1,280
1,311
1,344
20–24
1971
1976
1981
1986
1991
3,773
3,395
3,744
4,171
3,911
1,211
1,167
1,420
1,768
1,717
689
557
466
317
242
3
4
10
14
12
0
0
1
0
0
1,904
1,728
1,896
2,099
1,971
745
725
1,007
1,383
1,421
1,113
925
811
657
490
9
16
27
32
29
2
2
2
1
1
1,869
1,667
1,847
2,072
1,941
1996
1997
1998
1999
3,291
3,141
3,047
3,047
1,538
1,479
1,442
1,449
117
99
86
78
3
3
2
2
0
0
0
0
1,658
1,580
1,530
1,530
1,361
1,325
1,306
1,320
260
225
201
188
11
9
8
8
1
1
1
1
1,633
1,561
1,517
1,517
2000
2001
2002
2003
2004
3,088
3,157
3,211
3,283
3,358
1,470
1,501
1,534
1,573
1,621
74
74
69
69
67
3
3
3
3
3
0
1
1
1
1
1,548
1,579
1,607
1,646
1,692
1,352
1,390
1,428
1,466
1,499
180
178
166
161
156
8
8
8
8
8
1
1
1
1
2
1,540
1,578
1,604
1,637
1,665
25–29
1971
1976
1981
1986
1991
3,267
3,758
3,372
3,713
4,154
431
533
588
835
1,132
1,206
1,326
1,057
949
856
16
39
54
79
82
1
2
1
1
1
1,654
1,900
1,700
1,863
2,071
215
267
331
527
800
1,367
1,522
1,247
1,207
1,158
29
65
89
113
123
4
5
4
4
2
1,614
1,859
1,671
1,850
2,083
1996
1997
1998
1999
3,950
3,877
3,789
3,687
1,273
1,294
1,304
1,304
650
595
544
497
46
42
38
34
1
1
1
1
1,970
1,932
1,887
1,836
977
1,012
1,039
1,051
906
844
783
725
93
85
77
72
3
3
3
3
1,980
1,945
1,902
1,851
2000
2001
2002
2003
2004
3,605
3,487
3,348
3,262
3,260
1,305
1,293
1,276
1,271
1,292
459
420
371
337
318
31
28
26
25
24
1
1
1
1
1
1,796
1,742
1,674
1,634
1,635
1,065
1,059
1,052
1,053
1,080
677
625
567
524
497
65
58
52
49
47
3
3
3
2
2
1,810
1,745
1,674
1,628
1,625
National Statistics
32
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 1.5
continued
Summer 2006
Population: age, sex and legal marital status1
England and Wales
England and Wales
Mid-year
Numbers (thousands)
Total
population
Males
Single
Married
Divorced
Females
Widowed
Total
Single
Married
Divorced
Widowed
Total
30–34
1971
1976
1981
1986
1991
2,897
3,220
3,715
3,338
3,708
206
236
318
355
520
1,244
1,338
1,451
1,197
1,172
23
55
97
124
155
3
3
3
2
2
1,475
1,632
1,869
1,679
1,849
111
118
165
206
335
1,269
1,388
1,544
1,293
1,330
34
75
129
154
189
8
8
9
6
5
1,422
1,588
1,846
1,660
1,859
1996
1997
1998
1999
4,126
4,151
4,136
4,113
776
817
848
877
1,135
1,111
1,078
1,043
138
133
127
121
2
2
3
3
2,050
2,064
2,056
2,044
551
589
621
651
1,316
1,293
1,259
1,223
201
198
193
188
7
7
7
7
2,076
2,088
2,081
2,069
2000
2001
2002
2003
2004
4,076
4,050
4,000
3,928
3,813
904
934
961
981
987
1,007
971
921
868
811
114
108
105
102
97
2
2
2
2
2
2,027
2,016
1,990
1,954
1,897
679
711
743
767
777
1,182
1,142
1,094
1,043
985
181
174
167
159
149
7
7
6
6
5
2,049
2,033
2,010
1,974
1,916
35–44
1971
1976
1981
1986
1991
5,736
5,608
5,996
6,856
7,022
317
286
316
396
477
2,513
2,442
2,519
2,738
2,632
48
104
178
293
384
13
12
12
12
11
2,891
2,843
3,024
3,438
3,504
201
167
170
213
280
2,529
2,427
2,540
2,815
2,760
66
129
222
350
444
48
42
41
39
34
2,845
2,765
2,972
3,418
3,517
1996
1997
1998
1999
7,017
7,155
7,304
7,475
653
708
768
832
2,426
2,433
2,442
2,459
398
403
405
408
12
12
13
13
3,489
3,556
3,627
3,711
427
472
522
577
2,568
2,580
2,596
2,617
497
511
523
533
36
36
36
37
3,528
3,599
3,677
3,763
2000
2001
2002
2003
2004
7,661
7,816
7,962
8,062
8,140
899
963
1,031
1,089
1,142
2,481
2,494
2,489
2,471
2,445
410
411
424
435
444
12
12
12
12
11
3,802
3,881
3,955
4,006
4,043
635
692
751
805
858
2,640
2,649
2,650
2,634
2,614
547
558
571
583
593
37
36
35
34
32
3,859
3,935
4,007
4,056
4,098
45–64
1971
1976
1981
1986
1991
11,887
11,484
11,040
10,860
10,960
502
496
480
461
456
4,995
4,787
4,560
4,422
4,394
81
141
218
331
456
173
160
147
141
127
5,751
5,583
5,405
5,355
5,433
569
462
386
327
292
4,709
4,568
4,358
4,220
4,211
125
188
271
388
521
733
683
620
570
503
6,136
5,901
5,635
5,505
5,527
1996
1997
1998
1999
11,820
11,927
12,055
12,198
528
545
565
589
4,587
4,593
4,608
4,627
628
656
681
706
121
120
121
121
5,864
5,914
5,974
6,043
318
328
340
355
4,466
4,486
4,512
4,541
732
770
807
844
440
430
422
415
5,956
6,014
6,080
6,155
2000
2001
2002
2003
2004
12,328
12,447
12,580
12,715
12,857
615
644
671
702
736
4,638
4,647
4,649
4,647
4,644
727
747
780
815
850
121
121
120
118
117
6,101
6,159
6,220
6,283
6,347
372
391
413
437
465
4,564
4,578
4,596
4,613
4,628
881
918
960
1,002
1,045
410
401
391
380
371
6,227
6,289
6,359
6,433
6,510
65 and over
1971
1976
1981
1986
1991
6,592
7,119
7,548
7,768
8,080
179
197
216
223
231
1,840
2,033
2,167
2,234
2,332
17
33
54
76
99
492
510
534
539
586
2,527
2,773
2,971
3,072
3,248
580
569
533
477
422
1,437
1,579
1,692
1,759
1,853
32
60
90
127
152
2,016
2,138
2,263
2,333
2,405
4,065
4,347
4,578
4,696
4,832
1996
1997
1998
1999
8,221
8,237
8,258
8,262
247
248
250
251
2,390
2,404
2,418
2,431
134
143
152
161
597
597
597
594
3,367
3,391
3,417
3,437
369
358
348
338
1,897
1,904
1,913
1,922
196
207
218
230
2,393
2,377
2,362
2,336
4,854
4,845
4,841
4,825
2000
2001
2002
2003
2004
8,287
8,342
8,400
8,461
8,520
252
254
256
258
259
2,449
2,478
2,511
2,544
2,575
171
183
197
211
225
593
595
595
594
593
3,466
3,510
3,557
3,607
3,653
327
318
308
301
293
1,938
1,960
1,987
2,015
2,044
243
259
276
294
314
2,313
2,295
2,272
2,244
2,216
4,821
4,832
4,843
4,854
4,867
1 Marital Status Estimates for 1992 to 2002 were revised in light of the local authority population studies published 7 October 2004.
33
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 2.1
Summer 2006
Vital statistics summary
Constituent countries of the United Kingdom
Year and
quarter
All live
births
Numbers (thousands) and rates
Live births
outside marriage
Marriages
Divorces
Deaths
Number
Rate1
Number
Rate2
Number
Rate3
Number
Rate4
Number
United Kingdom
1976
1981
1986
1991
1996
675.5
730.7
754.8
792.3
733.2
12.0
13.0
13.3
13.8
12.6
61.1
91.3
154.3
236.1
260.4
90
125
204
298
355
406.0
397.8
393.9
349.7
317.5
..
49.4
..
..
..
135.4
156.4
168.2
173.5
171.7
..
11.3
..
..
..
680.8
658.0
660.7
646.2
636.0
1999
2000
2001
2002
2003
2004
2005
700.0
679.0
669.1
668.8
695.6
716.0
..
11.9
11.5
11.3
11.3
11.7
12.0
..
271.6
268.1
268.0
271.7
288.5
302.6
..
388
395
401
406
415
423
..
301.1
305.9
286.1
293.0
308.6
311.2P
..
..
..
..
..
..
..
..
158.7
154.6
156.8
160.5
166.7
167.1P
..
..
..
..
..
..
..
..
2003 March
June
Sept
Dec
165.6
173.4
182.2
174.3
11.3
11.7
12.2
11.6
68.7
70.3
75.7
73.6
415
405
415
423
38.2
85.9
127.0
56.1
..
..
..
..
42.6
42.0
41.3
40.8
2004 March
June
Sept
Dec
174.3
176.2
185.1
180.4
11.7
11.8
12.3
12.0
73.6
73.2
78.5
77.3
422
415
424
429
39.7P
85.5P
128.4P
57.6P
..
..
..
..
2005 March
June
Sept
Dec
173.2p
179.0P
189.0P
..
11.7p
11.9P
12.5P
..
74.5p
75.0P
81.8P
..
430p
419P
433P
..
..
..
..
..
England and Wales
1976
584.3
1981
634.5
1986
661.0
1991
699.2
1996
649.5
11.8
12.8
13.2
13.8
12.6
53.8
81.0
141.3
211.3
232.7
92
128
214
302
358
1999
2000
2001
2002
2003
2004
2005
621.9
604.4
594.6
596.1
621.5
639.7
..
12.0
11.6
11.4
11.3
11.8
12.1
..
241.9
238.6
238.1
242.0
257.2
269.7
..
2003 March
June
Sept
Dec
147.4
155.1
162.9
156.0
11.3
11.8
12.2
11.7
2004 March
June
Sept
Dec
155.2
157.4
165.4
161.7
2005 March
June
Sept
Dec
Neonatal
mortality6
Perinatal
mortality7
Number
Rate2
Number
Rate2
Number
12.1
11.7
11.7
11.2
10.9
9.79
8.16
7.18
5.82
4.50
14.5
11.2
9.5
7.4
6.1
6.68
4.93
4.00
3.46
3.00
9.9
6.7
5.3
4.4
4.1
12.25
8.79
7.31
6.45
6.41
18.0
12.0
9.6
8.1
8.7
632.1
608.4
602.3
606.2
612.0
583.1
583.0P
10.8
10.3
10.2
10.2
10.3
9.7
9.7P
4.05
3.79
3.66
3.50
3.69
3.61
3.67P
5.8
5.6
5.5
5.2
5.3
5.0
5.1P
2.73
2.63
2.43
2.36
2.53
2.46
2.52P
3.9
3.9
3.6
3.5
3.6
3.4
3.5P
5.79
5.56
5.39
5.57
5.94
5.85
..
8.2
8.1
8.0
8.3
8.5
8.1
..
..
..
..
..
162.5
145.8
140.7
162.2
11.1
9.8
9.4
10.8
0.96
0.88
0.89
0.96
5.8
5.0
4.9
5.5
0.65
0.60
0.62
0.66
3.9
3.4
3.4
3.8
1.45
1.49
1.52
1.49
8.7
8.5
8.3
8.5
43.1P
41.5P
42.3P
40.2P
..
..
..
..
159.7
139.3
135.1
149.0
10.7
9.4
9.0
9.9
0.97
0.84
0.90
0.90
5.5
4.8
4.9
5.0
0.64
0.59
0.64
0.58
3.7
3.4
3.5
3.2
1.50
1.45
1.55
1.36
8.5
8.2
8.3
7.5
..
..
..
..
..
..
..
..
..
..
..
..
164.7P
143.3P
131.6P
143.3P
11.1P
9.5P
8.7P
9.4P
0.91P
0.94P
0.92P
0.90P
5.3P
5.3P
4.8P
5.0P
0.63P
0.63P
0.66P
0.60P
3.6P
3.5P
3.5P
3.3P
1.32P
1.41P
1.42P
..
7.6P
7.9P
7.5P
..
358.6
352.0
347.9
306.8
279.0
57.7
49.6
43.6
36.0
30.9
126.7
145.7
153.9
158.7
157.1
10.1
11.9
12.9
13.5
13.8
598.5
577.9
581.2
570.0
560.1
12.1
11.6
11.6
11.2
10.9
8.34
7.02
6.31
5.16
3.99
14.3
11.1
9.6
7.4
6.1
5.66
4.23
3.49
3.05
2.68
9.7
6.7
5.3
4.4
4.1
10.45
7.56
6.37
5.65
5.62
17.7
11.8
9.6
8.0
8.6
389
395
400
406
414
422
..
263.5
268.0
249.2
255.6
270.1
270.7p
..
27.8
27.8
25.4
25.6
26.4
25.9p
..
144.6
141.1
143.8
147.7
153.5p
153.4
..
12.9
12.7
12.9
13.4
14.0
14.1
..
556.1
535.7
530.4
533.5
538.3
512.5
513.0P
10.7
10.3
10.1
10.1
10.2
9.7
9.6P
3.62
3.38
3.24
3.13
3.31
3.22
3.25P
5.8
5.6
5.4
5.2
5.3
5.0
5.0P
2.44
2.34
2.14
2.13
2.26
2.21
2.21P
3.9
3.9
3.6
3.6
3.6
3.5
3.4P
5.14
4.96
4.76
4.99
5.34
5.23
..
8.2
8.2
8.0
8.3
8.5
8.1
..
61.0
62.8
67.6
65.8
414
405
415
422
34.0
75.2
111.9
49.1
13.5
29.4
43.4
19.0
39.4
38.6
37.9
37.6
14.6
14.1
13.7
13.6
143.0
128.3
123.9
143.1
11.0
9.7
9.3
10.8
0.86
0.80
0.79
0.86
5.9
5.1
4.8
5.5
0.60
0.55
0.55
0.59
3.9
3.5
3.4
3.7
1.32
1.34
1.36
1.32
8.9
8.6
8.3
8.4
11.8
11.9
12.4
12.1
65.2
65.2
70.2
69.1
421
414
424
427
35.0p
74.3p
112.2P
49.2P
13.4pp
28.6
42.7P
18.7P
39.5p
38.1pp
39.0
36.9p
14.6p
14.0p
14.2p
13.5p
140.5
122.1
118.6
131.3
10.7
9.3
8.9
9.8
0.87
0.74
0.80
0.81
5.6
4.7
4.8
5.0
0.58
0.52
0.57
0.53
3.8
3.3
3.5
3.3
1.33
1.29
1.39
1.23
8.5
8.1
8.4
7.6
154.3pp
159.7
169.7P
..
11.7pp
12.0
12.6P
..
66.3pp
66.6
73.5P
..
430pp
417
433P
..
..
..
..
..
..
..
..
..
36.2p
36.5pP
35.6
..
13.5pp
13.4
13.0P
..
145.3Pp
125.9
115.4P
126.2P
11.0Pp
9.5
8.6P
9.4P
0.82Pp
0.83
0.80P
0.80P
5.3Pp
5.2
4.7P
4.9P
0.56Pp
0.56
0.57P
0.53P
3.6Pp
3.5
3.4P
3.3P
1.18Pp
1.24
1.27P
..
7.6Pp
7.8
7.5P
..
England
1976
1981
1986
1991
1996
550.4
598.2
623.6
660.8
614.2
11.8
12.8
13.2
13.7
12.7
50.8
76.9
133.5
198.9
218.2
92
129
214
301
355
339.0
332.2
328.4
290.1
264.2
..
..
..
..
..
..
..
146.0
150.1
148.7
..
..
..
..
..
560.3
541.0
544.5
534.0
524.0
12.0
11.6
11.6
11.2
10.8
7.83
6.50
5.92
4.86
3.74
14.2
10.9
9.5
7.3
6.1
5.32
3.93
3.27
2.87
2.53
9.7
6.6
5.2
4.3
4.1
9.81
7.04
5.98
5.33
5.36
17.6
11.7
9.5
8.0
8.7
1999
2000
2001
2002
2003
2004
2005
589.5
572.8
563.7
565.7
589.9
607.2
..
12.0
11.7
11.4
11.4
11.8
12.1
..
226.7
223.8
223.3
227.0
241.4
253.1
..
385
391
396
401
409
417
..
249.5
253.8
236.2
242.1
255.6
255.9p
..
..
..
..
..
..
..
..
137.0
133.9
136.4
140.2
145.8p
145.5
..
..
..
..
..
..
..
..
519.6
501.0
496.1
499.1
503.4
479.2
479.7P
10.8
10.2
10.0
10.1
10.1
9.6
9.5P
3.38
3.18
3.04
2.97
3.14
3.03
3.08P
5.7
5.6
5.4
5.2
5.3
5.0
5.0P
2.29
2.21
2.02
2.02
2.15
2.09
2.11P
3.9
3.9
3.6
3.6
3.7
3.4
3.4P
4.86
4.69
4.51
4.75
5.01
4.96
..
8.2
8.2
8.0
8.3
8.5
8.1
..
2003 March
June
Sept
Dec
139.9
147.3
154.5
148.2
11.4
11.8
12.3
11.8
57.2
58.9
63.4
61.8
409
400
411
417
32.3
71.2
105.6
46.5
..
..
..
..
37.5
36.6
36.0
35.7
..
..
..
..
133.8
119.6
116.0
134.0
10.9
9.1
8.7
10.1
0.83
0.76
0.74
0.82
5.9
5.1
4.8
5.5
0.55
0.52
0.52
0.56
3.9
3.6
3.3
3.8
1.25
1.28
1.28
1.26
8.9
8.6
8.3
8.4
2004 March
June
Sept
Dec
147.3
149.6
156.9
153.3
11.8
12.0
12.5
12.2
61.2
61.3
65.8
64.7
416
410
420
422
33.2p
70.3pp
105.8p
46.5
..
..
..
..
37.4p
36.0p
36.9pp
35.1
..
..
..
131.4
114.2
110.8
122.9
10.6
9.2
8.8
9.8
0.82
0.69
0.74
0.78
5.5
4.6
4.7
5.1
0.55
0.49
0.53
0.52
3.7
3.3
3.4
3.4
1.25
1.22
1.31
1.17
8.4
8.1
8.3
7.6
2005 March
June
Sept
Dec
146.4p
151.8pP
161.0
..
11.8pp
12.1
12.7P
..
62.1pp
62.5
68.9P
..
424pp
412
428P
..
..
..
..
..
34.4p
34.6p
33.8P
..
..
..
..
..
135.8Pp
117.7
108.0P
118.1P
10.9Pp
9.4
8.5P
9.3P
0.78Pp
0.79
0.76P
0.75P
5.3Pp
5.2
4.7P
4.9P
0.53Pp
0.53
0.54P
0.51P
3.6Pp
3.5
3.4P
3.3P
1.17Pp
1.18
1.21P
..
8.0Pp
7.7
7.5P
..
..
..
..
..
Notes: Rates for the most recent quarters will be particularly subject to revision, even
when standard detail is given, as they are based on provisional numbers or on estimates
derived from events registered in the period.
Figures for England and Wales represent the number of deaths registered in each
year up to 1992, and the number of deaths occurring in each year from 1993 to 2004.
Provisional figures for 2005 relate to registrations. Death rates for 2005 are based on
2004-based population projections for 2005.
Birth and death figures for England and also for Wales each exclude events for persons
usually resident outside England and Wales. These events are, however, included in the
totals for England and Wales combined, and for the United Kingdom.
From 1981 births to non-resident mothers in Northern Ireland are excluded from the
figures for Northern Ireland, and for the United Kingdom.
Rate1
Infant
mortality5
Birth and death rates for 2004 have been calculated using the revised mid-2004
population estimates published on 20 December 2005.
Birth rates for 2005 are based on the 2004-based population projections for
2005.
Marriage and divorce rates in England and Wales for 1986 have been calculated
using the interim revised marital status estimates (based on the original mid2001 estimates) and are subject to further revision. Marriage and divorce rates
for 2005 are based on 2004 marital status estimates.
Some stillbirths in 2004 are excluded from these and previously published
figures, as the relevant registration details were not sent to ONS before the
statistics were compiled. Revised figures for 2004 will be published as soon as
possible to include the additional stillbirth registrations.
See 'Notes to tables'.
National Statistics
34
Rate8
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 2.1
continued
Summer 2006
Vital statistics summary
Constituent countries of the United Kingdom
Year and
quarter
All live
births
Number
Rate1
Numbers (thousands) and rates
Live births
outside marriage
Marriages
Divorces
Number
Rate2
Number
Rate3
Number
Deaths
Rate4
Number
Rate1
Infant
mortality5
Number
Neonatal
mortality6
Rate2
Number
Rate2
Perinatal
mortality7
Number
Rate8
Wales
1976
1981
1986
1991
1996
33.4
35.8
37.0
38.1
34.9
11.9
12.7
13.1
13.3
12.1
2.9
4.0
7.8
12.3
14.4
86
112
211
323
412
19.5
19.8
19.5
16.6
14.8
..
..
..
..
..
..
..
7.9
8.6
8.4
..
..
..
..
..
36.3
35.0
34.7
34.1
34.6
13.0
12.4
12.3
11.9
12.0
0.46
0.45
0.35
0.25
0.20
13.7
12.6
9.5
6.6
5.6
0.32
0.29
0.21
0.16
0.13
9.6
8.1
5.6
4.1
3.6
0.64
0.51
0.38
0.30
0.26
19.0
14.1
10.3
7.9
7.5
1999
2000
2001
2002
2003
2004
2005
32.1
31.3
30.6
30.2
31.4
32.3
..
11.1
10.8
10.5
10.3
10.7
10.9
..
14.8
14.8
14.8
15.0
15.8
16.6
..
461
472
483
497
503
513
..
14.0
14.1
13.0
13.5
14.5
14.8p
..
..
..
..
..
..
..
..
7.5
7.2
7.4
7.6
7.7
7.9p
..
..
..
..
..
..
..
35.0
33.3
33.0
33.2
33.7
32.1
32.2P
12.1
11.5
11.3
11.3
11.5
10.9
10.9P
0.20
0.17
0.16
0.14
0.13
0.16
0.14P
6.1
5.3
5.4
4.5
4.3
4.9
4.3P
0.13
0.11
0.11
0.10
0.10
0.10
0.09P
4.0
3.5
3.5
3.2
3.1
3.1
2.9P
0.25
0.23
0.23
0.24
0.24
0.25
..
7.7
7.2
7.5
7.7
7.5
7.8
..
2003 March
June
Sept
Dec
7.5
7.8
8.3
7.8
10.3
10.7
11.2
10.5
3.8
3.9
4.2
4.0
505
494
503
511
1.7
4.0
6.2
2.6
..
..
..
..
2.0
2.0
2.0
1.8
..
..
..
..
8.9
8.3
7.6
8.8
12.3
11.4
10.2
11.9
0.04
0.03
0.04
0.03
4.7
4.0
4.6
3.8
0.03
0.02
0.03
0.02
3.8
2.7
3.5
2.3
0.06
0.06
0.07
0.05
7.7
7.3
8.2
6.9
2004 March
June
Sept
Dec
7.8
7.8
8.4
8.3
10.6
10.6
11.4
11.2
4.0
3.9
4.3
4.4
514
500
512
523
1.7p
4.0p
6.4P
2.7P
..
..
..
..
2.0P
2.0P
2.1P
1.8P
..
..
..
..
8.8
7.6
7.5
8.1
12.0
10.4
10.1
11.0
0.05
0.04
0.04
0.03
5.9
4.9
4.9
3.8
0.03
0.02
0.03
0.02
3.9
3.1
3.7
1.8
0.08
0.06
0.06
0.05
9.8
7.4
7.5
6.5
2005 March
June
Sept
Dec
7.8p
7.9p
8.7P
..
10.7p
10.7p
11.6P
..
4.1p
4.0p
4.6P
..
529p
510p
530P
..
..
..
..
..
..
..
..
..
1.8p
1.8p
1.8P
..
..
..
..
..
9.2P
8.0p
7.2P
7.8P
12.6P
10.8p
9.6P
10.5P
0.03P
0.04p
0.03P
0.04P
3.8P
4.6p
3.8P
4.9P
0.02P
0.03p
0.03P
0.02P
2.9P
3.2p
2.9P
2.6P
0.05P
0.06p
0.06P
..
6.9P
7.7p
6.7P
..
Scotland
1976
1981
1986
1991
1996
64.9
69.1
65.8
67.0
59.3
12.5
13.4
12.9
13.2
11.6
6.0
8.5
13.6
19.5
21.4
93
122
206
291
360
37.5
36.2
35.8
33.8
30.2
53.8
47.5
42.9
39.0
33.2
8.1
9.9
12.8
12.4
12.3
6.5
8.0
10.7
10.6
10.9
65.3
63.8
63.5
61.0
60.7
12.5
12.3
12.4
12.0
11.9
0.96
0.78
0.58
0.47
0.37
14.8
11.3
8.8
7.1
6.2
0.67
0.47
0.34
0.29
0.23
10.3
6.9
5.2
4.6
3.9
1.20
0.81
0.67
0.58
0.55
18.3
11.6
10.2
8.6
9.2
1999
2000
2001
2002
2003
2004
2005
55.1
53.1
52.5
51.3
52.4
54.0
..
10.9
10.5
10.4
10.1
10.4
10.6
..
22.7
22.6
22.8
22.5
23.9
25.2
..
412
426
433
440
455
467
..
29.9
30.4
29.6
29.8
30.8
32.2
..
31.5
31.6
31.0
30.8
31.3
32.2
..
11.9
11.1
10.6
10.8
10.1
11.2
..
10.9
10.3
9.7
10.0
10.2
10.5
..
60.3
57.8
57.4
58.1
58.5
56.2
55.7P
11.9
11.4
11.3
11.5
11.6
11.1
10.9P
0.28
0.31
0.29
0.27
0.27
0.27
0.28P
5.0
5.7
5.5
5.3
5.1
4.9
5.2P
0.18
0.21
0.20
0.16
0.18
0.17
0.19P
3.3
4.0
3.8
3.2
3.4
3.1
3.5P
0.42
0.45
0.45
0.39
0.42
0.44
0.42P
7.6
8.4
8.5
7.6
8.0
8.1
7.7P
2003 March
June
Sept
Dec
12.8
12.9
13.8
13.0
10.3
10.3
10.8
10.2
5.9
5.8
6.2
6.0
462
447
448
464
3.7
8.4
12.3
6.4
15.2
34.2
49.7
25.5
2.5
3.0
2.6
2.7
9.4
11.1
9.7
10.1
15.7
14.1
13.3
15.4
12.6
11.2
10.4
12.1
0.07
0.06
0.07
0.07
5.5
4.3
4.9
5.6
0.05
0.03
0.05
0.05
3.8
2.5
3.4
3.8
0.09
0.11
0.11
0.12
6.9
8.2
8.1
8.9
2004 March
June
Sept
Dec
13.5
13.3
13.8
13.3
10.7
10.5
10.8
10.4
6.4
6.1
6.4
6.3
472
459
462
475
3.9
8.7
12.7
6.8
15.6
35.1
50.6
27.3
2.9
2.8
2.7
2.8
10.9
10.5
10.2
10.4
15.3
13.6
13.1
14.2
12.2
10.7
10.2
11.1
0.06
0.07
0.07
0.06
4.6
5.1
5.3
4.7
0.04
0.05
0.05
0.03
2.7
3.6
3.4
2.6
0.13
0.11
0.11
0.09
9.2
8.4
7.8
6.9
2005 March
June
Sept
Dec
13.4p
13.5p
13.4P
..
10.6p
10.7p
10.4P
..
6.2p
6.4p
6.2P
..
464p
473p
464P
..
3.8p
8.6p
12.3P
..
15.4p
34.7p
49.1P
..
2.6p
2.8p
2.7p
..
9.9p
10.6p
9.9p
..
15.6P
13.7p
12.8P
13.6P
12.4P
10.8p
10.0P
10.6P
0.07P
0.07p
0.08P
0.07P
5.0P
5.1p
5.6P
5.2P
0.04P
0.05p
0.06P
0.05P
3.3P
3.4p
3.9P
3.4P
0.09P
0.13p
0.11P
0.10P
7.0P
9.2p
7.6P
7.1P
Northern Ireland
1976
1981
1986
1991
1996
26.4
27.2
28.0
26.0
24.4
17.3
17.6
17.8
16.2
14.7
1.3
1.9
3.6
5.3
6.3
50
70
128
203
260
9.9
9.6
10.2
9.2
8.3
..
45.4
..
..
..
0.6
1.4
1.5
2.3
2.3
..
4.2
..
..
..
17.0
16.3
16.1
15.1
15.2
11.2
10.6
10.3
9.4
9.2
0.48
0.36
0.36
0.19
0.14
18.3
13.2
13.2
7.4
5.8
0.35
0.23
0.23
0.12
0.09
13.3
8.3
8.3
4.6
3.7
0.59
0.42
0.42
0.22
0.23
22.3
15.3
15.3
8.4
9.4
1999
2000
2001
2002
2003
2004
2005
23.0
21.5
22.0
21.4
21.6
22.3
..
13.7
12.8
13.0
12.6
12.7
13.0
..
7.0
6.8
7.1
7.2
7.4
7.7
..
303
318
325
335
344
345
..
7.6
7.6
7.3
7.6
7.8
8.3
..
..
..
..
..
..
..
..
2.3
2.4
2.4
2.2
2.3
2.5
..
..
..
..
..
..
..
..
15.7
14.9
14.5
14.6
14.5
14.4
14.2P
9.3
8.9
8.6
8.6
8.5
8.4
8.3P
0.15
0.11
0.13
0.10
0.11
0.12
0.14P
6.4
5.1
6.1
4.7
5.3
5.5
6.3P
0.11
0.08
0.10
0.07
0.09
0.08
0.11P
4.8
3.8
4.5
3.5
4.0
3.7
5.1P
0.23
0.15
0.19
0.19
0.18
0.18
0.18P
10.0
7.3
8.5
8.9
8.1
8.2
8.1P
2003 March
June
Sept
Dec
5.4
5.4
5.6
5.3
12.7
12.7
13.0
12.4
1.8
1.8
1.9
1.9
344
331
341
359
0.8
2.2
3.3
1.4
..
..
..
..
6.6
5.4
5.6
5.6
..
..
..
..
3.9
3.4
3.5
3.7
9.2
8.1
8.1
8.6
0.03
0.02
0.04
0.03
5.0
4.3
6.3
5.6
0.02
0.02
0.03
0.03
3.7
3.0
4.5
4.9
0.04
0.04
0.04
0.05
7.8
7.2
7.8
9.7
2004 March
June
Sept
Dec
5.7
5.4
5.8
5.4
13.3
12.7
13.5
12.7
2.0
1.8
2.0
1.9
352
337
339
353
0.9
2.4
3.5
1.6
..
..
..
..
7.7
6.5
5.5
5.5
..
..
..
..
3.9
3.6
3.4
3.5
9.1
8.4
8.0
8.1
0.03
0.03
0.04
0.02
5.5
5.9
6.0
4.4
0.02
0.02
0.02
0.02
3.5
4.4
4.1
2.8
0.05
0.05
0.05
0.04
7.9
9.5
8.3
7.0
2005 March
June
Sept
Dec
5.5p
5.7p
5.9P
..
13.0p
13.3p
13.7P
..
2.0p
2.0p
2.0P
..
363p
359p
358P
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
3.8P
3.7p
3.4P
3.4P
8.9P
8.5p
7.7P
7.8P
0.03P
0.04p
0.04P
0.03P
5.2P
7.2p
6.6P
6.0P
0.02P
0.03p
0.03P
0.02P
4.3P
5.6p
5.6P
4.6P
0.05P
0.04p
0.04P
0.04P
8.8P
8.4p
7.2P
7.9P
See notes opposite.
1
Per 1,000 population of all ages.
2
Per 1,000 live births.
3
Persons marrying per 1,000 unmarried population 16 and over.
4
Persons divorcing per 1,000 married population.
5
Deaths under 1 year.
6
7
8
p
Deaths under 4 weeks.
Stillbirths and deaths under 1 week. In October 1992 the legal definition of a stillbirth
was changed, from baby born dead after 28 completed weeks of gestation or more, to
one born dead after 24 completed weeks of gestation or more.
Per 1,000 live births and stillbirths.
Provisional.
35
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 2.2
Summer 2006
Key demographic and health indicators
Constituent countries of the United Kingdom
Numbers (thousands), rates, percentages, mean age
Dependency ratio
Population
Live
births
Live births
Deaths
Children1
Elderly2
TFR3
Expectation of life
(in years) at birth
Standardised UnstandOutside
Agemean age
ardised
marriage as standardised
of mother mean age of percentage mortality
at birth
mother at
of total
rate6
(years)4 birth (years) 5 live births
United Kingdom
1976
56,216.1
1981
56,357.5
1986
56,683.8
1991
57,438.7
19968
58,164.4
675.5
730.7
754.8
792.3
733.2
680.8
658.0
660.7
646.2
636.0
42.1
37.1
33.5
33.2
33.9
29.5
29.7
29.7
30.0
30.0
1.74
1.82
1.78
1.82
1.73
..
27.0
27.4
27.7
28.2
26.4
26.8
27.0
27.7
28.6
9.0
12.5
21.4
29.8
35.5
19998
20008
20018
20028
2003
20049
2005P
58,684.4
58,886.1
59,113.5
59,321.7
59,553.8
59,834.3
700.0
679.0
669.1
668.8
695.6
716.0
632.1
608.4
602.3
606.2
612.0
583.1
33.4
33.1
32.6
32.2
31.8
31.4
29.9
29.9
29.8
29.8
29.9
30.0
1.68
1.64
1.63
1.64
1.71
1.77
28.4
28.5
28.6
28.7
28.8
28.9
28.9
29.1
29.2
29.3
29.4
29.4
38.8
39.5
40.1
40.6
41.5
42.3
England
1976
1981
1986
1991
19968
46,659.9
46,820.8
47,187.6
47,875.0
48,519.1
550.4
598.2
623.6
660.8
614.2
560.3
541.0
544.5
534.0
524.0
41.4
36.4
33.1
32.9
33.7
29.7
29.9
29.8
30.0
30.0
1.70
1.79
1.76
1.81
1.73
..
..
27.4
27.7
28.2
26.4
26.8
27.0
27.7
28.7
9.2
12.9
21.4
30.1
35.5
19998
20008
20018
20028
2003
20049
2005P
49,032.9
49,233.3
49,449.7
49,646.9
49,855.7
50,093.1
589.5
572.8
563.7
565.7
589.9
607.2
519.6
501.0
496.1
499.1
503.4
479.2
33.3
33.0
32.5
32.1
31.8
31.4
29.9
29.8
29.7
29.7
29.8
29.9
1.69
1.65
1.63
1.65
1.73
1.78
28.4
28.5
28.6
28.7
28.9
29.0
29.0
29.2
29.3
29.4
29.4
29.5
38.5
39.1
39.6
40.1
40.9
41.7
Wales
1976
1981
1986
1991
19968
2,799.3
2,813.5
2,810.9
2,873.0
2,891.3
33.4
35.8
37.0
38.1
34.9
36.3
35.0
34.7
34.1
34.6
42.0
37.6
34.3
34.4
34.9
30.9
31.6
32.5
33.5
33.7
1.78
1.87
1.86
1.88
1.81
..
..
26.9
27.1
27.5
26.0
26.6
26.5
27.0
27.8
8.7
11.2
21.1
32.3
41.2
19998
20008
20018
20028
2003
2004
2005P
2,900.6
2,906.9
2,910.2
2,923.4
2,938.0
2,952.5
32.1
31.3
30.6
30.2
31.4
32.1
35.0
33.3
33.0
33.2
33.7
32.1
34.4
34.1
33.7
33.2
32.7
32.2
33.6
33.5
33.6
33.6
33.7
33.9
1.72
1.68
1.66
1.63
1.71
1.77
27.6
27.7
27.8
28.0
28.1
28.2
28.1
28.2
28.3
28.4
28.5
28.5
46.1
47.2
48.3
49.7
50.3
51.3
Scotland
1976
1981
1986
1991
1996
5,233.4
5,180.2
5,111.8
5,083.3
5,092.2
64.9
69.1
65.8
67.0
59.3
65.3
63.8
63.5
61.0
60.7
44.7
38.2
33.6
32.4
32.3
28.4
28.4
28.1
28.9
29.2
1.79
1.84
1.67
1.69
1.56
..
..
27.1
27.5
28.0
26.0
26.3
26.6
27.4
28.5
9.3
12.2
20.6
29.1
36.0
1999
2000
2001
2002
2003
2004
2005P
5,072.0
5,062.9
5,064.2
5,054.8
5,057.4
5,078.4
55.1
53.1
52.5
51.3
52.4
54.0
60.3
57.8
57.4
58.1
58.5
56.2
31.7
31.4
30.8
30.3
29.9
29.5
29.7
29.8
30.0
30.2
30.3
30.5
1.51
1.48
1.49
1.48
1.54
1.60
28.3
28.4
28.5
28.6
28.7
28.9
28.9
29.0
29.2
29.2
29.3
29.4
41.2
42.6
43.3
44.0
45.5
46.7
Northern Ireland
1976
1,523.5
1981
1,543.0
1986
1,573.5
1991
1,607.3
1996
1,661.8
26.4
27.2
28.0
26.0
24.4
17.0
16.3
16.1
15.1
15.2
56.1
50.6
46.1
44.1
41.8
25.3
25.3
25.5
26.1
25.5
2.68
2.59
2.45
2.16
1.95
..
28.1
28.1
28.3
28.7
27.4
27.5
27.5
28.0
28.8
5.0
7.0
12.8
20.3
26.0
1999
2000
2001
2002
2003
2004
2005P
23.0
21.5
22.0
21.4
21.6
22.3
15.7
14.9
14.5
14.6
14.5
14.4
40.2
39.5
38.6
37.9
37.2
36.4
25.5
25.4
25.5
25.7
25.9
26.2
1.86
1.75
1.80
1.77
1.81
1.87
28.8
29.0
29.1
29.2
29.2
29.4
29.0
29.2
29.4
29.5
29.5
29.7
30.3
31.8
32.5
33.5
34.4
34.5
..
..
..
..
1,679.0
1,682.9
1,689.3
1,696.6
1,702.6
1,710.3
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
Notes: Some of these indicators are also in other tables. They are brought together to make
comparison easier.
Figures for England and Wales represent the number of deaths registered in each
year up to 1992, and the number of deaths occurring in each year from 1993 to 2004.
Births and deaths figures for England and also for Wales exclude events for persons
usually resident outside England and Wales. These events are, however, included in
totals for England and Wales combined, and for the United Kingdom.
From 1981 births to non-resident mothers in Northern Ireland are excluded from
the figures for Northern Ireland, and the United Kingdom.
1 Percentage of children under 16 to working population (males 16–64 and females 16–59).
2 Percentage of males 65 and over and females 60 and over to working population (males
16–64 and females 16–59).
3 TFR (total fertility rate) is the number of children that would be born to a woman if
current patterns of fertility persisted throughout her childbearing life. It is sometimes
called the TPFR (total period fertility rate).
National Statistics
36
..
..
..
..
..
..
..
..
..
..
..
..
..
..
..
10,486
9,506
8,914
8,168
7,584
7,318
6,974
6,807
6,765
6,757
6,390
6,27810
10,271
9,298
8,725
8,017
7,414
7,138
6,821
6,650
6,603
6,602
6,232
6,125 10
10,858
9,846
9,043
8,149
7,758
7,637
7,180
7,017
6,951
6,980
6,582
6,464 10
11,675
10,849
10,120
9,216
8,791
8,493
8,082
7,930
7,955
7,922
7,536
7,406 10
11,746
10,567
10,071
8,303
7,742
7,699
7,279
6,976
6,930
6,744
6,609
6,411 10
Males
Females
Infant
mortality
rate7
..
70.8
71.9
73.2
74.3
..
76.8
77.7
78.7
79.4
14.5
11.2
9.5
7.4
6.1
75.0
75.4
75.7
75.9
76.3
..
..
79.9
80.2
80.4
80.5
80.7
..
..
5.8
5.6
5.5
5.2
5.3
5.0
5.1
..
71.1
72.2
73.4
74.5
..
77.0
77.9
78.9
79.6
14.2
10.9
9.5
7.3
6.1
75.3
75.7
76.0
76.2
76.6
..
..
80.1
80.4
80.6
80.7
80.9
..
..
5.7
5.6
5.4
5.2
5.3
5.0
5.0
..
70.4
71.6
73.1
73.9
..
76.4
77.5
78.8
79.1
13.7
12.6
9.5
6.6
5.6
74.7
74.9
75.4
75.7
76.0
..
..
79.6
79.8
80.1
80.2
80.4
..
..
6.1
5.3
5.4
4.5
4.3
4.9
4.3
..
69.1
70.2
71.4
72.2
..
75.3
76.2
77.1
77.9
14.8
11.3
8.8
7.1
6.2
72.8
73.1
73.3
73.5
73.8
..
..
78.4
78.6
78.8
78.9
79.1
..
..
5.0
5.7
5.5
5.3
5.1
4.9
5.2
..
69.2
70.9
72.6
73.8
..
75.5
77.1
78.4
79.2
18.3
13.2
13.2
7.4
5.8
74.5
74.8
75.2
75.6
75.8
..
..
79.6
79.8
80.1
80.4
80.6
..
..
6.4
5.1
6.1
4.7
5.3
5.5
6.3
4 Standardised to take account of the age structure of the population.
5 Unstandardised and therefore takes no account of the age structure of the population.
6 Per million population. The age-standardised mortality rate makes allowances for changes
in the age structure of the population. See Notes to tables.
7 Deaths under one year per 1,000 live births.
8 These revised population estimates were published on 9 September 2004 (for mid-2001
and mid-2002) and 7 October (for mid-1992 to mid-2000), following the local authority
population studies, and replace all earlier versions. All figures shown on this table are
now therefore on a consistent basis.
9 Population estimates for mid-2004 for the United Kingdom, Great Britain, England and
Wales and England were revised due to the Harrow correction that was published on 20
December 2005. Rates for 2004 have been calculated using these revised estimates.
10 Calculated using the 2004-based population projections for 2005.
P Provisional
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 3.1
Live births: age of mother
England and Wales
Numbers (thousands), rates, mean age and TFRs
Age of mother at birth
Year and
quarter
Summer 2006
All
ages
Under
20
20–24
25–29
30–34
35–39
40 and
over
Mean1
age
(years)
Age of mother at birth
All
ages
Under
20
Total live births (numbers)
20–24
25–29
30–34
TFR3
35–39
40 and
over
Mean2
age
(years)
Age-specific fertility rates4
1961
811.3
59.8
249.8
248.5
152.3
77.5
23.3
27.6
89.2
37.3
172.6
176.9
103.1
48.1
15.0
27.4
2.77
1964(max)
876.0
76.7
276.1
270.7
153.5
75.4
23.6
27.2
92.9
42.5
181.6
187.3
107.7
49.8
13.7
27.3
2.93
1966
849.8
86.7
285.8
253.7
136.4
67.0
20.1
26.8
90.5
47.7
176.0
174.0
97.3
45.3
12.5
27.1
2.75
1971
783.2
82.6
285.7
247.2
109.6
45.2
12.7
26.2
83.5
50.6
152.9
153.2
77.1
32.8
8.7
26.6
2.37
1976
584.3
57.9
182.2
220.7
90.8
26.1
6.5
26.4
60.4
32.2
109.3
118.7
57.2
18.6
4.8
26.5
1.71
1977(min)
569.3
54.5
174.5
207.9
100.8
25.5
6.0
26.5
58.1
29.4
103.7
117.5
58.6
18.2
4.4
26.6
1.66
1981
634.5
56.6
194.5
215.8
126.6
34.2
6.9
26.8
61.3
28.1
105.3
129.1
68.6
21.7
4.9
27.0
1.80
1986
661.0
57.4
192.1
229.0
129.5
45.5
7.6
27.0
60.6
30.1
92.7
123.8
78.0
24.6
4.8
27.4
1.77
1991
699.2
52.4
173.4
248.7
161.3
53.6
9.8
27.7
63.6
33.0
89.3
119.4
86.7
32.1
5.3
27.7
1.82
1992
1993
1994
1995
1996
689.7
673.5
664.7
648.1
649.5
47.9
45.1
42.0
41.9
44.7
163.3
152.0
140.2
130.7
125.7
244.8
236.0
229.1
217.4
211.1
166.8
171.1
179.6
181.2
186.4
56.7
58.8
63.1
65.5
69.5
10.2
10.5
10.7
11.3
12.1
27.9
28.1
28.4
28.5
28.6
63.6
62.7
62.0
60.5
60.6
31.7
30.9
28.9
28.5
29.7
86.1
82.5
79.0
76.4
77.0
117.6
114.4
112.2
108.4
106.6
87.4
87.4
89.4
88.3
89.8
33.4
34.1
35.8
36.3
37.5
5.8
6.2
6.4
6.8
7.2
27.8
27.9
28.1
28.2
28.2
1.80
1.76
1.75
1.72
1.74
1997
1998
1999
2000
2001
643.1
635.9
621.9
604.4
594.6
46.4
48.3
48.4
45.8
44.2
118.6
113.5
110.7
107.7
108.8
202.8
193.1
181.9
170.7
159.9
187.5
188.5
185.3
180.1
178.9
74.9
78.9
81.3
85.0
86.5
12.9
13.6
14.3
15.1
16.3
28.8
28.9
29.0
29.1
29.2
60.0
59.2
57.8
55.9
54.7
30.2
30.9
30.9
29.3
28.0
76.0
74.9
73.0
70.0
69.0
104.3
101.5
98.3
94.3
91.7
89.8
90.6
89.6
87.9
88.0
39.4
40.4
40.6
41.4
41.5
7.6
7.9
8.1
8.3
8.8
28.3
28.3
28.4
28.5
28.6
1.73
1.72
1.70
1.65
1.63
2002
2003
20045
596.1
621.5
639.7
43.5
44.2
45.1
110.9
116.6
121.1
153.4
156.9
160.0
180.5
187.2
190.6
90.5
97.4
102.2
17.3
19.1
20.8
29.3
29.4
29.4
54.7
56.8
58.2
27.0
26.8
26.9
69.2
71.2
72.7
91.6
96.4
98.4
89.8
94.8
99.4
43.0
46.4
48.9
9.1
9.8
10.4
28.7
28.8
28.9
1.65
1.73
1.78
2000 March
June
Sept
Dec
148.7
150.7
155.0
150.1
11.4
11.1
11.8
11.5
26.4
26.0
27.8
27.5
42.5
42.8
43.6
41.8
44.1
45.7
46.2
44.1
20.6
21.4
21.7
21.4
3.6
3.7
3.9
3.9
29.1
29.2
29.1
29.1
55.3
56.0
57.0
55.2
29
29
30
29
69
68
72
71
95
95
96
92
87
90
90
86
40
42
42
41
8
8
9
9
28.5
28.6
28.5
28.5
1.64
1.66
1.69
1.64
2001 March
June
Sept
Dec
145.5
148.8
153.0
147.4
11.0
10.8
11.4
11.1
26.5
26.4
28.1
27.8
39.8
40.3
41.0
38.9
43.3
45.5
46.4
43.7
21.0
21.7
22.0
21.8
4.0
4.0
4.1
4.2
29.2
29.3
29.2
29.2
54.3
54.9
55.8
53.8
28
27
29
28
68
67
71
70
93
93
93
88
86
90
91
85
41
42
42
42
9
9
9
9
28.6
28.7
28.6
28.6
1.62
1.64
1.67
1.61
2002 March
June
Sept
Dec
143.3
147.2
155.0
150.6
10.5
10.4
11.4
11.2
26.5
26.7
28.9
28.8
37.4
37.9
39.9
38.2
43.2
45.5
46.9
45.0
21.6
22.4
23.4
23.0
4.1
4.3
4.5
4.5
29.3
29.4
29.3
29.3
53.3
54.1
56.4
54.8
26
26
28
28
67
67
72
71
91
91
95
91
87
91
93
89
42
43
44
44
9
9
9
9
28.7
28.8
28.7
28.7
1.61
1.63
1.70
1.65
2003 March
June
Sept
Dec
147.4
155.1
162.8
156.0
10.9
10.7
11.5
11.2
27.9
28.5
30.5
29.7
37.5
39.3
41.0
39.1
44.0
47.4
49.3
46.5
22.6
24.5
25.6
24.6
4.6
4.7
5.0
4.8
29.3
29.5
29.4
29.4
54.6
56.9
59.0
56.6
27
26
28
27
69
70
74
72
93
97
100
95
90
96
99
94
44
47
48
47
10
10
10
10
28.8
28.9
28.9
28.8
1.66
1.73
1.79
1.72
2004 March5
June5
Sept5
Dec5
155.2
157.4
165.4
161.7
11.0
10.7
11.7
11.6
29.3
29.3
31.4
31.1
38.7
39.4
41.6
40.3
46.6
47.7
49.0
47.2
24.7
25.2
26.3
26.0
4.9
5.0
5.4
5.5
29.4
29.5
29.4
29.4
56.8
57.6
59.9
58.6
27
26
28
28
71
71
75
74
96
97
102
99
98
100
102
98
47
49
50
49
10
10
11
11
28.9
29.0
28.9
28.9
1.74
1.77
1.84
1.80
2005 March6P 154.3
June6P 159.7
Sept6P 169.7
10.9
10.7
11.8
29.3
29.6
32.4
38.9
40.3
43.5
44.9
47.5
49.3
24.8
26.2
26.9
5.4
5.4
5.7
29.5
29.5
29.4
56.6
58.0
60.9
26
25
28
70
70
76
95
97
104
98
102
105
49
51
52
11
11
11
29.0
29.1
29.0
1.74
1.78
1.88
Notes: The rates for women of all ages, under 20, and 40 and over are based upon the populations of women aged 15–44, 15–19, and 40–44 respectively.
1 Unstandardised and therefore takes no account of the age structure of the population.
2 Standardised to take account of the age structure of the population. This measure is more appropriate for use when analysing trends or making comparisons between different
geographies.
3 TFR (total fertility rate) is the number of children that would be born to a woman if current patterns of fertility persisted throughout her childbearing life. It is sometimes called the TPFR
(total period fertility rate). During the post Second World War period the TFR reached a maximum in 1964 and a minimum in 1977.
4 Births per 1,000 women in the age-group; all quarterly age-specific fertility rates are adjusted for days in the quarter. They are not adjusted for seasonality.
5 Rates for 2004 have been calculated using the revised mid-2004 population estimates published on 20 December 2005.
6 Birth rates for 2005 are based on the 2004-based population projections for 2005.
p Provisional
37
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Live births outside marriage: age of mother and type of registration
Table 3.2
England and Wales
Numbers (thousands), mean age and percentages
Age of mother at birth
Year and
quarter
All
ages
Under
20
20–24
25–29
30–34
Age of mother at birth
35–39
40 and
over
Mean1
age
(years)
All
ages
Under
20
20–24
25–29
30–34
Registration2
35–39
40 and
over
Joint
Sole
Same3 Different3
address addresses
Percentage of total live births
in age-group
As a percentage of all
births outside marriage
{
Live births outside marriage (numbers)
65.7
53.8
81.0
21.6
19.8
26.4
22.0
16.6
28.8
11.5
9.7
14.3
6.2
4.7
7.9
3.2
2.3
1.3
1.1
0.7
0.9
23.7
23.3
23.4
8.4
9.2
12.8
26.1
34.2
46.7
7.7
9.1
14.8
4.7
4.4
6.6
5.7
5.2
6.2
7.0
8.6
3.9
9.0
10.1
12.5
45.5
51.0
58.2
54.5
49.0
41.8
1986
1991
141.3
211.3
39.6
43.4
54.1
77.8
27.7
52.4
13.1
25.7
5.7
9.8
1.1
2.1
23.8
24.8
21.4
30.2
69.0
82.9
28.2
44.9
12.1
21.1
10.1
16.0
12.6
18.3
14.7
21.3
46.6
54.6
19.6
19.8
33.8
25.6
1992
1993
1994
1995
1996
215.2
216.5
215.5
219.9
232.7
40.1
38.2
35.9
36.3
39.3
77.1
75.0
71.0
69.7
71.1
55.9
57.5
58.5
59.6
62.3
28.9
31.4
34.0
37.0
40.5
10.9
11.9
13.4
14.4
16.2
2.3
2.5
2.7
3.0
3.2
25.2
25.5
25.8
26.0
26.1
31.2
32.2
32.4
33.9
35.8
83.7
84.8
85.5
86.6
88.0
47.2
49.4
50.6
53.3
56.5
22.8
24.4
25.5
27.4
29.5
17.3
18.4
18.9
20.4
21.7
19.3
20.2
21.2
22.0
23.4
22.9
23.5
25.2
26.2
26.7
55.4
54.8
57.5
58.1
58.1
20.7
22.0
19.8
20.1
19.9
23.9
23.2
22.7
21.8
21.9
1997
1998
1999
2000
2001
238.2
240.6
241.9
238.6
238.1
41.1
43.0
43.0
41.1
39.5
69.5
67.8
67.5
67.5
68.1
63.4
62.4
61.2
59.1
56.8
42.2
43.9
45.0
43.9
45.2
18.2
19.6
20.8
22.3
23.3
3.7
3.9
4.3
4.7
5.1
26.2
26.3
26.4
26.5
26.7
37.0
37.8
38.9
39.5
40.0
88.7
89.1
89.0
89.7
89.5
58.6
59.7
61.0
62.6
62.6
31.3
32.3
33.6
34.6
35.5
22.5
23.3
24.3
24.4
25.3
24.3
24.8
25.6
26.2
26.9
28.6
29.0
30.2
31.0
31.6
59.5
60.9
61.8
62.7
63.2
19.3
18.3
18.2
18.2
18.4
21.2
20.8
19.9
19.2
18.4
2002
2003
2004
242.0
257.2
269.7
38.9
39.9
41.0
70.2
75.7
79.8
55.8
58.2
61.4
46.4
49.2
50.7
25.1
27.8
29.7
5.6
6.4
7.1
26.8
26.9
27.0
40.6
41.4
42.2
89.5
90.2
91.0
63.3
64.9
65.9
36.4
37.1
38.4
25.7
26.3
26.6
27.7
28.5
29.0
32.2
33.3
34.0
63.7
63.5
63.6
18.5
19.0
19.6
17.8
17.4
16.8
1997 March
June
Sept
Dec
58.6
58.9
61.4
59.3
10.2
10.1
10.5
10.4
17.4
17.1
17.9
17.2
15.7
15.5
16.5
15.7
10.2
10.6
10.9
10.4
4.2
4.7
4.7
4.6
0.9
0.9
0.9
0.9
26.1
26.3
26.2
26.2
37.0
36.1
37.3
37.8
88.7
89.1
88.8
88.3
58.4
58.0
58.9
59.2
31.1
30.1
31.8
32.2
22.4
22.0
22.7
23.0
23.9
24.3
24.4
24.8
28.7
28.4
27.8
29.3
58.4
59.6
59.9
60.0
19.5
19.4
18.9
19.2
22.0
21.0
21.2
20.7
1998 March
June
Sept
Dec
58.5
58.4
63.2
60.5
10.4
10.3
11.3
11.0
16.5
16.2
17.9
17.2
15.3
15.4
16.3
15.4
10.7
10.8
11.5
10.9
4.6
4.7
5.2
5.0
1.0
0.9
1.0
1.0
26.3
26.3
26.3
26.3
37.5
36.8
38.1
38.9
89.0
89.6
89.2
88.5
59.5
59.1
60.0
60.4
31.9
31.8
32.3
33.3
23.1
22.5
23.6
24.0
24.4
24.0
25.2
25.7
29.6
28.3
28.5
29.7
60.5
61.0
60.9
61.2
18.4
18.2
18.4
18.4
21.1
20.8
20.7
20.4
1999 March
June
Sept
Dec
59.0
59.8
62.9
60.2
10.8
10.5
11.1
10.6
16.4
16.5
17.7
17.0
15.0
15.3
16.0
14.9
10.9
11.2
11.7
11.1
5.0
5.2
5.4
5.3
1.0
1.1
1.1
1.1
26.3
26.5
26.4
26.4
38.8
38.0
39.3
39.5
89.7
89.2
88.7
88.4
60.5
60.6
61.7
61.2
33.4
33.0
34.1
34.0
24.1
23.4
24.7
24.8
25.4
25.3
25.6
26.2
29.5
31.3
29.3
30.8
61.4
61.6
62.2
62.0
18.2
18.2
18.1
18.4
20.4
20.1
19.6
19.5
2000 March
June
Sept
Dec
59.0
57.9
61.7
60.1
10.2
10.0
10.6
10.3
16.5
16.1
17.6
17.3
14.8
14.4
15.3
14.7
10.9
10.9
11.3
10.9
5.4
5.5
5.7
5.7
1.2
1.1
1.2
1.2
26.5
26.6
26.5
26.5
39.7
38.5
39.8
40.0
89.7
89.7
89.7
89.5
62.6
61.9
63.3
62.8
34.8
33.5
35.0
35.2
24.7
23.8
24.5
24.7
26.1
25.7
26.5
26.6
31.7
30.6
30.4
31.4
62.5
62.9
62.7
62.6
18.1
17.8
18.1
18.6
19.5
19.2
19.2
18.8
2001 March
June
Sept
Dec
58.0
58.1
61.8
60.2
9.9
9.6
10.2
9.9
16.7
16.3
17.6
17.5
13.9
14.1
14.7
14.1
10.8
11.2
12.0
11.3
5.7
5.7
6.0
5.9
1.1
1.3
1.3
1.4
26.5
26.7
26.7
26.7
39.8
39.1
40.4
40.9
90.4
89.0
89.5
89.2
63.0
61.5
62.6
63.1
34.9
34.9
35.9
36.4
24.8
24.5
25.8
25.9
26.9
26.4
27.2
27.2
28.0
32.2
32.2
33.9
62.5
63.3
63.5
63.4
18.7
18.6
18.4
18.6
18.8
18.6
18.2
18.0
2002 March
June
Sept
Dec
58.0
58.3
63.4
62.3
9.4
9.3
10.2
10.0
16.7
16.6
18.4
18.4
13.6
13.5
14.6
14.1
10.9
11.4
12.3
11.9
6.0
6.1
6.5
6.5
1.3
1.4
1.5
1.5
26.8
26.8
26.8
26.8
40.5
39.6
40.9
41.4
89.4
89.4
89.3
89.7
63.0
62.2
63.8
64.1
36.4
35.6
36.6
36.9
25.4
25.0
26.1
26.4
27.7
27.2
27.9
28.0
31.5
31.7
32.7
32.8
63.2
64.2
63.9
63.3
18.5
18.2
18.5
18.9
18.3
17.7
17.5
17.8
2003 March
June
Sept
Dec
61.0
62.8
67.6
65.8
9.8
9.6
10.3
10.2
18.0
18.3
20.0
19.5
13.9
14.2
15.3
14.9
11.6
12.2
13.0
12.5
6.3
6.9
7.3
7.3
1.5
1.6
1.7
1.6
26.8
27.0
26.9
26.9
41.4
40.5
41.5
42.2
90.1
90.0
90.2
90.4
64.5
64.0
65.6
65.6
37.0
36.2
38.3
38.0
26.9
25.7
26.4
27.7
29.1
28.3
28.6
29.5
33.3
33.7
33.3
32.9
63.0
64.0
63.7
63.3
18.9
18.5
19.3
19.4
18.1
17.4
18.0
17.4
2004 March
June
Sept
Dec
65.2
65.2
70.2
69.1
10.1
9.8
10.7
10.6
19.3
19.1
20.7
20.7
14.8
14.9
16.1
15.7
12.5
12.5
13.0
12.7
7.0
7.3
7.9
7.5
1.7
1.7
1.8
1.9
26.9
27.0
27.0
26.9
42.0
41.4
42.4
42.7
91.2
91.0
91.2
90.6
65.8
65.1
66.1
66.6
38.2
37.7
38.6
39.0
26.8
26.2
26.5
27.0
28.2
28.8
30.0
29.0
34.3
34.5
33.5
33.9
63.1
63.9
63.7
63.6
19.4
19.5
19.7
19.8
17.4
16.6
16.6
16.6
2005 MarchP
JuneP
SeptP
66.3
66.6
73.5
10.0
9.8
10.9
19.6
19.7
22.1
15.2
15.4
17.2
12.2
12.6
13.4
7.3
7.4
7.8
1.9
1.8
2.0
27.0
27.0
27.0
43.0
41.7
43.3
92.0
91.2
92.1
67.0
66.5
68.1
39.0
38.1
39.7
27.1
26.4
27.2
29.6
28.1
29.1
35.2
33.3
35.6
63.1
63.7
63.8
20.3
19.8
20.3
16.6
16.5
15.9
{
1971
1976
1981
1
2
3
P
The mean ages in this table are unstandardised and therefore take no account of the structure of the population by age or marital status.
Births outside marriage can be registered by both the mother and father (joint) or by the mother alone (sole).
Usual address(es) of parents.
Provisional
National Statistics
38
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 4.1
Summer 2006
Conceptions: age of women at conception
England and Wales (residents)
Numbers (thousands) and rates; and percentage terminated by abortion
Age of woman at conception
Year and quarter
All ages
Under 16
Under 18
Under 20
20–24
25–29
30–34
35–39
40 and over
(a) numbers (thousands)
1991
1996
853.7
816.9
7.5
8.9
40.1
43.5
101.6
94.9
233.3
179.8
281.5
252.6
167.5
200.0
57.6
75.5
12.1
14.1
1999
2000
2001
2002
2003
2004P
774.0
767.0
763.7
787.0
806.8
825.8
7.9
8.1
7.9
7.9
8.0
7.6
42.0
41.3
41.0
42.0
42.2
42.2
98.8
97.7
96.0
97.1
98.6
101.2
157.6
159.0
161.6
167.8
175.3
181.1
218.5
209.3
199.3
199.4
199.8
204.9
197.1
195.3
196.7
204.3
209.0
209.9
86.0
88.7
92.2
98.9
103.1
106.6
16.0
17.0
17.8
19.6
20.9
22.7
2001 March
June
Sept
Dec
189.2
187.4
189.3
197.9
1.9
2.1
1.9
2.0
10.2
10.2
10.0
10.6
24.3
24.0
23.1
24.6
40.4
39.8
39.2
42.3
50.0
48.8
49.5
51.1
47.8
47.7
49.9
51.3
22.3
22.8
23.2
23.9
4.4
4.4
4.4
4.7
2002 March
June
Sept
Dec
191.6
190.4
197.4
207.6
1.9
2.0
2.0
2.0
10.3
10.5
10.2
11.0
24.1
24.2
23.4
25.4
41.3
40.7
41.4
44.4
48.8
48.2
50.2
52.3
49.0
48.8
52.4
54.2
23.7
23.8
25.2
26.2
4.6
4.8
4.9
5.2
2003 March
June
Sept
Dec
198.2
198.5
200.1
210.0
1.9
2.1
2.0
2.0
10.5
10.8
10.2
10.7
24.5
24.7
23.7
25.7
42.9
43.2
43.1
46.1
49.4
49.1
49.3
52.0
51.2
51.1
52.8
54.0
25.2
25.2
26.1
26.7
4.9
5.2
5.2
5.6
2004 Marchp
JuneP
SeptP
DecP
207.9
200.0
203.6
214.3
2.0
1.9
1.8
1.9
10.9
10.6
10.0
10.8
26.2
25.0
24.0
26.0
45.9
43.7
44.1
47.5
51.1
49.3
50.7
53.8
52.6
50.4
52.7
53.7
26.6
25.9
26.6
27.5
5.6
5.7
5.6
5.8
204.2
1.9
10.4
25.0
45.3
50.7
51.0
26.5
5.7
2005 MarchP
(b) rates (conceptions per thousand women in age group)1
1991
1996
77.7
76.2
8.9
9.5
44.6
46.3
64.1
63.2
120.2
110.1
135.1
127.6
90.1
96.3
34.4
40.7
6.6
8.4
1999
2000
2001
2002
2003
2004P
71.9
70.9
70.3
72.2
73.7
75.2
8.3
8.3
8.0
7.9
8.0
7.5
45.1
43.9
42.7
42.8
42.3
41.7
63.1
62.5
60.8
60.3
59.8
60.3
103.9
103.2
102.5
104.6
107.1
108.7
118.0
115.7
114.2
119.1
122.8
126.0
95.3
95.3
96.7
101.6
105.9
109.2
42.9
43.2
44.3
47.0
49.1
50.9
9.1
9.4
9.6
10.3
10.7
11.3
2001 March
June
Sept
Dec
70.7
69.2
69.1
72.1
7.8
8.4
7.7
8.1
43.3
42.8
41.1
43.5
62.7
61.0
57.8
61.4
104.8
101.4
98.4
105.6
114.5
111.6
113.1
118.0
95.0
94.0
97.6
100.5
43.7
44.0
44.2
45.4
9.7
9.5
9.3
10.0
2002 March
June
Sept
Dec
71.3
70.1
71.8
75.4
7.7
8.1
7.7
8.0
42.9
42.9
41.2
44.1
61.3
60.4
57.5
62.1
105.1
101.9
102.1
108.9
116.4
114.8
119.4
125.1
98.4
97.1
103.5
107.6
45.8
45.5
47.6
49.4
9.9
10.2
10.2
10.7
2003 March
June
Sept
Dec
73.5
72.8
72.5
76.0
7.8
8.3
7.9
7.8
42.8
43.3
40.5
42.5
60.8
60.3
56.8
61.4
107.2
106.1
104.2
110.9
121.8
120.6
120.2
126.8
104.5
103.5
106.4
109.7
48.6
48.0
49.3
50.5
10.3
10.8
10.5
11.2
2004 Marchp
JuneP
SeptP
DecP
76.2
73.3
73.7
77.5
7.8
7.7
7.1
7.4
43.4
42.1
39.2
42.3
63.1
60.1
56.8
61.4
111.5
105.8
105.0
112.6
126.3
122.1
123.6
130.5
109.1
105.3
109.9
113.1
51.1
49.7
50.6
52.5
11.4
11.5
11.1
11.3
75.2
7.6
41.4
60.1
108.9
124.7
110.5
51.7
11.4
2005 MarchP
(c) percentage terminated by abortion
1991
1996
19.4
20.8
51.1
49.2
39.9
40.0
34.5
36.2
22.2
25.7
13.4
15.6
13.7
14.1
22.0
21.2
41.6
37.6
1999
2000
2001
2002
2003
2004P
22.6
22.7
23.2
22.5
22.5
22.4
52.6
54.0
55.8
55.6
57.4
57.1
43.0
44.2
45.7
45.3
45.7
45.6
38.6
39.3
40.4
39.9
40.2
40.1
28.5
29.2
29.7
28.8
29.0
28.9
17.5
17.7
18.4
17.9
17.9
18.2
14.7
14.5
14.6
13.9
13.6
13.2
21.2
20.5
20.4
19.5
18.9
18.4
37.0
35.4
34.6
34.6
34.7
33.0
2001 March
June
Sept
Dec
23.4
23.8
22.5
22.9
54.4
58.8
55.0
54.9
44.9
47.0
45.7
45.2
40.2
41.1
40.1
40.0
29.8
30.3
29.2
29.5
18.6
18.6
18.1
18.1
14.8
15.3
13.8
14.4
20.7
21.0
19.9
20.2
34.9
36.0
33.5
34.1
2002 March
June
Sept
Dec
22.9
22.9
21.6
22.6
54.3
55.5
56.1
56.4
44.9
45.0
45.0
46.3
40.2
39.4
39.4
40.7
29.4
28.9
27.8
29.0
18.1
18.4
17.3
17.8
14.1
14.5
13.2
13.9
19.8
20.1
18.7
19.4
35.1
34.8
34.2
34.5
2003 March
June
Sept
Dec
22.8
23.1
21.6
22.5
58.9
58.3
56.9
55.7
46.1
46.2
45.3
45.0
40.2
40.9
39.5
40.3
29.5
29.3
28.0
29.0
17.9
18.4
17.1
18.1
13.8
14.2
13.0
13.5
19.7
19.2
18.0
18.5
34.5
36.1
33.8
34.5
2004 Marchp
JuneP
SeptP
DecP
22.7
23.0
21.9
22.1
58.2
57.2
56.8
56.1
45.7
46.4
45.8
44.5
40.2
40.8
40.1
39.3
29.4
29.2
28.4
28.7
18.5
18.6
17.9
17.8
13.4
13.7
12.8
13.1
18.2
19.2
17.8
18.3
32.9
33.5
33.0
32.6
2005 MarchP
22.4
57.3
47.2
41.0
29.1
18.0
13.1
17.9
32.5
Notes:
Conceptions are estimates derived from birth registrations and abortion notifications.
Rates for women of all ages, under 16, under 18, under 20 and 40 and over are based on the population of women aged 15–44, 13–15, 15–17, 15–19 and 40–44 respectively.
For a quarterly analysis of conceptions under 18 for local authority areas see the National Statisitcs website, www.statistics.gov.uk
1 Rates for provisional annual 2004 conceptions are based on mid-year population estimates published on 20 December 2005.
Rates for provisional 2005 conceptions are based on the 2004-based population projections for 2005.
P Provisional
39
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 4.2
Summer 2006
England and Wales
Abortions: residents and non-residents; age and gestation (residents only)
England and Wales
Numbers (thousands) and rates; and percentages for gestation weeks
All women (residents)
All ages
Year and quarter
All1
women
Residents1
Age group
Gestation weeks (percentages)
Non-1
residents
Under
16
16–19
20–24
25–29
30–34
35–44
45 and
over
Numbers (thousands)
Under
9
9–12
13–19
20 and
over
Percentages
1976
1981
1986
1991
1996
129.7
162.5
172.3
179.5
177.5
101.9
128.6
147.6
167.4
167.9
27.8
33.9
24.7
12.1
9.6
3.4
3.5
3.9
3.2
3.6
24.0
31.4
33.8
31.1
28.8
23.6
34.3
45.3
52.7
46.4
19.3
21.9
28.7
38.6
39.3
14.6
18.7
18.0
23.4
28.2
14.7
17.6
17.5
17.9
21.1
0.5
0.6
0.4
0.4
0.4
24.8
31.0
33.4
35.2
40.0
55.8
53.4
53.8
52.9
48.7
15.0
13.5
11.5
10.6
10.1
1.1
1.3
1.4
1.2
1.3
1997
1998
1999
2000
2001
2002
2003
2004
179.7
187.4
183.2
185.4
186.3
185.4
190.7
194.2
170.1
177.9
173.7
175.5
176.4
175.9
181.6
185.4
9.6
9.5
9.5
9.8
9.9
9.5
9.1
8.8
3.4
3.8
3.6
3.7
3.7
3.7
4.0
3.8
29.9
33.2
32.8
33.2
33.4
33.0
34.2
35.4
45.0
45.8
45.0
47.1
48.3
48.4
51.1
52.7
40.2
40.4
38.5
37.9
36.5
35.8
36.0
37.8
28.9
30.4
29.1
28.7
28.8
28.5
28.7
28.1
22.3
23.8
24.1
24.4
25.2
26.0
26.9
27.2
0.5
0.5
0.5
0.5
0.5
0.5
0.5
0.5
41.2
41.4
42.5
43.3
42.8
42.2
43.6
46.2
47.9
47.6
46.5
45.0
45.0
45.2
43.7
41.5
9.6
9.7
9.5
10.3
10.6
11.0
11.1
10.8
1.2
1.3
1.4
1.5
1.6
1.6
1.6
1.6
2000 March
June
Sept
Dec
49.5
45.8
46.1
43.9
46.9
43.4
43.6
41.7
2.6
2.5
2.5
2.2
1.0
0.9
1.0
0.9
9.1
8.2
8.1
7.8
12.5
11.8
11.5
11.2
10.2
9.2
9.5
8.9
7.5
7.1
7.3
6.8
6.4
6.0
6.1
5.9
0.1
0.1
0.1
0.1
38.9
42.2
44.5
47.8
47.9
46.0
44.0
41.7
11.6
10.3
10.1
9.0
1.6
1.4
1.4
1.4
2001 March
June
Sept
Dec
47.8
46.6
46.2
45.6
45.3
44.1
43.8
43.3
2.5
2.5
2.4
2.4
0.9
0.9
1.0
0.9
8.7
8.3
8.2
8.2
12.4
12.1
11.8
11.9
9.4
9.1
9.1
8.9
7.3
7.2
7.3
7.0
6.4
6.3
6.3
6.2
0.1
0.1
0.1
0.1
40.5
42.0
43.1
45.7
46.3
45.8
44.7
43.1
11.6
10.6
10.6
9.7
1.5
1.6
1.5
1.6
2002 March
June
Sept
Dec
47.6
45.9
46.5
45.3
45.2
43.5
44.1
43.2
2.5
2.5
2.4
2.1
0.9
0.9
1.0
0.9
8.6
8.2
8.2
8.0
12.6
12.0
11.9
11.9
9.2
8.9
8.9
8.8
7.3
7.0
7.3
6.9
6.5
6.4
6.6
6.5
0.1
0.1
0.1
0.1
38.9
40.0
42.9
47.0
47.4
46.4
45.1
41.8
12.0
11.8
10.4
9.7
1.6
1.8
1.6
1.5
2003 March
June
Sept
Dec
50.0
47.7
47.7
46.0
47.6
45.4
44.8
43.9
2.4
2.3
2.3
2.1
1.0
1.0
1.0
0.9
9.1
8.5
8.3
8.3
13.4
12.7
12.5
12.5
9.4
9.1
8.9
8.6
7.5
7.2
7.2
6.9
7.0
6.7
6.7
6.5
0.1
0.1
0.1
0.1
40.9
42.5
43.3
47.7
45.3
44.4
43.9
41.0
12.2
11.4
11.2
9.6
1.6
1.6
1.5
1.7
2004 March
June
Sept
Dec
51.1
48.7
48.3
46.1
48.6
46.4
46.2
44.2
2.4
2.3
2.1
1.9
1.0
0.9
0.9
0.9
9.3
8.8
8.9
8.4
13.9
13.2
13.0
12.6
9.8
9.5
9.4
9.1
7.5
6.9
7.0
6.6
7.0
6.8
7.0
6.5
0.1
0.1
0.1
0.1
41.7
43.7
47.8
52.0
44.5
43.3
40.5
37.2
12.0
11.2
10.3
9.5
1.7
1.8
1.4
1.3
2005 Marchp
JuneP
SeptP
50.0
50.1
46.9
47.9
48.0
45.0
2.1
2.1
1.9
0.9
0.9
1.0
9.1
9.1
8.5
13.9
13.8
12.6
9.7
9.8
9.3
7.2
7.1
6.9
7.0
6.9
6.6
0.1
0.1
0.1
47.2
53.9
56.6
40.4
35.5
33.6
11.0
9.2
8.4
1.4
1.4
1.3
Rates (per thousand women residents)
ASR3
Crude rate2
(women 15–44) (women 15–44)
1976
10.2
10.5
1981
11.9
12.4
1986
13.0
13.5
1991
15.0
15.2
1996
16.0
15.7
:
:
:
:
:
2.9
3.0
3.7
3.8
3.9
16.9
19.4
22.0
24.0
24.2
14.2
18.6
21.9
27.1
28.4
10.4
13.1
15.5
18.5
19.9
9.2
10.1
10.8
12.6
13.6
5.3
5.9
5.1
5.1
6.0
0.3
0.4
0.3
0.3
0.2
1997
1998
1999
2000
2001
16.3
17.1
16.8
17.0
17.0
15.9
16.6
16.2
16.3
16.2
:
:
:
:
:
3.7
4.0
3.8
3.9
3.7
24.4
26.8
26.3
26.9
26.6
28.8
30.2
29.7
30.7
30.6
20.7
21.2
20.8
20.9
20.9
13.8
14.6
14.1
14.1
14.2
6.2
6.5
6.4
6.3
6.4
0.3
0.3
0.3
0.3
0.3
2002
2003
20044
17.0
17.5
17.8
16.1
16.6
16.9
:
:
:
3.7
3.9
3.7
25.8
26.1
26.5
30.1
31.2
31.9
21.4
22.1
23.3
14.2
14.6
14.6
6.5
6.6
6.6
0.3
0.3
0.3
2000 March
June
Sept
Dec
18.2
16.8
16.9
16.1
17.4
16.1
16.1
15.4
:
:
:
:
4.2
3.7
4.0
3.6
29.3
26.4
26.3
25.2
32.8
30.7
29.9
29.0
22.4
20.4
21.1
20.0
14.7
13.9
14.2
13.4
6.7
6.3
6.3
6.0
0.3
0.3
0.3
0.2
2001 March
June
Sept
Dec
17.5
17.0
16.9
16.7
16.7
16.2
16.1
15.9
:
:
:
:
3.6
3.8
3.9
3.6
27.9
26.6
25.9
26.0
31.8
30.8
29.9
30.0
21.2
20.9
20.9
20.8
14.3
14.1
14.4
13.8
6.6
6.4
6.4
6.3
0.3
0.3
0.3
0.2
2002 March
June
Sept
Dec
17.4
16.7
16.9
16.5
16.6
15.9
16.1
15.7
:
:
:
:
3.7
3.7
3.8
3.7
26.9
25.6
25.1
24.7
31.6
29.9
29.2
29.2
21.7
21.1
21.9
21.4
14.4
13.9
14.8
13.9
6.6
6.4
6.5
6.4
0.2
0.3
0.2
0.3
2003 March
June
Sept
Dec
18.3
17.4
17.2
16.8
17.4
16.6
16.4
16.0
:
:
:
:
4.0
4.0
4.0
3.7
28.0
26.1
25.3
25.2
33.0
31.1
30.6
30.4
22.9
22.3
21.8
21.1
15.1
14.5
14.6
14.2
6.9
6.6
6.6
6.4
0.3
0.3
0.3
0.3
2004 March
June
Sept
Dec
18.7
17.8
17.8
17.0
17.8
17.0
16.9
16.2
:
:
:
:
3.9
3.7
3.7
3.5
28.2
26.6
26.6
25.0
33.7
32.2
31.4
30.4
24.1
23.3
22.9
22.3
15.4
14.3
14.8
14.2
6.9
6.7
6.8
6.3
0.3
0.3
0.3
0.3
20054 Marchp
18.3
17.5
:
3.7
27.0
33.4
23.8
15.2
JuneP
18.4
17.5
:
3.8
27.1
33.2
24.0
15.3
P
Sept
17.2
16.4
:
3.8
25.1
30.3
22.5
14.9
Notes: Rates for Under 16 and 45 and over are based on female populations aged 13–15 and 45–49 respectively.
1 Includes cases with not stated age and/or gestation week.
2 Includes incomplete forms that have been returned to practitioners.
3 Rates for all women residents age-standardised to the European population for ages 15–44.
4 Based on the 2004-based population projections for 2005.
p Provisional
6.8
6.7
6.4
0.3
0.3
0.3
National Statistics
40
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 5.1
Summer 2006
Expectation of life at birth and selected age
Constituent countries of the United Kingdom
Years
Males
Year
At
birth
Females
At age
Year
5
20
30
50
60
70
80
At
birth
At age
5
20
30
50
60
70
80
United Kingdom
1981
1986
1991
1996
70.8
71.9
73.2
74.3
66.9
67.8
68.9
69.8
52.3
53.2
54.2
55.1
42.7
43.6
44.7
45.6
24.1
24.9
26.0
26.9
16.3
16.8
17.7
18.5
10.1
10.5
11.1
11.6
5.8
6.0
6.4
6.6
1981
1986
1991
1996
76.8
77.7
78.7
79.4
72.7
73.4
74.3
74.9
57.9
58.6
59.5
60.1
48.2
48.8
49.7
50.3
29.2
29.8
30.6
31.2
20.8
21.2
21.9
22.3
13.3
13.8
14.3
14.5
7.5
7.8
8.2
8.3
1997
1998
1999
2000
2001
2002
2003
74.5
74.8
75.0
75.4
75.7
75.9
76.3
70.1
70.3
70.6
70.9
71.2
71.5
71.8
55.4
55.6
55.9
56.2
56.5
56.7
57.0
45.9
46.1
46.3
46.6
46.9
47.2
47.4
27.2
27.4
27.6
28.0
28.3
28.5
28.8
18.8
18.9
19.2
19.5
19.8
20.0
20.2
11.7
11.9
12.0
12.3
12.5
12.6
12.9
6.7
6.7
6.8
7.0
7.1
7.2
7.3
1997
1998
1999
2000
2001
2002
2003
79.6
79.7
79.9
80.2
80.4
80.5
80.7
75.1
75.2
75.4
75.6
75.9
76.0
76.2
60.2
60.4
60.5
60.8
61.0
61.1
61.3
50.4
50.5
50.7
51.0
51.2
51.3
51.5
31.3
31.4
31.6
31.9
32.1
32.2
32.4
22.5
22.6
22.8
23.0
23.2
23.3
23.4
14.6
14.7
14.8
15.0
15.2
15.2
15.3
8.4
8.4
8.5
8.6
8.7
8.7
8.7
England and Wales
1981
1986
1991
1996
71.0
72.1
73.4
74.5
67.1
68.0
69.1
70.1
52.5
53.4
54.4
55.4
42.9
43.8
44.8
45.8
24.3
25.0
26.1
27.1
16.4
16.9
17.8
18.7
10.1
10.5
11.2
11.6
5.8
6.1
6.4
6.6
1981
1986
1991
1996
77.0
77.9
78.9
79.6
72.9
73.6
74.5
75.1
58.1
58.8
59.7
60.2
48.3
49.0
49.9
50.4
29.4
30.0
30.8
31.3
20.9
21.4
22.0
22.5
13.4
13.9
14.4
14.6
7.5
7.9
8.3
8.4
1997
1998
1999
2000
2001
2002
2003
74.8
75.0
75.3
75.6
76.0
76.2
76.5
70.3
70.6
70.8
71.2
71.5
71.7
72.0
55.6
55.8
56.1
56.4
56.7
57.0
57.3
46.1
46.3
46.5
46.9
47.2
47.4
47.7
27.4
27.6
27.8
28.1
28.5
28.7
28.9
18.9
19.1
19.3
19.6
19.9
20.1
20.4
11.8
11.9
12.1
12.3
12.6
12.7
13.0
6.7
6.8
6.9
7.0
7.1
7.2
7.3
1997
1998
1999
2000
2001
2002
2003
79.7
79.9
80.1
80.3
80.6
80.7
80.9
75.2
75.4
75.6
75.8
76.0
76.1
76.4
60.4
60.5
60.7
61.0
61.2
61.3
61.5
50.6
50.7
50.9
51.1
51.4
51.5
51.7
31.5
31.6
31.8
32.0
32.2
32.3
32.5
22.6
22.7
22.9
23.1
23.3
23.4
23.6
14.7
14.8
14.9
15.1
15.2
15.3
15.4
8.4
8.4
8.5
8.6
8.7
8.7
8.8
England
1981
1986
1991
1996
71.1
72.2
73.4
74.5
67.1
68.1
69.1
70.1
52.5
53.4
54.4
55.4
42.9
43.8
44.9
45.9
24.3
25.1
26.2
27.1
16.4
17.0
17.8
18.7
10.1
10.6
11.2
11.7
5.8
6.1
6.4
6.6
1981
1986
1991
1996
77.0
77.9
78.9
79.6
72.9
73.6
74.5
75.1
58.2
58.8
59.7
60.3
48.4
49.0
49.9
50.5
29.4
30.0
30.8
31.3
20.9
21.4
22.0
22.5
13.4
13.9
14.4
14.6
7.5
7.9
8.3
8.4
1997
1998
1999
2000
2001
2002
2003
74.8
75.0
75.3
75.7
76.0
76.2
76.6
70.4
70.6
70.9
71.2
71.5
71.8
72.1
55.6
55.9
56.1
56.5
56.8
57.0
57.3
46.1
46.3
46.6
46.9
47.2
47.4
47.7
27.4
27.6
27.9
28.2
28.5
28.7
29.0
18.9
19.1
19.4
19.6
19.9
20.1
20.4
11.8
12.0
12.1
12.4
12.6
12.8
13.0
6.7
6.8
6.9
7.0
7.1
7.2
7.3
1997
1998
1999
2000
2001
2002
2003
79.8
79.9
80.1
80.4
80.6
80.7
80.9
75.3
75.4
75.6
75.8
76.1
76.2
76.4
60.4
60.6
60.8
61.0
61.2
61.3
61.5
50.6
50.7
50.9
51.2
51.4
51.5
51.7
31.5
31.6
31.8
32.0
32.3
32.4
32.6
22.6
22.7
22.9
23.1
23.4
23.4
23.6
14.7
14.8
14.9
15.1
15.3
15.3
15.5
8.4
8.5
8.5
8.6
8.7
8.7
8.8
Wales
1981
1986
1991
1996
70.4
71.6
73.1
73.9
66.5
67.5
68.8
69.4
51.9
52.8
54.1
54.7
42.2
43.2
44.6
45.3
23.6
24.6
25.8
26.6
15.8
16.6
17.6
18.2
9.7
10.3
11.0
11.3
5.6
6.0
6.4
6.4
1981
1986
1991
1996
76.4
77.5
78.8
79.1
72.3
73.3
74.3
74.6
57.5
58.5
59.5
59.7
47.7
48.7
49.7
49.9
28.9
29.7
30.6
30.9
20.5
21.1
21.8
22.1
13.1
13.7
14.3
14.4
7.4
7.8
8.3
8.3
1997
1998
1999
2000
2001
2002
2003
74.3
74.4
74.7
74.9
75.4
75.7
76.0
69.8
70.0
70.2
70.5
70.9
71.1
71.4
55.1
55.2
55.5
55.8
56.2
56.3
56.7
45.6
45.8
46.1
46.3
46.7
46.9
47.1
26.9
27.1
27.4
27.6
28.0
28.2
28.5
18.5
18.6
18.9
19.1
19.5
19.7
20.0
11.6
11.6
11.9
12.0
12.3
12.4
12.6
6.6
6.6
6.8
6.8
7.1
7.1
7.2
1997
1998
1999
2000
2001
2002
2003
79.3
79.4
79.6
79.8
80.1
80.2
80.4
74.8
74.9
75.1
75.3
75.5
75.6
75.8
60.0
60.0
60.2
60.4
60.6
60.7
60.9
50.2
50.2
50.4
50.6
50.8
50.9
51.1
31.1
31.1
31.3
31.5
31.8
31.8
32.0
22.3
22.3
22.5
22.6
22.9
22.9
23.1
14.5
14.5
14.6
14.7
14.9
15.0
15.1
8.4
8.3
8.4
8.4
8.5
8.6
8.6
Scotland
1981
1986
1991
1996
69.1
70.2
71.4
72.2
65.2
66.0
67.1
67.8
50.6
51.4
52.5
53.1
41.1
41.9
43.0
43.7
22.9
23.5
24.6
25.3
15.4
15.8
16.6
17.3
9.6
9.9
10.4
10.9
5.5
5.7
6.1
6.3
1981
1986
1991
1996
75.3
76.2
77.1
77.9
71.2
71.9
72.7
73.3
56.4
57.1
57.9
58.5
46.7
47.3
48.1
48.8
27.9
28.4
29.2
29.8
19.7
20.1
20.7
21.2
12.7
13.0
13.5
13.8
7.2
7.5
7.9
8.0
1997
1998
1999
2000
2001
2002
2003
72.4
72.6
72.8
73.1
73.3
73.5
73.8
68.0
68.2
68.4
68.6
68.8
69.0
69.3
53.3
53.5
53.7
53.9
54.2
54.3
54.6
43.9
44.2
44.4
44.6
44.8
45.0
45.2
25.6
25.8
26.0
26.3
26.6
26.7
27.0
17.5
17.8
18.0
18.2
18.4
18.6
18.8
11.0
11.1
11.3
11.5
11.7
11.8
12.0
6.4
6.5
6.6
6.6
6.8
6.8
6.9
1997
1998
1999
2000
2001
2002
2003
78.0
78.2
78.4
78.6
78.8
78.9
79.1
73.5
73.6
73.8
74.0
74.2
74.3
74.5
58.7
58.8
59.0
59.2
59.4
59.5
59.7
48.9
49.0
49.2
49.4
49.6
49.7
49.9
30.0
30.1
30.3
30.5
30.7
30.8
30.9
21.4
21.4
21.6
21.8
22.0
22.1
22.2
13.9
13.9
14.0
14.1
14.3
14.4
14.5
8.0
8.0
8.1
8.1
8.2
8.2
8.3
Northern Ireland
1981
1986
1991
1996
69.2
70.9
72.6
73.8
65.4
66.8
68.2
69.4
50.9
52.2
53.6
54.7
41.5
42.7
44.1
45.3
23.2
24.2
25.5
26.6
15.6
16.4
17.3
18.2
9.7
10.4
11.0
11.4
5.8
6.2
6.4
6.6
1981
1986
1991
1996
75.5
77.1
78.4
79.2
71.6
72.9
74.0
74.7
56.8
58.1
59.2
59.9
47.1
48.3
49.4
50.0
28.3
29.3
30.3
30.9
20.0
20.8
21.6
22.1
12.8
13.4
14.2
14.4
7.3
7.8
8.3
8.4
1997
1998
1999
2000
2001
2002
2003
74.2
74.3
74.5
74.8
75.2
75.6
75.8
69.7
69.8
70.0
70.4
70.7
71.1
71.4
55.0
55.2
55.4
55.7
56.1
56.4
56.7
45.5
45.7
45.9
46.2
46.6
46.9
47.1
26.8
27.0
27.2
27.6
27.9
28.2
28.4
18.4
18.6
18.8
19.1
19.4
19.7
19.9
11.5
11.6
11.7
11.9
12.3
12.4
12.6
6.6
6.6
6.6
6.6
6.9
7.0
7.2
1997
1998
1999
2000
2001
2002
2003
79.5
79.5
79.6
79.8
80.1
80.4
80.6
75.0
75.0
75.1
75.2
75.6
75.9
76.0
60.2
60.2
60.2
60.4
60.7
61.0
61.1
50.3
50.4
50.4
50.6
50.9
51.2
51.3
31.2
31.2
31.3
31.5
31.8
32.0
32.2
22.4
22.4
22.5
22.6
22.9
23.1
23.3
14.5
14.5
14.6
14.6
14.9
15.1
15.2
8.4
8.2
8.2
8.2
8.4
8.5
8.6
Note: Figures from 1981 are calculated from the population estimates revised in the light of the 2001 Census. All figures are based on a three-year period.
41
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Table 6.1
Summer 2006
Deaths: age and sex
England and Wales
Numbers (thousands) and rates
Age group
Year and quarter
All ages
Under 11
1–4
5–9
10–14
15–19
20–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and over
Numbers (thousands)
Males
1976
1981
1986
1991
1996
300.1
289.0
287.9
277.6
268.7
4.88
4.12
3.72
2.97
2.27
0.88
0.65
0.57
0.55
0.44
0.68
0.45
0.33
0.34
0.24
0.64
0.57
0.38
0.35
0.29
1.66
1.73
1.43
1.21
0.93
1.66
1.58
1.75
1.76
1.41
3.24
3.18
3.10
3.69
4.06
5.93
5.54
5.77
6.16
5.84
20.4
16.9
14.4
13.3
13.6
52.0
46.9
43.6
34.9
30.1
98.7
92.2
84.4
77.2
71.0
80.3
86.8
96.2
95.8
90.7
29.0
28.5
32.2
39.3
47.8
1999
2000
2001
2002
2003
2004
2005P
264.3
255.5
252.4
253.1
253.9
244.1
243.9
2.08
1.89
1.81
1.81
1.81
1.79
1.88
0.41
0.34
0.32
0.32
0.31
0.29
0.30
0.22
0.22
0.19
0.20
0.19
0.17
0.17
0.28
0.28
0.28
0.28
0.24
0.26
0.27
0.90
0.87
0.88
0.83
0.81
0.78
0.86
1.27
1.22
1.27
1.24
1.23
1.15
1.22
3.85
3.76
3.63
3.47
3.26
3.10
3.15
5.93
6.05
6.07
6.20
6.32
6.19
6.36
13.6
13.4
13.3
12.9
12.7
12.2
12.2
28.7
27.9
27.5
27.7
28.2
27.0
27.3
64.3
60.6
57.5
56.3
55.1
52.5
51.1
90.4
87.1
87.0
88.3
89.6
87.3
84.7
52.3
51.9
52.7
53.6
54.0
51.3
54.5
Females
1976
1981
1986
1991
1996
298.5
288.9
293.3
292.5
291.5
3.46
2.90
2.59
2.19
1.69
0.59
0.53
0.49
0.44
0.32
0.45
0.30
0.25
0.25
0.18
0.42
0.37
0.27
0.22
0.20
0.62
0.65
0.56
0.46
0.43
0.67
0.64
0.67
0.64
0.51
1.94
1.82
1.65
1.73
1.85
4.04
3.74
3.83
3.70
3.66
12.8
10.5
8.8
8.4
8.9
29.6
27.2
25.8
21.3
18.2
67.1
62.8
58.4
54.2
50.2
104.7
103.6
106.5
103.3
96.7
72.1
73.9
83.6
95.7
108.7
1999
2000
2001
2002
2003
2004
2005P
291.8
280.1
277.9
280.4
284.4
268.4
269.1
1.55
1.49
1.43
1.31
1.50
1.43
1.37
0.30
0.25
0.27
0.24
0.28
0.23
0.22
0.17
0.16
0.19
0.16
0.15
0.13
0.13
0.22
0.18
0.18
0.19
0.19
0.16
0.19
0.39
0.38
0.38
0.38
0.35
0.38
0.38
0.47
0.47
0.47
0.43
0.46
0.46
0.48
1.67
1.69
1.59
1.61
1.57
1.49
1.48
3.79
3.87
3.77
3.77
3.86
3.80
3.81
9.0
9.1
8.9
8.7
8.5
8.1
8.2
18.0
17.6
17.6
17.7
18.0
17.6
17.8
45.1
42.2
40.5
39.6
39.0
36.9
35.9
93.9
89.3
88.8
90.0
92.7
88.3
86.3
117.2
113.4
113.9
116.3
117.9
109.4
112.9
Rates (deaths per 1,000 population in each age group)
Males
1976
1981
1986
1991
1996
12.5
12.0
11.8
11.2
10.7
16.2
12.6
11.0
8.3
6.8
0.65
0.53
0.44
0.40
0.32
0.34
0.27
0.21
0.21
0.14
0.31
0.29
0.23
0.23
0.18
0.88
0.82
0.72
0.72
0.60
0.96
0.83
0.83
0.89
0.85
0.92
0.89
0.88
0.94
1.01
2.09
1.83
1.68
1.76
1.67
6.97
6.11
5.27
4.56
4.06
19.6
17.7
16.6
13.9
11.9
50.3
45.6
42.8
38.1
34.5
116.4
105.2
101.2
93.1
85.0
243.2
226.5
215.4
205.6
198.8
1999
2000
2001
2002
2003
20043
20052P
10.4
10.0
9.9
9.8
9.8
9.4
9.3
6.5
6.1
5.9
5.9
5.7
5.5
5.7
0.31
0.26
0.25
0.25
0.25
0.23
0.24
0.12
0.13
0.11
0.12
0.11
0.10
0.10
0.16
0.16
0.16
0.16
0.14
0.15
0.16
0.56
0.54
0.53
0.49
0.46
0.44
0.48
0.83
0.79
0.80
0.77
0.95
0.68
0.70
0.99
0.98
0.97
0.95
0.91
0.88
0.89
1.60
1.59
1.56
1.57
1.58
1.53
1.56
3.99
3.92
3.89
3.85
3.81
3.67
3.61
10.9
10.4
10.0
9.7
9.6
9.0
8.9
31.6
29.7
28.0
27.2
26.3
24.9
24.0
79.9
75.9
74.0
73.4
72.8
69.8
67.2
194.4
187.5
186.4
187.5
190.4
175.2
171.6
2003 March
June
Sept
Dec
10.5
9.4
9.0
10.3
6.4
5.5
5.2
5.8
0.27
0.24
0.19
0.29
0.12
0.09
0.11
0.13
0.16
0.12
0.14
0.13
0.48
0.45
0.52
0.39
0.77
0.74
0.79
0.69
0.94
0.92
0.93
0.84
1.62
1.60
1.57
1.52
3.94
3.78
3.63
3.91
10.0
9.2
9.1
10.0
27.8
25.4
24.6
27.7
72.8
70.2
66.1
77.0
214.3
179.1
165.9
202.8
20043 March
June
Sept
Dec
10.2
9.1
8.7
9.5
5.9
5.2
5.3
5.5
0.25
0.23
0.23
0.23
0.12
0.12
0.10
0.08
0.15
0.14
0.18
0.11
0.46
0.39
0.46
0.43
0.67
0.74
0.71
0.58
0.92
0.94
0.86
0.78
1.59
1.58
1.47
1.49
3.81
3.72
3.58
3.58
9.4
8.8
8.5
9.2
26.6
24.5
23.2
25.4
76.9
66.9
64.5
70.8
199.3
164.0
154.8
183.0
20052 MarchP
JuneP
SeptP
DecP
10.5
9.2
8.4
9.2
6.0
5.6
5.5
5.7
0.26
0.25
0.21
0.24
0.09
0.11
0.09
0.12
0.18
0.16
0.17
0.13
0.49
0.48
0.45
0.50
0.68
0.72
0.64
0.76
0.92
0.90
0.87
0.88
1.60
1.62
1.49
1.53
3.79
3.60
3.48
3.57
9.6
9.0
8.3
8.7
26.4
23.8
22.3
23.6
77.1
67.0
59.7
65.5
202.3
165.4
146.5
172.8
Females
1976
1981
1986
1991
1996
11.8
11.3
11.4
11.2
11.0
12.2
9.4
8.0
6.4
5.3
0.46
0.46
0.40
0.33
0.25
0.24
0.19
0.17
0.16
0.10
0.21
0.19
0.17
0.15
0.12
0.35
0.32
0.29
0.29
0.29
0.40
0.35
0.33
0.33
0.31
0.56
0.52
0.47
0.44
0.46
1.46
1.26
1.12
1.05
1.04
4.30
3.80
3.24
2.87
2.63
10.1
9.5
9.2
8.2
7.1
26.0
24.1
23.4
21.8
20.6
74.6
66.2
62.5
58.7
55.8
196.6
178.2
169.4
161.6
158.9
1999
2000
2001
2002
2003
2004 3
20052P
11.0
10.5
10.4
10.4
10.6
9.9
9.9
5.1
5.1
4.9
4.5
4.9
4.6
4.3
0.24
0.20
0.22
0.20
0.24
0.20
0.19
0.10
0.10
0.12
0.10
0.10
0.09
0.09
0.13
0.11
0.11
0.11
0.12
0.10
0.11
0.25
0.25
0.24
0.24
0.21
0.22
0.22
0.31
0.30
0.30
0.27
0.28
0.27
0.28
0.43
0.44
0.42
0.44
0.44
0.42
0.42
1.01
1.00
0.96
0.94
0.95
0.93
0.92
2.61
2.62
2.57
2.54
2.51
2.39
2.38
6.7
6.4
6.3
6.0
5.9
5.7
5.6
19.2
18.1
17.4
17.0
16.7
15.8
15.3
53.4
50.8
50.1
50.4
51.3
48.6
48.0
162.6
155.2
155.0
159.4
165.8
154.3
152.4
2003 March
June
Sept
Dec
11.4
10.0
9.6
11.2
5.3
4.8
4.5
5.2
0.26
0.24
0.20
0.26
0.09
0.09
0.12
0.09
0.09
0.17
0.10
0.10
0.19
0.22
0.21
0.24
0.33
0.25
0.30
0.25
0.48
0.43
0.43
0.40
1.00
0.90
0.97
0.94
2.59
2.58
2.38
2.49
6.1
5.8
5.6
6.2
17.6
16.1
15.3
17.8
54.8
49.3
46.8
54.3
184.6
153.6
147.6
177.5
20043 March
June
Sept
Dec
11.1
9.4
9.1
10.1
5.3
4.1
4.3
4.6
0.22
0.17
0.20
0.19
0.09
0.08
0.06
0.11
0.10
0.11
0.09
0.09
0.27
0.26
0.20
0.17
0.32
0.27
0.24
0.27
0.42
0.43
0.42
0.40
0.95
0.94
0.88
0.93
2.50
2.41
2.27
2.36
6.0
5.4
5.4
5.9
17.1
15.0
14.9
16.1
53.9
46.5
44.6
49.5
177.0
144.3
137.5
158.4
20052 MarchP
JuneP
SeptP
DecP
11.6
9.7
8.7
9.6
4.6
4.7
3.9
4.2
0.24
0.17
0.15
0.19
0.09
0.11
0.07
0.08
0.13
0.10
0.12
0.12
0.18
0.25
0.22
0.24
0.30
0.29
0.27
0.27
0.47
0.39
0.37
0.45
0.96
0.97
0.90
0.86
2.53
2.35
2.37
2.29
6.0
5.5
5.4
5.5
17.1
15.3
13.9
15.0
56.8
47.4
42.2
45.8
184.7
146.6
130.4
148.5
Note: Figures represent the numbers of deaths registered in each year up to 1992 and the numbers of deaths occurring in each year from 1993 to 2004. Provisional figures for 2005 relate to registrations.
1 Rates per 1,000 live births.
2 Based on the 2004-based population projections for 2005.
3 Rates for 2004 have been calculated using the revised mid-2004 population estimates published on 20 December 2005.
P Provisional
National Statistics
42
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 6.2
Summer 2006
Deaths: subnational
Government Office Regions of England1
Year and
quarter
North East
Rates
North
West
Yorkshire and
the Humber
East Midlands
West
Midlands
East
London
South
East
South
West
Total deaths (deaths per 1,000 population of all ages)
1996
1997
1998
1999
2000
11.7
11.6
11.9
11.6
10.8
11.7
11.6
11.7
11.5
10.7
11.2
11.1
11.2
10.9
10.3
10.7
10.5
10.8
10.7
10.0
10.7
10.6
10.6
10.7
10.3
10.3
10.2
10.2
10.3
9.9
9.4
9.0
8.8
8.7
8.2
10.7
10.6
10.4
10.5
9.8
11.7
11.7
11.4
11.6
11.3
2001
2002
2003
20042
20052P
11.1
11.2
11.3
10.9
10.8
11.0
11.0
11.0
10.5
10.4
10.4
10.5
10.5
10.1
10.0
10.1
10.2
10.3
9.7
9.8
10.2
10.2
10.4
9.8
9.9
9.9
10.0
9.9
9.5
9.6
7.9
7.8
7.8
7.2
7.1
9.9
9.9
9.9
9.4
9.5
11.0
11.1
11.2
10.4
10.5
20042 March
June
Sept
Dec
11.8
10.6
9.8
11.2
11..6
10.0
9.7
10.6
11..2
9.6
9.3
10.3
10.7
9.3
9.0
9.9
10.8
9.5
9.0
10.1
10.5
9.2
8.8
9.6
8.0
7.0
6.6
7.4
10.4
9.1
8.7
9.6
11.6
9.9
9.5
10.7
20052 MarchP
JuneP
SeptP
DecP
12.0
10.7
9.7
10.6
12.0
10.2
9.4
10.2
11.5
9.8
9.0
9.8
11.2
9.6
8.7
9.7
11.6
9.7
8.8
9.7
11.0
9.4
8.5
9.4
8.3
7.0
6.4
6.9
10.9
9.4
8.5
9.2
12.1
10.5
9.4
10.3
Infant mortality (deaths under 1 year per 1,000 live births)
1996
1997
1998
1999
2000
6.2
5.8
5.0
5.6
6.5
6.3
6.7
6.3
6.5
6.2
6.5
6.5
6.9
6.3
7.3
6.3
5.7
5.6
6.0
5.4
6.8
7.0
6.5
6.9
6.8
5.3
4.8
5.0
4.6
4.4
6.3
5.8
6.0
6.0
5.4
5.3
5.0
4.4
4.8
4.4
5.5
5.8
4.8
4.7
4.7
2001
2002
2003
2004
2005P
5.4
4.8
4.9
4.6
4.5
5.8
5.4
5.9
5.4
5.8
5.5
6.1
5.7
5.8
6.1
4.9
5.6
5.9
4.9
4.7
6.4
6.6
7.4
6.3
6.4
4.5
4.3
4.5
4.2
4.0
6.1
5.5
5.4
5.2
5.1
4.2
4.5
4.2
3.9
3.9
5.4
4.3
4.1
4.5
4.5
2004 March
June
Sept
Dec
5.9
4.6
3.1
4.8
6.1
4.9
5.3
5.3
6.1
5.8
4.9
6.3
4.8
4.8
4.3
5.6
6.9
5.6
7.0
5.6
4.9
4.0
4.3
3.5
5.7
4.6
5.0
5.5
4.5
3.3
3.5
4.5
5.0
4.8
4.2
4.2
2005 MarchP
JuneP
SeptP
DecP
4.3
4.5
5.2
3.8
5.6
6.4
5.0
6.3
6.5
6.8
5.5
5.7
6.1
5.5
3.6
3.6
6.7
6.1
7.1
5.8
4.8
3.8
3.8
3.7
5.1
5.8
4.9
4.5
4.2
3.5
3.7
4.3
4.9
3.7
3.9
5.7
Neonatal mortality (deaths under 4 weeks per 1,000 live births)
1996
1997
1998
1999
2000
4.1
3.7
3.1
4.1
4.4
4.0
4.3
4.1
4.4
4.3
4.2
4.4
4.5
4.1
5.0
4.2
3.7
3.7
4.3
4.1
4.9
5.0
4.8
4.8
5.0
3.5
3.3
3.4
3.0
3.0
4.4
3.7
4.1
4.1
3.7
3.5
3.4
2.9
3.2
3.1
3.8
3.9
3.3
3.2
3.0
2001
2002
2003
2004
2005P
3.5
3.2
3.2
2.8
2.8
3.8
3.6
4.1
3.6
3.8
3.2
4.0
4.0
3.8
4.0
3.4
4.0
4.2
3.5
3.4
4.4
4.8
5.1
4.7
4.9
2.9
2.9
3.0
2.9
2.6
4.1
3.6
3.7
3.6
3.4
2.9
2.9
2.8
2.8
2.8
3.7
3.1
2.9
3.2
3.2
2004 March
June
Sept
Dec
3.7
3.2
1.4
2.8
3.5
3.4
3.8
3.5
4.0
4.0
3.2
4.1
3.5
3.6
3.3
3.6
5.3
4.2
5.5
3.9
3.4
3.1
3.0
2.1
3.9
3.1
3.5
3.6
2.7
2.5
2.6
3.2
3.8
2.9
3.0
3.1
2005 MarchP
JuneP
SeptP
DecP
3.2
3.0
2.8
2.4
3.8
3.6
3.0
4.7
4.5
4.5
3.8
3.4
4.5
3.8
3.0
2.4
5.0
4.7
5.7
4.2
3.0
2.6
2.7
2.1
3.0
4.0
3.6
2.9
2.9
2.2
2.8
3.2
3.6
2.6
2.8
3.8
Perinatal mortality (stillbirths and deaths under 1 week per 1,000 total births)3
1996
1997
1998
1999
2000
9.2
8.0
8.2
8.2
8.5
8.6
8.9
8.7
8.7
8.6
8.3
8.3
9.2
8.3
9.6
8.7
7.7
8.0
7.8
7.8
10.2
9.6
9.3
9.9
9.6
7.5
7.3
7.4
7.0
7.1
9.6
9.0
9.0
9.0
9.0
7.8
7.3
6.8
6.9
6.6
7.5
8.7
7.3
7.8
6.6
2001
2002
2003
2004p
2005
7.8
8.1
7.8
7.6
..
8.7
8.5
9.0
8.2
..
7.5
9.0
9.0
8.8
..
7.9
8.5
9.5
8.1
..
9.1
10.0
10.2
9.4
..
7.1
7.5
7.3
7.5
..
8.9
9.3
9.5
8.9
..
6.9
6.9
7.0
7.0
..
7.2
6.8
7.0
7.1
..
2004 March
June
Sept
Dec
9.6
8.8
6.4
5.7
8.2
8.3
8.1
8.4
8.9
9.1
9.3
7.8
8.4
8.5
8.2
7.2
10.1
8.9
10.1
8.3
8.0
7.4
7.6
7.0
9.2
8.5
9.2
8.6
7.2
6.8
7.0
6.9
6.6
7.5
7.9
6.6
2005 MarchP
JuneP
SeptP
DecP
6.5
8.0
9.5
8.8
8.8
6.7
7.6
6.2
6.7
8.6
7.2
9.7
7.6
10.0
6.7
7.8
6.4
6.5
7.0
6.9
7.9
7.1
10.8
5.9
8.4
6.8
5.4
..
..
..
..
..
..
..
..
..
Note: Figures represent the numbers of deaths occurring in each year with the exception of provisional figures for 2005 which relate to registrations.
Some stillbirths in 2004 are excluded from these and previously published figures, as the relevant registration details were not sent to ONS before the statistics were compiled. Revised
figures for 2004 will be published as soon as possible to include the additional stillbirth registrations.
1 The regions presented in this table have changed from the Regional Offices of the Department of Health to the Government Office Regions. See ‘In brief’ Health Statistics Quarterly 15 for details.
2 Rates for 2004 and 2005 have been calculated using the revised mid-2004 population estimates published on 20 December 2005.
3 In October 1992 the legal definition of a stillbirth was changed, from a baby born dead after 28 completed weeks of gestation or more, to one born dead after 24 completed weeks of
gestation or more.
P Provisional.
43
National Statistics
Heal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Deaths: selected causes (International Classification)1 and sex
Table 6.3
England and Wales
Number (thousands) and rate for all deaths and age-standardised rates3 per million population for selected causes
Malignant neoplasms
Year and
quarter
All deaths
Number
(thousands)
Crude
rate per
100,000
population
All causes Oesophagus
(age standardised
per
million
population,3)
Stomach
Colon
Rectosigmoid Trachea,
junction,
bronchus
rectum, and and lung
anus
(C19–C21)
A00–R99
V01–Y89
(C15)
(C16)
(C18)
Melanoma
of skin
Other
malignant
neoplasms
of skin
Breast
Cervix
uteri
Ovary
(C33–C34)
(C43)
(C44)
(C50)
(C53)
(C56)
Males
1971
1981
1991
288.4
289.0
277.6
1,207
1,196
1,125
13,466
12,189
10,291
76
90
117
317
251
185
187
181
194
144
135
117
1,066
1,028
842
10
17
23
12
9
10
4
3
3
:
:
:
:
:
:
1993
1994
1995
1996
1997
279.6
267.6
274.4
268.7
264.9
1,127
1,077
1,100
1,074
1,055
10,101
9,577
9,659
9,353
9,106
123
129
126
126
126
163
163
149
146
137
189
183
182
174
175
106
101
100
99
93
769
746
714
683
651
26
24
26
25
25
8
9
9
8
7
3
3
3
2
2
:
:
:
:
:
:
:
:
:
:
1998
1999
2000
2001
2002
2003
20042
20054P
264.7
264.3
255.5
252.4
253.1
253.9
244.1
243.9
1,064
1,044
1,005
987
985
982
939
931
8,981
8,862
8,437
8,188
8,074
7,985
7,535
7,362
129
127
128
129
131
134
129
132
132
127
118
111
109
101
95
92
169
161
158
155
150
145
142
137
95
90
89
89
90
90
91
91
643
611
592
570
559
538
520
511
26
27
28
26
27
28
30
28
8
7
7
7
8
8
9
8
3
2
2
3
3
2
2
2
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
20042 March
June
Sept
Dec
66.2
58.8
56.8
62.4
1,024
909
869
955
8,194
7,311
6,989
7,651
130
122
128
136
95
98
93
93
145
142
142
141
86
90
98
91
518
511
513
539
27
30
30
31
10
8
8
11
3
2
2
1
:
:
:
:
:
:
:
:
20054 Marchp
JuneP
SeptP
DecP
67.6
60.3
55.4
60.6
1,047
923
840
917
8,228
7,300
6,673
7,264
134
134
132
127
93
95
95
86
140
131
134
144
90
95
89
91
525
494
496
529
29
27
28
28
7
7
8
9
3
2
3
2
:
:
:
:
:
:
:
:
Females
1971
1981
1991
278.9
288.9
292.5
1,104
1,134
1,122
8,189
7,425
6,410
40
42
50
149
111
74
176
157
146
79
74
61
183
252
300
14
16
18
6
5
4
379
405
401
83
69
54
126
121
118
1993
1994
1995
1996
1997
299.2
285.6
295.2
291.5
290.4
1,142
1,088
1,121
1,105
1,098
6,427
6,115
6,206
6,068
6,001
52
51
52
52
51
66
67
62
55
57
138
136
131
126
122
53
52
49
49
48
296
296
294
293
285
22
22
20
20
20
3
4
4
3
3
378
371
361
344
337
47
42
42
41
37
115
114
116
121
115
1998
1999
2000
2001
2002
2003
20042
20054P
290.3
291.8
280.1
277.9
280.4
284.4
268.4
269.1
1,108
1,097
1,049
1,038
1,044
1,055
992
989
5,945
5,929
5,655
5,543
5,526
5,578
5,259
5,189
49
52
51
48
51
50
48
48
54
51
48
46
44
42
42
39
117
115
107
103
104
98
96
96
47
46
45
45
44
46
47
45
291
289
285
283
284
285
284
289
21
20
21
20
19
20
19
20
3
3
3
3
3
3
3
3
328
319
311
308
302
293
285
282
35
33
33
31
29
27
27
26
116
111
109
112
112
108
102
102
20042 March
June
Sept
Dec
74.4
63.4
61.8
68.9
1,105
942
908
1,013
5,795
5,022
4,863
5,359
51
46
50
46
38
41
43
44
97
94
95
100
46
47
45
49
292
265
281
299
21
18
19
20
3
4
3
2
287
284
276
293
28
25
27
28
105
97
102
101
20054 Marchp
JuneP
SeptP
DecP
77.7
65.7
60.0
65.7
1,158
969
875
958
5,950
5,110
4,673
5,039
49
46
50
46
41
36
40
38
92
96
102
94
47
46
43
45
291
291
282
293
20
22
20
20
4
4
3
3
290
280
282
276
27
27
26
24
101
105
98
104
Note: Figures represent the numbers of deaths registered in each year up to 1992 and the numbers of deaths occurring in each year from 1993 to 2004. Provisional figures for 2005 relate to registrations.
Between 1 January 1984 and 31 December 1992, ONS applied its own interpretation of the International Classification of Diseases Section Rule 3 in the coding of deaths where terminal events and other
‘modes of dying’ such as cardiac arrest, cardiac failure, certain thrombembolic disorders, and unspecified pneumonia and bronchopneumonia, were stated by the certifier to be the underlying cause of death
and other major pathology appeared on the certificate. In these cases ONS Rule 3 allowed the terminal event to be considered a direct sequel to the major pathology and that primary condition was selected
as the underlying cause of death. Prior to 1984 and between 1 January 1993 and 31 December 2000, such certificates were coded to the terminal event. National Statistics also introduced automated coding
of cause of death in 1993, which may also affect comparisons of deaths by cause from 1993. Further details can be found in the annual volumes Mortality statistics: Cause 1984, Series DH2 no. 11, and Mortality
statistics: Cause 1993 (revised) and 1994, Series DH2 no. 21.
From 1 January 2001, under ICD-10, Rule 3 has again been changed – for details see the article in Health Statistics Quarterly no. 13. This has resulted in a fall in the death rates from respiratory diseases, notably
pneumonia, and consequently slight rises in the rates for other causes eg. strokes. For details of the major changes between ICD-9 and ICD-10, see the articles in Health Statistics Quarterly 08, 13 and 14.
The rates in this table by cause of death are based on final underlying cause. For further details see the Explanatory Notes in the ‘Report: Death registrations in England and Wales, 2004: causes’ in HSQ26.
1 The Ninth Revision of the International Classification of Diseases, 1975, came into operation in England and Wales on 1 January 1979. The Tenth Revision of the International Classification of Diseases, 1992, came
into operation in England and Wales on 1 January 2001. The cause descriptions and codes relate to ICD-10. For changes to this table see ‘In Brief’, Health Statistics Quarterly 14.
2 Rates for 2004 have been calculated using the revised mid-2004 population estimates published on 20 December 2005.
3 Directly age-standardised to the European Standard Population. See Notes to Tables.
4 Based on the 2004-based population projections for 2005.
p Provisional
National Statistics
44
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Summer 2006
Deaths: selected causes (International Classification)1 and sex
Table 6.3
continued
England and Wales
Age-standardised rates3 per million population for selected causes
Malignant neoplasms
Prostate
(C61)
Bladder Leukaemia
(C67)
Diabetes
mellitus
(C91–C95) (E10–E14)
Ischaemic
heart
disease
Cerebro
vascular
diseases
(120–125) (160–169)
Pneumonia
Bronchitis,
emphysema
and other
chronic
obstructive
pulmonary
disease
Asthma
(J12–J18)
(J40–J44)
(J45–J46)
Gastric
and
duodenal
ulcer
Diseases
of the liver
Land
transport
accidents
Intentional
self harm and
events of
undetermined
intent
with inquest
verdict
’Open‘
(K25–K27) (K70–K76)
(V01–V89)
(X60–X84,
Y10–Y34)
Year and
quarter
198
214
304
124
121
121
74
74
77
82
82
131
3,801
3,664
2,984
1,541
1,141
940
920
1,053
391
944
683
606
21
28
31
107
90
73
41
58
76
209
119
125
124
151
160
Males
1971
1981
1991
298
297
298
289
279
114
109
112
105
101
70
69
71
66
67
101
98
101
97
95
2,844
2,609
2,549
2,427
2,276
801
762
761
751
722
769
689
765
738
753
570
498
528
484
478
25
23
20
19
20
67
67
64
64
61
77
84
92
97
103
96
93
89
94
94
153
152
150
141
144
1993
1994
1995
1996
1997
277
272
260
274
271
272
266
255
99
93
92
93
90
87
84
80
67
67
67
70
68
71
67
67
94
94
88
94
91
91
82
78
2,215
2,095
1,959
1,872
1,782
1,700
1,562
1,463
706
673
622
690
690
661
594
551
720
770
735
388
387
407
359
352
463
474
416
403
396
411
363
366
18
18
17
16
15
14
15
12
60
64
59
55
56
53
50
46
115
119
119
139
144
157
151
155
86
86
86
86
83
84
77
85
152
151
141
134
131
129
125
128
1998
1999
2000
2001
2002
2003
2004 2
20054P
279
258
260
267
86
82
88
81
67
63
70
66
91
80
74
85
1,708
1,538
1,418
1,584
692
571
519
594
465
332
278
361
463
338
293
360
15
13
17
14
54
49
44
52
149
144
145
166
69
90
79
71
137
133
127
103
264
251
250
255
85
80
77
79
67
66
64
69
91
75
69
78
1,670
1,475
1,292
1,418
643
542
483
538
500
335
248
327
490
369
272
338
14
12
9
13
55
47
41
42
164
154
144
159
85
90
82
83
121 20054 MarchP
133
JuneP
126
SeptP
132
DecP
:
:
:
32
35
34
47
47
44
89
66
95
1,668
1,601
1,407
1,352
1,012
812
624
740
325
193
155
211
25
30
30
44
57
46
31
43
49
82
41
45
84
81
51
Females
1971
1981
1991
:
:
:
:
:
34
35
33
32
31
43
42
41
41
43
74
69
73
67
66
1,347
1,237
1,194
1,140
1,074
724
689
690
680
651
585
512
568
548
574
224
204
229
222
227
27
24
24
21
23
46
44
42
43
42
49
50
55
57
61
35
34
30
30
29
48
44
47
45
45
1993
1994
1995
1996
1997
:
:
:
:
:
:
:
:
32
30
31
29
30
30
28
28
41
45
39
41
43
39
40
39
65
65
62
62
65
66
60
56
1,055
986
907
878
844
811
738
686
645
629
577
620
617
606
550
518
546
591
546
307
316
337
297
297
226
241
216
220
224
244
214
224
22
22
20
19
20
20
18
17
41
39
41
39
37
36
35
32
64
67
68
77
79
81
83
81
28
28
24
23
24
24
21
23
43
45
45
40
41
41
41
43
1998
1999
2000
2001
2002
2003
2004 2
20054P
:
:
:
:
27
30
28
28
43
39
39
39
69
54
55
63
806
720
674
750
626
530
496
550
399
254
227
307
283
184
167
221
23
16
14
18
37
33
32
37
84
80
80
86
25
21
19
20
46
42
42
36
:
:
:
:
30
29
27
25
43
41
34
39
65
54
50
57
807
689
606
643
603
504
464
502
455
269
200
268
322
211
158
205
24
16
12
15
36
32
29
30
86
76
75
85
22
25
22
22
41 20054 Marchp
44
JuneP
41
SeptP
44
DecP
See notes opposite.
45
National Statistics
20042 March
June
Sept
Dec
20042 March
June
Sept
Dec
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Report:
Death registrations in
England and Wales: 2005,
causes
This report presents numbers of deaths registered in England and
Wales in 2005 by age, sex and selected underlying causes of death. It
also compares mortality rates in 2005 with those for previous years.
)RUWKH¿UVWWLPHLQWKLVUHSRUWFDXVHVRIGHDWKKDYHEHHQUDQNHGWR
provide a summary of the ten leading causes of death for both males
and females.
lowest annual number of death registrations for 50 years, when in
1954 the number of deaths registered was 501,896.
DEATHS BY SEX AND AGE OF DECEASED
•
There were 512,993 deaths registered in 2005, compared with
514,250 registered in 2004, a decrease of 0.2 per cent. This is the
Table 1
•
The total number of deaths in 2005 comprised 243,870 male deaths
and 269,123 female deaths. The number of male deaths decreased
E\SHUFHQWRQWKH¿JXUHZKLOHIHPDOHGHDWKVLQFUHDVHGE\
0.03 per cent.
•
In 2005, there were 3,248 infant deaths registered in England and
Wales, giving a rate of 5.0 per 1,000 live births. This is the lowest
rate ever recorded in England and Wales.
Death rates (registrations): by sex and age, 1995, 2004 and 2005
England and Wales
Age group
1995
2005†
2004*
Percentage change
2004–2005
Percentage change
1995–2005
Males
Females
Males
Females
Males
Females
Males
Females
Males
Females
9,599
6,169
7,575
5,279
7,361
5,188
-2.9
-1.7
-23.3
-15.9
10.9
11.1
9.4
9.9
9.3
9.9
-1.3
-0.5
-14.8
-11.2
Under 1††
1–4
5–9
10–14
15–19
6.9
0.3
0.2
0.2
0.6
5.3
0.3
0.1
0.1
0.3
5.5
0.2
0.1
0.1
0.5
4.7
0.2
0.1
0.1
0.2
5.7
0.2
0.1
0.2
0.5
4.3
0.2
0.1
0.1
0.2
2.9
-3.0
-3.5
8.8
1.9
-8.0
-14.4
-3.3
9.6
-9.1
-17.5
-15.9
-36.3
-22.9
-18.6
-18.4
-26.2
-25.3
-20.6
-15.4
20–24
25–29
30–34
35–39
40–44
0.9
0.9
1.1
1.4
2.1
0.3
0.4
0.5
0.8
1.3
0.7
0.8
1.0
1.3
1.8
0.3
0.4
0.5
0.8
1.1
0.7
0.8
1.0
1.3
1.8
0.3
0.4
0.5
0.7
1.1
-6.4
-10.6
0.7
-2.7
0.2
-5.5
-0.4
-4.5
-6.6
0.3
-22.0
-19.9
-7.0
-5.9
-11.2
-7.6
-6.0
-9.7
-10.8
-14.2
45–49
50–54
55–59
60–64
65–69
3.1
5.3
9.0
15.7
27.4
2.1
3.5
5.5
9.1
15.8
2.9
4.6
6.9
11.8
19.2
1.9
2.9
4.5
7.2
11.8
2.9
4.4
6.8
11.5
18.3
1.9
3.0
4.5
7.0
11.6
-0.1
-4.5
-0.4
-2.4
-5.0
-1.9
1.1
0.4
-2.9
-1.7
-8.3
-15.9
-23.7
-26.6
-33.1
-12.5
-14.6
-18.0
-22.9
-26.2
45.5
71.6
115.2
200.1
26.7
42.8
73.6
159.9
31.9
54.9
91.5
175.2
20.2
36.1
63.5
154.3
30.9
52.5
88.9
171.6
19.4
35.4
63.1
152.4
-3.4
-4.6
-2.9
-2.1
-4.1
-1.9
-0.6
-1.3
-32.2
-26.7
-22.8
-14.3
-27.2
-17.3
-14.2
-4.7
Age-standardised rate**
Rates per 1,000 population
All ages
70–74
75–79
80–84
85 and over
*
Figures vary from previous rates published. For 2004, the population projections used to calculate rates have been replaced with 2004 mid-year estimates. For 1995, the midyear estimates used in the rates have been revised following the 2001 Census.
† Provisional rates based on 2004-based population projections for 2005 and 2005 live births.
** These rates are standardised to the European Standard Population, expressed per million population; they allow comparisons between populations with different age structures,
including between males and females and over time.
†† Deaths per 1,000 live births.
Nati o n a l S t a t ist ic s
46
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Age−standardised rate (per million population)
Figure 1
Age-standardised rates* (per million
population), all causes, by sex, 1995–2005
•
7KHODUJHVWSHUFHQWDJHIDOOLQIHPDOHDJHVSHFL¿FUDWHVEHWZHHQ
and 2005 were among girls aged 1–4 years, with a fall of 14.4 per
cent. The largest decrease for males was among those aged 25–29
(10.6 per cent). The largest percentage increase was among females
and males both aged 10–14, with a 9.6 per cent and 8.8 per cent rise
respectively. However, all these rates are based on small numbers of
deaths, and relatively small changes in such numbers can result in
large percentage changes.
•
At the older ages, where most deaths occur, between 2004 and 2005
WKHUHZHUHVL]HDEOHSHUFHQWDJHIDOOVLQDJHVSHFL¿FUDWHVDPRQJERWK
men and women aged over 70. The largest decrease for females was
for those aged 70–74 with fall of 4.1 per cent, and for males aged
75–79 with a 4.6 per cent decrease.
•
Between 1995 and 2005, the greatest decrease for females was in the
±DQG±DJHJURXSVZKHUHWKHUDWHIHOOE\RYHUDTXDUWHU
(26.2 and 27.2 per cent respectively). For males the largest decrease
in rates was also in the 65–69 and 70–74 age groups but to a greater
extent, as the rates fell by a third. In addition the younger age groups
also saw proportionally large changes over this period. For example
for those aged 5–9 years, the rate fell by over a third (36.3 per cent)
IRUPDOHVDQGDTXDUWHUSHUFHQWIRUIHPDOHV
10,000
Males
9,000
8,000
7,000
Females
6,000
5,000
4,000
3,000
2,000
1,000
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Year
* These rates are standardised to the European Standard Population, expressed per
million population; they allow comparisons between populations with different age
structures, including between males and females and over time.
Table 1 shows death rates by age and sex, for the years 1995, 2004 and
2005, together with percentage changes.
•
The provisional age-standardised mortality rates (standardised to the
European Standard Population) were 7,361 per million population for
males and 5,188 per million for females. The rate for males is 2.9 per
cent lower than in 2004, while that for females is 1.7 per cent lower.
Figure 1 shows the downward trend in age-standardised rates since
1995: rates have decreased by 23.3 per cent for males and 17.3 per
cent for females over this period.
Figure 2
DEATHS BY UNDERLYING CAUSE
Table 2 presents deaths by age and sex for selected underlying causes of
GHDWKJURXSHGDFFRUGLQJWRWKH,QWHUQDWLRQDO&ODVVL¿FDWLRQRI'LVHDVHV
7HQWK5HYLVLRQ,&'
The chapters (broad disease groups) of ICD-10 with the largest numbers
of deaths in 2005 were circulatory diseases (accounting for 35.8 per cent
of all deaths), which include coronary heart disease and strokes, followed
by cancer (26.9 per cent) and respiratory diseases (14.1 per cent), which
include pneumonia.
Age-standardised rates* for the three categories† of cause of death (per million population), 1995–2005
Females
4,500
4,000
Circulatory diseases
3,000
2,500
Cancer
2,000
1,500
Respiratory diseases
1,000
Age−standardised rate (per million population)
Age−standardised rate (per million population)
Males
3,500
Summer 2006
4,500
4,000
3,500
3,000
2,500
Circulatory diseases
2,000
1,500
Cancer
1,000
500
500
0
0
Respiratory diseases
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
1995 1996 1997 1998 1999 2000
2001 2002 2003 2004 2005
Year
Year
*
These rates are standardised to the European Standard Population, expressed per million population; they allow comparisons between populations with different age
structures, including between males and females and over time.
† These categories correspond to the three chapters of ICD-10 with the largest number of deaths in England and Wales.
Note: The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10) came into operation in 2001. Comparability ratios have been applied to
data for 1994 to 2000. See the Explanatory Notes.
47
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Table 2
Summer 2006
Deaths by age, sex and underlying cause, 2005 registrations
England and Wales
Numbers
Age group
ICD-10 code Causes of death*
A00–R99,
V01–Y89
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
All causes, all ages
M
F
243,870
269,123
1,877
1,371
297
222
438
323
2,073
857
3,146
1,481
6,362
3,805
All causes, ages under
28 days
M
F
1,273
947
1,273
947
-
-
-
-
-
A00–R99,
V01–Y89
All causes, ages 28 days
and over
M
F
242,597
268,176
604
424
297
222
438
323
2,073
857
3,146
1,481
6,362
3,805
A00–B99
Certain infectious and
parasitic diseases
M
F
2,627
3,478
46
23
31
22
9
8
23
26
61
56
140
64
163
104
230
152
413
382
875
1,101
636
1,540
A00–A09
Intestinal infectious
diseases
M
F
733
1,473
3
2
3
-
1
-
-
2
2
2
6
14
22
24
88
105
320
492
288
832
A15–A16
Respiratory tuberculosis
M
F
178
83
-
-
-
2
-
6
4
8
2
10
6
29
4
33
19
67
31
23
17
A17–A19
Other tuberculosis
M
F
35
52
-
1
1
3
3
2
5
2
3
2
1
9
5
6
10
10
16
3
5
A39
Meningococcal infection
M
F
48
38
13
5
16
11
1
-
6
6
2
2
2
2
2
1
3
3
2
3
1
1
4
A40–A41
Septicaemia
M
F
1,009
1,341
19
9
8
3
1
1
7
8
9
9
20
22
30
37
82
59
187
172
380
453
266
568
B15–B19
Viral hepatitis
M
F
127
76
1
-
1
-
1
1
1
1
19
3
48
13
26
13
19
23
11
18
1
3
B20–B24
Human immunodeficiency virus
[HIV] disease
M
F
150
56
1
-
-
1
2
27
20
59
17
35
13
16
3
11
-
1
-
-
B90
Sequelae of tuberculosis
M
F
21
30
-
-
-
-
1
-
-
1
-
1
3
2
4
13
13
3
10
C00–D48
Neoplasms
M
F
71,722
66,358
9
5
45
20
97
91
165
141
296
379
1,091
1,576
3,579
4,102
11,091
9,655
20,086
15,238
24,974
21,922
10,289
13,229
C00–C97
Malignant neoplasms
M
F
70,220
64,644
4
5
42
20
85
81
158
131
285
367
1,052
1,551
3,525
4,052
10,947
9,527
19,789
14,975
24,379
21,325
9,954
12,610
C00–C14
Malignant neoplasms of lip,
oral cavity and pharynx
M
F
1,118
590
-
-
1
1
5
3
3
3
43
15
180
47
316
114
288
128
201
151
81
128
C15
Malignant neoplasm of
oesophagus
M
F
4,246
2,216
-
-
-
2
-
6
2
60
15
282
88
932
259
1,181
450
1,346
873
437
529
C16
Malignant neoplasm of stomach
M
F
3,094
1,834
-
-
-
1
1
7
16
54
36
137
60
386
154
932
384
1,151
670
426
513
C18
Malignant neoplasm of colon
M
F
4,589
4,475
-
-
-
5
3
13
15
44
62
203
147
617
495
1,314
965
1,687
1,630
706
1,158
C19–C21
Malignant neoplasm of rectosigmoid M
junction, rectum and anus
F
2,981
2,062
-
-
-
1
2
9
3
32
34
162
104
536
220
867
473
967
657
407
569
C22
Malignant neoplasm of liver and
intrahepatic bile ducts
M
F
1,462
1,004
-
1
1
1
-
6
5
11
5
27
18
117
47
255
124
462
249
456
357
126
198
C23–C24
Malignant neoplasm of gallbladder M
and biliary tract
F
163
365
-
-
-
-
-
1
5
9
18
28
48
45
88
65
136
15
70
C25
Malignant neoplasm of pancreas
M
F
3,093
3,386
-
-
-
1
-
5
3
37
30
180
132
594
495
1,019
868
949
1,213
308
645
C32
Malignant neoplasm of larynx
M
F
525
136
-
-
-
-
1
-
6
2
45
15
124
17
156
33
140
46
53
23
C33–C34
Malignant neoplasm of trachea,
bronchus and lung
M
F
16,775
11,895
-
-
-
2
1
11
8
144
99
804
622
2,960
1,891
5,249
3,417
5,902
4,405
1,703
1,452
C43
Malignant melanoma of skin
M
F
855
764
-
-
-
5
6
17
22
62
71
114
83
179
125
208
149
192
191
78
117
* The figures for individual cause categories exclude deaths at ages under 28 days.
Nati o n a l S t a t ist ic s
48
12,158 27,292 51,019 84,661 54,547
8,175 17,797 35,913 86,309 112,870
-
-
-
-
-
12,158 27,292 51,019 84,661 54,547
8,175 17,797 35,913 86,309 112,870
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 2
continued
Summer 2006
Deaths by age, sex and underlying cause, 2005 registrations
England and Wales
Numbers
Age group
ICD-10 code Causes of death*
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
C44
Other malignant neoplasms
of skin
M
F
266
183
-
-
-
-
-
1
-
11
3
17
7
38
24
104
44
95
105
C45
Mesothelioma
M
F
1,477
263
-
-
-
1
-
2
-
8
1
54
20
331
47
540
73
445
98
96
24
C46
Kaposi’s sarcoma
M
F
6
4
-
-
-
-
2
1
1
1
-
3
-
-
1
1
C50
Malignant neoplasm of breast
M
F
82
10,986
-
-
-
2
76
577
5
1,218
12
2,102
23
2,097
27
2,815
15
2,099
C53
Malignant neoplasm of cervix
uteri
F
917
-
-
-
2
51
113
128
137
167
205
114
C54–C55
Malignant neoplasm of other
and unspecified parts of uterus
F
1,464
-
-
-
-
2
15
67
253
418
440
269
C56
Malignant neoplasm of ovary
F
3,859
-
-
-
6
22
78
325
826
1,088
1,059
455
C61
Malignant neoplasm of prostate
M
9,018
-
-
1
-
-
3
61
549
1,985
3,898
2,521
C62
Malignant neoplasm of testis
M
67
-
-
-
6
13
14
11
9
4
8
2
C64
Malignant neoplasm of kidney,
except renal pelvis
M
F
1,842
1,090
1
4
1
2
3
2
1
4
5
34
18
155
67
362
156
580
279
535
373
164
186
C67
Malignant neoplasm of bladder
M
F
2,767
1,426
-
-
1
1
-
1
-
14
9
56
36
274
80
674
271
1,136
561
611
468
C71
Malignant neoplasm of brain
M
F
1,770
1,196
3
14
1
32
28
25
16
45
27
126
82
237
146
421
305
504
285
315
243
51
60
C81
Hodgkin’s disease
M
F
146
106
-
-
2
8
8
8
10
9
10
10
13
28
13
38
22
35
22
10
6
C82–C85
Non-Hodgkin’s lymphoma
M
F
2,089
1,842
-
3
1
5
4
12
7
32
16
69
48
134
90
352
239
572
443
648
630
262
364
C90
Multiple myeloma and malignant
plasma cell neoplasms
M
F
1,124
1,060
-
-
-
-
2
-
19
4
48
48
175
127
325
272
404
385
151
224
C91–C95
Leukaemia
M
F
2,183
1,708
2
-
5
8
20
16
33
38
31
30
76
52
81
62
287
166
602
344
721
584
325
408
C97
Malignant neoplasms of independent M
(primary) multiple sites
F
509
407
-
-
-
-
1
1
3
5
23
28
61
66
106
80
222
128
93
99
D00–D48
In situ and benign neoplasms,
and neoplasms of uncertain or
unknown behaviour
M
F
1,502
1,714
5
-
3
-
12
10
7
10
11
12
39
25
54
50
144
128
297
263
595
597
335
619
D50–D89
Diseases of the blood and
blood-forming organs and certain
disorders involving the immune
mechanism
M
F
437
653
7
4
4
7
5
7
6
10
14
10
16
15
34
18
39
46
71
92
136
183
105
261
D50–D64
Anaemias
M
F
177
351
1
2
2
2
1
3
3
3
7
2
6
2
2
9
7
5
20
26
59
91
69
206
E00–E90
Endocrine, nutritional and
metabolic diseases
M
F
3,312
4,103
9
9
13
17
20
17
39
42
55
44
104
85
205
104
340
244
689
575
1,139
1,314
699
1,652
E10–E14
Diabetes mellitus
M
F
2,640
3,012
-
-
1
3
9
7
28
10
58
48
134
56
246
156
583
446
993
1,069
588
1,217
F00–F99
Mental and behavioural disorders M
F
4,749
9,893
-
1
2
4
110
23
320
62
305
79
213
66
168
95
342
308
1,501
2,627
1,788
6,628
F01,F03
Vascular and unspecified dementia M
F
3,548
9,408
-
-
-
-
1
-
-
5
2
45
44
284
279
1,455
2,567
1,758
6,516
F10–F19
Mental and behavioural disorders M
due to psychoactive substance use F
1,122
279
-
-
2
110
18
317
57
302
72
204
61
119
42
48
16
18
5
4
6
* The figures for individual cause categories exclude deaths at ages under 28 days.
49
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Table 2
continued
Summer 2006
Deaths by age, sex and underlying cause, 2005 registrations
England and Wales
Numbers
Age group
ICD-10 code Causes of death*
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
G00–G99
Diseases of the nervous system
M
F
7,110
8,092
40
36
32
28
61
51
137
76
136
104
268
165
367
311
614
550
1,298
1,033
2,593
2,745
1,564
2,993
G00–G03
Meningitis
(excluding meningococcal)
M
F
110
79
9
2
10
5
4
1
6
6
3
1
7
6
15
7
20
9
17
12
15
22
4
8
G12.2
Motor neuron disease
M
F
887
681
-
-
-
-
2
3
26
14
57
29
185
102
306
244
252
221
59
68
G20
Parkinson’s disease
M
F
2,398
1,767
-
-
-
-
-
1
-
4
1
37
15
415
214
1,238
810
703
727
G30
Alzheimer’s disease
M
F
1,528
3,381
-
-
-
-
-
1
2
6
6
35
49
190
228
692
1,271
604
1,825
G35
Multiple sclerosis
M
F
349
613
-
-
1
1
-
3
6
33
46
82
120
98
181
74
127
49
98
9
34
H00–H59
Diseases of the eye and adnexa
M
F
5
9
-
-
-
1
-
-
-
1
-
-
1
2
1
1
7
H60–H95
Diseases of the ear and
mastoid process
M
F
15
15
1
1
-
-
1
2
2
1
4
-
2
-
3
3
6
1
1
2
I00–I99
Diseases of the circulatory system M
F
88,071
95,586
22
18
22
11
22
12
101
59
308
158
1,394
563
3,673
1,380
9,061
3,433
18,403
10,438
33,484
33,447
21,581
46,067
I05–I09
Chronic rheumatic heart diseases M
F
338
804
1
1
-
-
1
-
4
3
11
2
13
19
41
48
85
176
126
315
56
240
I10–I15
Hypertensive diseases
M
F
1,576
2,165
-
-
-
1
12
6
44
11
90
42
196
104
316
239
516
719
402
1,043
I20–I25
Ischaemic heart diseases
M
F
49,205
38,969
1
3
1
-
10
1
85
21
749
155
2,410
513
6,095
1,650
11,515
5,031
18,263
14,499
10,077
17,095
I21–I22
Acute myocardial infarction
M
F
20,492
15,889
1
1
-
-
7
1
40
13
333
74
1,040
220
2,588
769
5,004
2,303
7,614
6,310
3,865
6,198
I26–I51
Other heart diseases
M
F
9,770
14,362
14
10
15
5
11
8
57
23
112
44
262
136
396
221
840
466
1,483
1,259
3,375
4,245
3,205
7,945
I60–I69
Cerebrovascular diseases
M
F
19,266
31,366
5
4
6
4
9
3
20
19
59
53
227
178
501
450
1,194
869
3,097
2,642
7,938
10,619
6,210
16,525
I60–I62
Intracranial haemorrhage
M
F
3,194
4,254
-
2
9
3
17
14
50
36
174
153
336
351
515
495
713
781
971
1,413
409
1,006
I63
Cerebral infarction
M
F
2,073
2,910
1
-
-
-
2
3
5
12
27
10
59
35
161
79
397
278
824
1,074
597
1,419
I64
Stroke, not specified as
haemorrhage or infarction
M
F
9,363
16,792
-
-
-
1
-
3
4
23
14
88
55
423
231
1,461
1,215
4,125
5,818
3,239
9,455
I70
Atherosclerosis
M
F
249
483
-
-
-
-
-
2
-
3
1
9
6
35
29
98
144
102
303
I71
Aortic aneurysm and dissection
M
F
4,881
3,272
-
-
1
-
6
4
10
9
31
12
105
30
376
82
1,257
495
2,170
1,501
925
1,139
J00–J99
Diseases of the respiratory system
M
F
32,681
39,704
41
24
34
21
28
23
40
40
86
45
230
144
656
437
2,126
1,477
5,605
4,349
12,796
12,872
11,039
20,272
J10–J11
Influenza
M
F
18
24
4
3
3
1
2
-
1
-
1
-
1
1
2
-
2
2
3
3
4
9
J12–J18
Pneumonia
M
F
12,191
19,231
21
9
17
11
3
4
15
14
37
24
113
63
264
151
536
348
1,353
1,041
4,203
4,909
5,629
12,657
J40–J44
Bronchitis, emphysema and other M
chronic obstructive pulmonary
F
disease
12,864
11,310
1
-
1
-
1
-
5
-
5
1
28
18
181
142
1,058
762
2,952
2,399
5,730
5,124
2,902
2,864
* The figures for individual cause categories exclude deaths at ages under 28 days.
Nati o n a l S t a t ist ic s
50
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 2
continued
Summer 2006
Deaths by age, sex and underlying cause, 2005 registrations
England and Wales
Numbers
Age group
ICD-10 code Causes of death*
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
J45–J46
Asthma
M
F
375
810
1
-
1
11
10
8
13
19
5
27
23
43
40
44
81
57
96
84
239
81
302
K00–K93
Diseases of the digestive system
M
F
11,541
13,655
17
13
7
6
8
4
26
26
133
90
723
389
1,537
837
1,947
1,122
2,126
1,865
3,124
4,431
1,893
4,872
K25–K27
Gastric and duodenal ulcer
M
F
1,537
1,714
-
-
1
-
2
1
11
5
30
11
96
44
193
91
318
230
586
675
300
657
K40–K46
Hernia
M
F
341
488
-
-
-
1
1
2
-
3
3
14
11
24
18
61
66
127
179
109
210
K57
Diverticular disease of intestine
M
F
469
1,415
-
-
-
-
2
-
3
-
14
14
33
40
72
175
203
600
142
586
K70–K76
Diseases of the liver
M
F
4,338
2,543
3
3
2
2
5
1
7
8
89
60
572
302
1,178
607
1,239
616
764
453
391
380
88
111
L00–L99
Diseases of the skin and
subcutaneous tissue
M
F
594
1,195
-
-
-
1
2
6
15
6
22
24
48
45
98
107
225
383
184
623
M00–M99
Diseases of the musculoskeletal
system and connective tissue
M
F
1,292
3,102
1
1
2
2
3
2
3
6
10
19
22
22
43
53
94
152
232
315
476
1,019
406
1,511
M05–M06,
M08
Rheumatoid arthritis and
juvenile arthritis
M
F
176
657
-
-
-
-
1
1
1
7
8
16
44
46
120
78
273
28
210
M80–M81
Osteoporosis
M
F
332
1,093
-
-
-
-
-
-
2
1
2
7
11
28
123
309
194
748
N00–N99
Diseases of the genitourinary
system
M
F
4,058
6,112
2
5
1
1
1
4
5
9
9
42
41
76
79
169
190
522
554
1,579
1,941
1,654
3,286
N00–N15
Glomerular and renal
tubulo-interstitial diseases
M
F
322
374
1
2
-
-
1
2
2
9
6
9
20
26
25
53
58
125
120
98
139
N17–N19
Renal failure
M
F
1,377
1,601
1
1
1
1
3
1
4
2
23
17
31
20
67
72
190
168
540
521
518
797
N40
Hyperplasia of prostate
M
158
-
-
-
-
-
-
-
2
13
62
81
O00–O99
Pregnancy, childbirth and
the puerperium
F
46
-
-
-
7
24
15
-
-
-
-
-
P00–P96
Certain conditions originating
in the perinatal period
M
F
115
84
112
76
1
4
1
2
1
1
1
-
-
-
-
-
-
Q00–Q99
Congenital malformations,
deformations and chromosomal
abnormalities
M
F
692
604
128
95
49
41
31
30
48
33
43
42
62
52
73
61
106
79
67
59
60
71
25
41
Q20–Q28
Congenital malformations of
the circulatory system
M
F
281
257
62
45
17
17
17
13
28
20
24
22
33
23
30
23
21
22
25
25
18
32
6
15
R00–R99
Symptoms, signs and abnormal
clinical and laboratory findings,
not elsewhere classified
M
F
2,790
8,646
141
89
6
10
8
7
37
13
75
25
123
49
146
54
140
57
136
78
373
797
1,605
7,467
R54
Senility without mention
of psychosis
M
F
1,809
7,927
-
-
-
-
-
-
-
-
9
12
266
676
1,534
7,239
R95
Sudden infant death syndrome
M
F
86
54
85
51
1
3
-
-
-
-
-
-
-
-
-
R99
Other ill-defined and unspecified
causes of mortality
M
F
726
341
55
37
5
7
6
5
27
6
55
21
117
46
131
51
132
48
104
41
75
61
19
18
V01–Y89
External causes of morbidity
and mortality
M
F
10,786
6,841
29
25
50
31
142
64
1,332
346
1,597
405
1,826
536
1,370
545
1,117
500
928
516
1,318
1,454
1,077
2,419
V01–X59
Accidents
M
F
6,396
5,107
15
12
39
22
114
45
837
186
784
163
815
225
591
245
589
260
603
358
1,056
1,282
953
2,309
* The figures for individual cause categories exclude deaths at ages under 28 days.
51
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Table 2
continued
Summer 2006
Deaths by age, sex and underlying cause, 2005 registrations
England and Wales
Numbers
Age group
ICD-10 code Causes of death*
All ages
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
V01–V99,
Y85
Transport accidents†
M
F
2,330
697
2
12
7
73
25
656
136
416
71
380
78
249
71
190
72
128
78
156
111
70
46
V01–V89
Land transport accidents involving M
pedestrians, pedal cyclists, motor F
cyclists and occupants of motor
vehicles
2,252
678
2
11
7
73
25
645
135
409
71
366
75
224
67
179
65
120
76
155
109
70
46
W00–W19
Falls
M
F
1,550
1,535
1
-
4
1
6
2
27
5
38
12
96
30
119
56
186
90
255
130
465
486
353
723
W65–W74
Accidental drowning and
submersion
M
F
145
49
1
1
10
2
8
6
28
2
16
3
19
2
21
11
19
8
13
7
10
6
1
X00–X09
Exposure to smoke,
fire and flames
M
F
144
114
-
6
5
4
6
7
2
16
8
24
9
8
13
26
5
20
18
22
35
11
13
X40–X49
Accidental poisoning by and
exposure to noxious substances
M
F
666
304
-
1
3
2
66
33
218
51
205
81
97
61
45
42
19
15
7
12
6
6
X41
Accidental poisoning by and
M
exposure to antiepileptic,
F
sedative-hypnotic, antiparkinsonism
and psychotropic drugs,
not elsewhere classified
63
70
-
-
1
9
7
20
12
12
19
13
19
6
9
1
3
1
-
1
-
X42
Accidental poisoning by and
exposure to narcotics and
psychodysleptics [hallucinogens],
not elsewhere classified
M
F
325
64
-
-
1
-
34
14
143
16
107
15
29
9
7
6
2
3
1
-
1
1
X44
Accidental poisoning by and
M
exposure to other and unspecified F
drugs, medicaments and
biological substances
128
77
-
1
-
14
9
39
13
36
17
19
13
11
8
6
4
2
10
1
2
X59
Accidental exposure to unspecified M
factor
F
1,042
2,117
1
1
-
-
7
1
18
2
27
5
35
14
52
27
103
85
331
555
468
1,427
X60–X84
Intentional self-harm
M
F
2,511
803
-
-
1
2
217
58
454
130
635
163
488
170
341
130
178
63
129
55
68
32
X85–Y09
Assault
M
F
90
46
2
1
1
2
1
2
23
8
28
6
10
8
14
5
8
2
2
3
1
5
4
Y10–Y34
Event of undetermined intent
M
F
1,526
641
10
10
10
7
23
14
248
91
321
98
349
126
252
111
151
73
85
49
57
41
20
21
X60–X84,
Y10–Y34,
excl
Y33.9
Intentional self-harm; and event
M
of undetermined intent, excluding F
other specified events of
undetermined intent
3,487
1,231
1
3
1
2
12
6
340
105
647
183
876
253
673
256
443
188
238
100
173
85
83
50
X85–Y09,
Y33.9
Assault; and other specified
events of undetermined intent
640
259
11
8
10
7
13
12
148
52
156
51
118
44
81
30
57
17
27
15
14
16
5
7
M
F
* The figures for individual cause categories exclude deaths at ages under 28 days.
† Including sequelae of transport accidents.
Nati o n a l S t a t ist ic s
52
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Figure 2 shows the trends in age-standardised mortality rates
(standardised to the European Standard Population) for these three
cause of death groups between 1995 and 2005. The highest death rate
throughout the period for both sexes was for circulatory diseases, despite
the rate for males falling by 37.8 per cent to 2,591 per million population,
and the rate for females falling 34.5 per cent to 1,642 per million
population since 1995. The male and female death rates for cancer were
18.5 and 13 per cent respectively lower in 2005 than in 1995. The rate
for respiratory diseases in males decreased by 16.6 per cent over this
period, while the rate for females was 0.9 per cent lower in 2005 than
LQ5HVSLUDWRU\GLVHDVHPRUWDOLW\UDWHVLQDJLYHQ\HDUDUHVWURQJO\
LQÀXHQFHGE\WKHVHDVRQDOSDWWHUQRIPRUWDOLW\LQWKDW\HDUDQGVR
differences between two years should always be examined in the context
RIORQJWHUPWUHQGV&RPSDUDELOLW\UDWLRVKDYHEHHQDSSOLHGWRWKH¿JXUHV
IRU±LQRUGHUWRSURGXFHDFRQVLVWHQWWUHQGWKDWDGMXVWVIRUWKH
change to ICD-10 in 2001; see the Explanatory Notes.
LEADING CAUSES OF DEATH
Both Table 3 and Figure 3 show the ten leading underlying causes of
death in 2005 for both males and females. These are ranked according to
a World Health Organisation (WHO) list which categorises causes using
,&'JURXSVVSHFL¿FDOO\GHVLJQHGIRUGHWHUPLQLQJWKHOHDGLQJFDXVHV
of death; see the Explanatory Notes. Figure 3 also shows how the leading
causes of death for 2005 have changed since 2001.
The leading cause of death for both sexes was ischaemic heart diseases
ZKLFKDFFRXQWHGIRURQHLQ¿YHPDOHGHDWKVDQGDSSUR[LPDWHO\RQH
in six female deaths during 2005. Cerebrovascular diseases were the
second leading cause of death for both sexes and accounted for a higher
proportion of female deaths (12.9 per cent) than males (7.9 per cent).
Table 3
Summer 2006
The difference between the top two causes of death was greater among
males (a difference of nearly 30,000 deaths) whilst there was a difference
of around 7,500 deaths between ischaemic heart and cerebrovascular
GLVHDVHVLQZRPHQ$IXUWKHU¿YHFDXVHVRIGHDWKDSSHDULQERWKWKH
male and female top ten underlying causes but not at the same ranks.
For example while dementia is the fourth leading cause of death among
females, it ranks ninth among males.
Of the ten leading causes of death for males in 2005, different cancers
appeared four times compared with females where cancers appeared
three times. For females both cancers and circulatory diseases appeared
HTXDOO\WKUHHWLPHVHDFK)RUERWKVH[HVLQOXQJFDQFHUZDVWKH
most common cancer appearing third in the list for males and sixth for
females.
For females, the ranking on age-standardised rates does not match the
ranking on numbers of deaths, for example dementia and Alzheimer’s
disease is ranked four on number of deaths but would be ranked seven
if looking at the age-standardised rate. For males, the ranking on agestandardised rates matches that obtained when ranking on numbers. This
is because the age-standardisation process gives very little weight to
deaths at older ages (where most of the dementia and Alzheimer deaths
occur).
Figure 3 shows that for males, the age-standardised mortality rates for all
WKHOHDGLQJXQGHUO\LQJFDXVHVLQKDYHGHFOLQHGRYHUWKH¿YH\HDUV
since 2001. The largest percentage falls in male mortality rates were
for ischaemic heart diseases and cerebrovascular diseases which both
IHOOE\D¿IWKSHUFHQWDQGSHUFHQWUHVSHFWLYHO\7KHVPDOOHVW
decrease in mortality rates was for malignant neoplasm of the colon,
VLJPRLGUHFWXPDQGDQXVZKLFKIHOOE\SHUFHQWRYHUWKH¿YH\HDUV
Leading causes of mortality: by sex, 2005
England and Wales
Underlying Cause of death*
Numbers
Number of deaths
Percentage of all
deaths
Age-standardised
rate per 100,000
population
49,205
19,266
16,775
13,589
12,209
9,018
7,570
5,606
5,076
4,881
20.2
7.9
6.9
5.6
5.0
3.7
3.1
2.3
2.1
2.0
146.2
55.1
51.1
38.9
35.3
25.5
22.8
17.2
14.1
13.9
243,870
100.0
38,969
31,366
19,255
12,789
12,605
11,895
10,986
7,212
6,537
5,977
16.0
12.9
7.9
5.2
5.2
4.9
4.5
3.0
2.7
2.5
269,123
100.0
Males
Rank
1
2
3
4
5
6
7
8
9
10
Ischaemic heart diseases (I20–I25)
Cerebrovascular diseases (I60–I69)
Malignant neoplasm of trachea, bronchus and lung (C33, C34)
Chronic lower respiratory diseases (J40–J47)
Influenza and Pneumonia (J10–J18)
Malignant neoplasm of prostate (C61)
Malignant neoplasm of colon, sigmoid, rectum and anus (C18–C21)
Malignant neoplasms of lymphoid, haematopoietic and related tissue (C81–C96)
Dementia and Alzheimer’s disease (F01, F03, G30)
Aortic aneurysm and dissection (I71)
All deaths
Females
Rank
1
2
3
4
5
6
7
8
9
10
Ischaemic heart diseases (I20–I25)
Cerebrovascular diseases (I60–I69)
Influenza and Pneumonia (J10–J18)
Dementia and Alzheimer’s disease (F01, F03, G30)
Chronic lower respiratory diseases (J40–J47)
Malignant neoplasm of trachea, bronchus and lung (C33, C34)
Malignant neoplasms of female breast (C50)
Heart failure and complications and ill-defined heart disease (I50–I51)
Malignant neoplasm of colon, sigmoid, rectum and anus (C18–C21)
Diseases of the urinary system (N00–N39)
All deaths
68.5
51.8
29.8
18.7
25.1
28.9
28.2
11.2
14.1
9.9
* The cause of death groups used here are based on a list provided developed by WHO, modified for use in England and Wales. For more information see Griffiths C, Rooney C
and Brock A. Leading causes of death in England and Wales – how should we group causes? Health Statistics Quarterly 28, 6–17.
53
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Summer 2006
Age-standardised rates for the ten leading causes of deaths:* by sex, 2005 and comparison rate for 2001†
Figure 3
England and Wales
Males
Female s
Rate per 100,000 population
Rate per 100,000 population
( #! ')!(((/
*"%#")+#***1
''%+(*"'!(((/
))'-*,$)#***1
"!$$)$%&"(#%)' '%$ *($"*$
&3,&0&&,%'&#1
'%$!"%,''(&!')%'-!(((
/
%&+#&$0"#%)*#**
$0*$.$$*#%$!/
")'&#$'.))*(#)+')/#***
1
"!$$)$%&"(#%&'%())
$#!&&+&'($*%' +)"
)'&",*&$,&!
"!$$)$%&"(#%%"%$
(!#%!')*#$$*(/
$#!&&+&'($*%*' %$
)*+
"!$$)$%&"(#(%"-#& %!
#)%&%!)!$'"))!((*/
#$)!$". !#'(!((
)+ #$,)&'%($#+#'&*
&#$$12&")+#**1
$#!&&+&'($*%' '$'&*#!%'#)+,%
&&,*1
#***' +",)#&)/*/*+%
1
%')!$*'-(#$!(()!%$
*
†
The cause of death groups used here are based on a list provided developed by WHO, modified for use in England and Wales. For more information see Griffiths C, Rooney C
and Brock A. Leading causes of death in England and Wales – how should we group causes? Health Statistics Quarterly 28, 6–17.
For 2001 the mortality rates are given for the top ten causes of death in 2005 as a comparison.
Age-standardised mortality rates for females, by contrast, have not shown
a decrease since 2001 for all of the ten leading causes. While mortality
rates for ischaemic heart diseases showed the largest decrease of between
2001 and 2005 (22 per cent), rates for diseases of the urinary system
increased by nearly a third (32.4 per cent). Three other causes of death
also showed an increase in age-standardised mortality rates from 2001
to 2005 though to a lesser extent: dementia and Alzheimer’s disease (2.9
per cent); chronic lower respiratory diseases (0.7 per cent); and malignant
neoplasm of trachea, bronchus and lung (2.2 per cent).
EXPLANATORY NOTES
Registrations and occurrences
The year in which a death is registered may not correspond to the year in
which the death occurred. Up to 1992 ONS publications gave numbers
of deaths registered in the data year. However, since 1993 most of our
SXEOLVKHG¿JXUHVUHSUHVHQWWKHQXPEHURIGHDWKVWKDWRFFXUUHGLQWKHGDWD
year. In most years (and for most causes of death) this change has little
HIIHFWRQDQQXDOWRWDOV+RZHYHU¿JXUHVEDVHGRQGDWHRIRFFXUUHQFH
provide a more reliable basis for assessing the impact on mortality
RIH[WHUQDOIDFWRUVVXFKDVµÀXRXWEUHDNVRUFROGZHDWKHUZKLOH
registrations are more timely. We, therefore, take two annual extracts
from our deaths database.1
A change was made last year regarding the basis for presenting
underlying cause of death. The cause of death data in this report are
based on the cause of death as given in the death register and based on
WKHGRFWRU¶VRUFRURQHU¶VFHUWL¿FDWHRIFDXVHRIGHDWKWKLVLVNQRZQDVWKH
original underlying cause of death. Previously all ONS mortality statistics
ZHUHEDVHGRQ¿QDOXQGHUO\LQJFDXVHRIGHDWKZKLFKWDNHVDFFRXQWRI
any additional information provided by medical practitioners or coroners
after the death has been registered. The underlying cause of death only
changes in a very small number of deaths. In 2004 there were around 900
GHDWKVZLWKDGLIIHUHQW¿QDOXQGHUO\LQJFDXVHWRWKDWRULJLQDOO\JLYHQRQ
WKHFDXVHRIGHDWKFHUWL¿FDWH,QJHQHUDODOOIXWXUHUHJLVWUDWLRQVRXWSXWV
showing data for 2004 or later years will use original cause as the basis
for presenting cause of death data, while occurrence-based data (for
example, ONS annual reference volumes) will continue to be based on
¿QDOFDXVH
The exception will be where registration-based cause data is presented
in the same table as occurrences, for example, Table 6.3 in the reference
tables in +HDOWK6WDWLVWLFV4XDUWHUO\, when all data will be presented as
¿QDOFDXVHIRUFRPSDUDWLYHSXUSRVHV
Coding underlying cause of death
•
7KH¿UVWDQQXDOH[WUDFWSURGXFHGLQ$SULOIROORZLQJWKHGDWD\HDU
comprises deaths that were registered in that year. Outputs produced
using this extract include this report and a report by area of residence
published in the summer edition of 3RSXODWLRQ7UHQGV and reproduced
in the autumn edition of +HDOWK6WDWLVWLFV4XDUWHUO\, as well as the
annual Vital Statistics tables.
6LQFH-DQXDU\FDXVHRIGHDWKKDVEHHQFRGHGWRWKH7HQWK5HYLVLRQ
RIWKH,QWHUQDWLRQDO&ODVVL¿FDWLRQRI'LVHDVHVDQG5HODWHG+HDOWK
Problems (ICD-10).2 This was introduced on the recommendation of
:+2DQGUHSODFHGWKH1LQWK5HYLVLRQ,&'3 which had been in use
since 1979. ICD-10 represents the largest change in the ICD in over
\HDUV7KHPDMRUFKDQJHVKDYHEHHQGHVFULEHGLQGHWDLOLQ+HDOWK
6WDWLVWLFV4XDUWHUO\ 084 and 135 and also on the National Statistics
website (www.statistics.gov.uk/icd10mortality).
•
The second extract, produced in the September following the data
year, comprises deaths that occurred in that year. This extract forms
the basis for the mortality annual reference volumes in the DH series.
Cause of death is assigned by an automated coding system with the
exception of deaths due to external causes (ICD-10 codes V01–Y89).
7KHVHDUHFRGHGFOHULFDOO\XVLQJLQIRUPDWLRQIURPFRURQHUVFHUWL¿FDWHV
Nati o n a l S t a t ist ic s
54
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
LQFOXGLQJLQTXHVWYHUGLFWVWRSURGXFHFRQVLVWHQW¿JXUHVRQVXLFLGHV
homicides and other deaths not from natural causes.
Comparability ratios
,QRUGHUWRKHOSTXDQWLI\WKHFKDQJHVDULVLQJDVDUHVXOWRIWKHFKDQJHWR
ICD-10, ONS carried out a bridge coding study.6 All deaths registered
in 1999 were independently coded to both ICD-9 and ICD-10 and the
causes in each revision were compared using internationally agreed
JURXSVRIHTXLYDOHQWFRGHV&RPSDUDELOLW\UDWLRVZHUHSURGXFHGIRU
selected causes of death, including each ICD cause chapter, to indicate
WKHQHWHIIHFWRIWKHFKDQJHLQFODVVL¿FDWLRQRQDSDUWLFXODUFDXVH7KH
ratios were calculated by dividing the number of deaths coded to a
particular cause in ICD-10 by the number coded to that cause in ICD-9.
These ratios can then be applied to England and Wales data (from 1993
onwards) coded to ICD-9 in order to examine trends over time. For a
SDUWLFXODUFDXVHWKHQXPEHURIGHDWKVFRGHGWRWKHHTXLYDOHQWFDXVH
in ICD-9 is multiplied by the comparability ratio in order to give an
‘expected’ number of deaths that would have been coded to this cause
in ICD-10. The ratios can also be applied directly to rates, to give an
‘expected’ rate.
Population estimates
,QWKLVUHSRUWWKHSRSXODWLRQ¿JXUHVXVHGWRFDOFXODWHPRUWDOLW\UDWHV
IRUDUHWKHEDVHGSRSXODWLRQSURMHFWLRQVIRU7KHVHDUH
available on the Government Actuary’s Department website (www.gad.
JRYXN7KHSRSXODWLRQ¿JXUHVXVHGWRFDOFXODWHPRUWDOLW\UDWHVIRU
and earlier years are ONS mid-year population estimates.
The population estimates used were the most up-to-date at the time
of publication of this report. Population estimates for mid-2004 were
published on 20 December 2005. Estimates for 2003 and revised data
IRU±ZHUHSXEOLVKHGRQ6HSWHPEHU5HYLVHGHVWLPDWHV
for 1992–2000 were published on 7 October 2004. All these estimates
LQFRUSRUDWHWKH¿QGLQJVRIWKHORFDODXWKRULW\SRSXODWLRQVWXGLHVWKH
results of which were published in July 2004. Further information on
population estimates can be found on the National Statistics website
(www.statistics.gov.uk/popest).
Summer 2006
Leading Causes of Death in England and Wales
The cause of death groups used here are based on a list developed by
WHO which categorises causes using ICD-10JURXSVVSHFL¿FDOO\GHVLJQHG
IRUGHWHUPLQLQJWKHOHDGLQJFDXVHVRIGHDWK7KHOLVWKDVEHHQPRGL¿HG
for use in England and Wales. The use of this ranking list was agreed
after a period of public consultation which ended on 13th March 2006.
Further information on the rationale behind ranking leading causes of
death and how causes are grouped can be found in an article published on
WKLVVXEMHFWLQ+HDOWK6WDWLVWLFV4XDUWHUO\ 28.7
REFERENCES
2I¿FHIRU1DWLRQDO6WDWLVWLFV0RUWDOLW\6WDWLVWLFVFDXVH
series DH2 no 31, section 2.2.
2. World Health Organisation (1992–1994) ,QWHUQDWLRQDO6WDWLVWLFDO
&ODVVL¿FDWLRQRI'LVHDVHVDQG5HODWHG+HDOWK3UREOHPV Tenth
5HYLVLRQ9ROXPHVDQG:RUOG+HDOWK2UJDQLVDWLRQ*HQHYD
3. World Health Organisation (1977–1978),QWHUQDWLRQDO6WDWLVWLFDO
&ODVVL¿FDWLRQRI'LVHDVHV,QMXULHVDQG&DXVHVRI'HDWKNinth
5HYLVLRQ9ROXPHVDQG:RUOG+HDOWK2UJDQLVDWLRQ*HQHYD
5RRQH\&DQG6PLWK6,PSOHPHQWDWLRQRI,&'IRU
mortality in England and Wales from January 2000. +HDOWK6WDWLVWLFV
4XDUWHUO\08, 40–50.
5RRQH\&*ULI¿WKV&DQG&RRN/7KHLPSOHPHQWDWLRQRI
ICD-10 for cause of death coding – some preliminary results from the
bridge coding study. +HDOWK6WDWLVWLFV4XDUWHUO\ 13, 31–41.
2I¿FHIRU1DWLRQDO6WDWLVWLFV5HSRUW5HVXOWVRIWKH,&'
bridge coding study, England and Wales, 1999. +HDOWK6WDWLVWLFV
4XDUWHUO\ 14, 75–83.
*ULI¿WKV&5RRQH\&DQG%URFN$/HDGLQJFDXVHVRIGHDWKLQ
England and Wales – how should we group causes? +HDOWK6WDWLVWLFV
4XDUWHUO\ 28, 6–17.
55
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
S p r in g 2 0 0 6
Report:
Deaths involving Clostridium
difficile: England and
Wales,1999–2004
INTRODUCTION
7KLVLVWKH¿UVWUHSRUWRQGHDWKVLQ(QJODQGDQG:DOHVZKHUH&ORVWULGLXP
GLI¿FLOH was mentioned as a contributory factor. This report covers the
SHULRGWRDQGLQFOXGHV¿JXUHVIRUWKRVH\HDUVIRUZKLFK
ONS has coded all deaths to the tenth revision of the International
&ODVVL¿FDWLRQRI'LVHDVHV,&'6LQFH216KDVURXWLQHO\
coded deaths to ICD-10. Deaths registered in 1999 were coded to both
ICD-9 and ICD-10, and are also included in the analysis. As deaths in
ZHUHRQO\FRGHGWR,&'QR¿JXUHVDUHSUHVHQWHGIRUWKDW\HDU
BACKGROUND
This report examines trends in those deaths that involved &GLI¿FLOH as a
contributory factor between 1999 and 2004. &GLI¿FLOH is a spore forming
bacterium found naturally in the gut of a small proportion (around 3 per
cent)1 of the healthy adult population. &GLI¿FLOH can cause diarrhoea,
ranging from a mild disturbance to very severe illness with ulceration
and bleeding from the colon (colitis), and perforation of the intestine
leading to peritonitis, which can be fatal.2 &GLI¿FLOH disease occurs when
normal, healthy intestinal bacteria are subdued by the use of antibiotics.
This allows &GLI¿FLOHWRÀRXULVKLQWKHJXWDQGSURGXFHDWR[LQWKDW
causes diarrhoea.
Box One explains the terms used in this report.
&GLI¿FLOHZDV¿UVWGHVFULEHGLQWKHV3EXWLWZDVQRWLGHQWL¿HGDV
the cause of pseudomembranous colitis following antibiotic therapy until
the late 1970s.4-7 Patients who have been treated with broad spectrum
antibiotics (those affecting a wide range of bacteria, including intestinal
bacteria) are at the greatest risk of &GLI¿FLOH infection. In addition to
antibiotic exposure, the risk of contracting &GLI¿FLOH is also raised for
elderly patients, those who have recently had gastrointestinal surgery,
those who have a long length of stay in healthcare settings, and those
who have a serious underlying illness or a condition that compromises
their immune system.8, 9 Patients are also at risk of developing &GLI¿FLOH
disease when there are outbreaks in hospitals. Infection control is also an
important risk factor.
A recent Department of Health report addresses actions that should be
WDNHQWRUHGXFHOHYHOVRIKRVSLWDODFTXLUHGLQIHFWLRQV10 A report on &
GLI¿FLOH and actions to reduce the chances of outbreaks was released by
Nati o n a l S t a t ist ic s
56
the Health Protection Agency (HPA) in February 2003.11 In January
2004, the HPA began to carry out a mandatory reporting scheme for all
cases of &GLI¿FLOHin persons 65 years and over.125HVXOWVIURPWKH¿UVW
year’s surveillance (January to December 2004) were published by the
Department of Health.13
The number of deaths due to &GLI¿FLOHLVGLI¿FXOWWRHVWLPDWH7UHQGV
in mortality are normally monitored using the underlying cause of
death (the disease which initiated the train of events leading directly
to death). &GLI¿FLOHDQGRWKHUKRVSLWDODFTXLUHGLQIHFWLRQVVXFKDV
056$DUHRIWHQQRWWKHXQGHUO\LQJFDXVHRIGHDWK7KRVHZKRGLHZLWK
&GLI¿FLOH are usually patients who were already very ill and it may be
their existing illness, rather than &GLI¿FLOH, which is designated as the
underlying cause of death. There is therefore an interest in the number
of deaths where &GLI¿FLOH contributed to the death – only conditions
which contribute directly to the death should be recorded on the medical
FHUWL¿FDWHRIFDXVHRIGHDWKGHDWKFHUWL¿FDWH5HVXOWVSUHVHQWHGLQWKLV
report identify deaths where the underlying cause was &GLI¿FLOHand
WKRVHZKHUHLWZDVPHQWLRQHGRQWKHGHDWKFHUWL¿FDWHDVDFRQWULEXWRU\
factor.
METHODS
Identification of deaths involving Clostridium difficile
$OOGHDWKVDUHFRGHGE\WKH2I¿FHIRU1DWLRQDO6WDWLVWLFV216
DFFRUGLQJWRWKH,QWHUQDWLRQDO&ODVVL¿FDWLRQRI'LVHDVHV,&'VXSSOLHG
E\WKH:RUOG+HDWK2UJDQL]DWLRQ,QWKH7HQWK5HYLVLRQ,&'
XVHGE\216IURPRQZDUGVWKHUHLVDVSHFL¿FFRGH$IRU
‘Enterocolitis due to &ORVWULGLXPGLI¿FLOH’:KLOHWKLVFRGHLGHQWL¿HV
WKHYDVWPDMRULW\RIGHDWKVLQYROYLQJ&GLI¿FLOH, a small number of &
GLI¿FLOHrelated deaths are not captured by this code alone. Since 1993
216KDVVWRUHGWKHWH[WRIGHDWKFHUWL¿FDWHVRQDGDWDEDVHLQDGGLWLRQ
WRDOOWKH,&'FRGHVUHODWLQJWRFDXVHVLGHQWL¿HGRQWKHGHDWKFHUWL¿FDWH
This means that it is possible to identify records where &GLI¿FLOHis
PHQWLRQHGEXWLVQRWFRGHGXQGHUWKHVSHFL¿F,&'FRGH,QDGGLWLRQ
WRH[WUDFWLQJDOOGHDWKVUHODWHGWRWKHVSHFL¿F$,&'FRGHGHDWKV
mentioning a number of other ICD categories to which diseases including
&GLI¿FLOHcould be coded were also extracted. The text of these records
was then searched manually for mentions of &ORVWULGLXPGLI¿FLOH&
GLI¿FLOHRUSVHXGRPHPEUDQRXVFROLWLV,QWKH1LQWK5HYLVLRQRIWKH,&'
,&'WKHUHLVQRVSHFL¿FFRGHIRUµ(QWHURFROLWLVGXHWR&ORVWULGLXP
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
GLI¿FLOH’. Identifying deaths involving &GLI¿FLOHZRXOGWKHUHIRUHUHTXLUH
H[WHQVLYHWH[WVHDUFKLQJRIYHU\ODUJHQXPEHUVRIGHDWKFHUWL¿FDWHV
The ICD-10 codes used to select deaths to search manually are shown
in Table 1. ONS used ICD-10 coded data from 2001 onwards for this
report. All deaths registered in 1999 in England and Wales were coded
to both ICD-9 and ICD-10, to provide comparisons between the two ICD
UHYLVLRQV'HDWKVUHJLVWHUHGLQLGHQWL¿HGIURPWKHLU,&'FRGHV
as involving &GLI¿FLOH, are also included in this report.
Since 1986 ONS has used the internationally recommended death
FHUWL¿FDWHIRUQHRQDWDOGHDWKV7KLVPHDQVWKDWWKHVHGHDWKVFDQQRWEH
assigned an underlying cause of death.14 However, as the data for this
report were based on all mentions of &GLI¿FLOHor pseudomembranous
colitis, neonates have been included. Neonatal deaths were extracted in
the same way as described above for post-neonatal deaths.
Deaths with an underlying cause of death of &GLI¿FLOH were
LGHQWL¿HGE\VHOHFWLQJWKRVHGHDWKVZLWKDPHQWLRQRI&GLI¿FLOHor
pseudomembranous colitis that also had one of the underlying causes of
death noted in Table 1.
Derivation of place of death categories
The place of death categories used in this analysis have been derived
from three items of information recorded by ONS (Table 2). First,
the communal establishment code distinguishes between deaths in
FRPPXQDOHVWDEOLVKPHQWVZKLFKDUHJLYHQDFRGHVSHFL¿FWRWKH
particular institution) and those at home or occurring elsewhere. Second,
WKHHVWDEOLVKPHQWW\SHFRGHFODVVL¿HVFRPPXQDOHVWDEOLVKPHQWVLQWR
different types (e.g. hospital, hospice, local authority residential home).
Lastly, the NHS Indicator code shows whether the establishment was
NHS or non-NHS funded.
Spring 2006
RESULTS
Number of deaths where Clostridium difficile
contributed to the death or was the underlying cause
of death
7KHQXPEHURIGHDWKFHUWL¿FDWHVPHQWLRQLQJ&GLI¿FLOH increased each
year in England and Wales between 1999 and 2004 (Table 3). Figure
VKRZVWKHLQFUHDVLQJQXPEHURIGHDWKFHUWL¿FDWHVZKHUH&GLI¿FLOH
was mentioned since 1999. Mentions of &GLI¿FLOHRQGHDWKFHUWL¿FDWHV
increased from 975 in 1999 to 2247 in 2004. Overall the number of
deaths with a mention of &GLI¿FLOHwas 2.3 times higher in 2004 than it
was in 1999. Among deaths with a mention of &GLI¿FLOH, the percentage
for which it was the underlying cause was similar (around 55 per cent) in
each year (Table 3).
Mortality rates for all deaths mentioning Clostridium
difficile
Age-standardised rates for deaths involving &GLI¿FLOHin England and
Wales have more than doubled since 1999, from 11.4 to 23.6 per million
for males and from 10.7 per million to 23.4 per million for females
(Table 4). Overall, rates for deaths involving &GLI¿FLOH were very
similar for both males and females in each year (Figure 2).
Most of the deaths involving &GLI¿FLOHoccurred among people aged 65
DQGRYHU0RUWDOLW\UDWHVLQVSHFL¿FDJHJURXSVIRU(QJODQGDQG:DOHV
are shown in Table 5. Between ages 75 and 84, there were 208.4 and
214.7 deaths per million population for males and females respectively
in the period 2001 to 2004. This compares with 0.1 and 0.2 deaths per
million population, for males and females respectively, in the under 45
age group (Table 5).
Methods of analysis
This report presents the number of &GLI¿FLOH related deaths by sex, age
DQGSODFHRIGHDWK%RWKDJHVSHFL¿FDQGDJHVWDQGDUGLVHGGHDWKUDWHV
for &GLI¿FLOHare presented in this report. Age-standardised rates are
explained in Box One.
Number of death certificates mentioning
Clostridium difficile, by whether it was the
underlying cause of death, 1999–2004*
Figure 1
England and Wales
2,500
Specific and non-specific ICD-10 codes related
to Clostridium difficile
Specific codes*
Non-specific codes*
A04.7
(Enterocolitis due to
Clostridium difficile)
A05.8 (Other specified bacterial food borne intoxications)
A41.4
A48.0
A49.8
P36.5
(Septicaemia due to anaerobes (Excludes: gas gangrene))
(Gas gangrene: Clostridial; cellulites, myoncrosis)
(Other bacterial infections of unspecified site)
(Sepsis of newborn due to anaerobes)
* Codes used to identify deaths where C. difficile was the underlying cause of death
(on deaths where C. difficile was mentioned): A04.7, A09, A41.4, and A49.8.
Number of deaths
Underlying cause
Table 1
Mentions
2,000
1,500
1,000
500
0
1999
2000
2001
2002
2003
* Deaths registered in 1999. Deaths occurring in 2001–2004.
57
N a t i o n a l S t a t i s t i cs
2004
H eal th Stati sti cs Q u a r t e rly 3 0
Table 2
S p r in g 2 0 0 6
Derivation of Place of Death Classification
Place of death classification
Communal Establishment
Establishment type
NHS Indicator
Own home
NHS general hospital
Non-NHS general hospital
Hospice
NHS nursing home
Non-NHS nursing home
Home
Communal Establishment Code
N/A
General hospital or Multi-function site
General hospital or Multi-function site
Hospice
Homes for the chronic sick or Medical nursing home
Homes for the chronic sick, Medical nursing home,
Private nursing home or Private nursing home (aged)
Residential home (private)
Residential home (Local Authority)
All other codes
N/A
NHS
Non-NHS
Private residential home
Local Authority residential home
Other places
Table 3
Elsewhere
NHS
Non-NHS
Non-NHS
NHS
N/A
Number of death certificates with Clostridium difficile mentioned and as the underlying cause, 1999–2004
England and Wales
1999
2001
2002
2003
2004
% change
1999–2004
England and Wales*
Certificates mentioning C.difficile
Certificates where C.difficile was the underlying cause of death†
Percentage of mentions selected as underlying cause
975
531
54
1,214
691
57
1,428
756
53
1,788
958
54
2,247
1,245
55
130
134
England
Certificates mentioning C.difficile
Certificates where C.difficile was the underlying cause of death†
Percentage of mentions selected as underlying cause
918
499
54
1,150
661
57
1,338
709
53
1,702
912
54
2,155
1,187
55
135
138
Wales
Certificates mentioning C.difficile
Certificates where C.difficile was the underlying cause of death†
Percentage of mentions selected as underlying cause
56
31
55
63
29
46
88
46
52
85
46
54
88
55
63
57
77
* England and Wales data include non-residents who died in England and Wales. Data for England and Wales on their own exclude deaths of non-residents.
† Excludes neonatal deaths.
Table 4
Age-standardised mortality rates for Clostridium difficile by sex, 1999–2004
England and Wales
Rates per million population
1999
2001
2002
2003
2004
England and Wales*
Males
Females
11.4
10.7
13.1
12.8
15.5
15.1
18.6
18.8
23.6
23.4
106
120
England
Males
Females
11.6
10.6
13.2
12.9
15.3
15.1
18.8
19.0
23.9
23.9
107
126
Wales
Males
Females
9.5
11.6
11.9
10.6
17.9
15.1
13.7
15.9
16.7
16.2
76
39
* England and Wales data include non-residents who died in England and Wales. Data for England and Wales on their own exclude deaths of non-residents.
Nati o n a l S t a t ist ic s
58
% change
1999–2004
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Table 5
Spring 2006
Age-specific mortality rates for Clostridium difficile by sex, 2001–2004
England and Wales
Rates per million population
England and Wales*
England
Wales
Age group
Males
Females
Males
Females
Males
Females
Under 45
45-54
55-64
65-74
75-84
85 and over
0.1
1.4
5.2
39.5
208.4
832.0
0.2
1.6
7.5
37.8
214.7
789.8
0.1
1.3
5.2
40.3
212.0
832.6
0.2
1.6
7.8
37.8
218.3
798.0
0.0
1.3
4.3
27.8
154.2
806.7
0.9
2.6
2.8
39.0
152.7
647.1
* England and Wales data includes non-residents who died in England and Wales. Data for England and Wales on their own exclude deaths of non-residents.
Figure 2
Box One
Age-standardised mortality rates for
Clostridium difficile by sex, 1999–2004*
Glossary of Terms
England and Wales*
Clostridium difficile (C. difficile): is a spore forming bacterium which
is present as one of the ‘normal’ bacteria in the gut of up to 3 per
cent of healthy adults. It is much more common in babies – up to two
thirds of infants may have C. difficile in the gut, where it rarely causes
problems. People over the age of 65 years are more susceptible to
contracting infection.
25
Rate per million population
Males
Females
20
15
Diarrhoea: Diarrhoea occurs when the lining of the small or large
intestine is irritated. C. difficile toxins are a major cause of antibioticassociated diarrhoea. This leads to increased water being passed in
the stools. Acute diarrhoea is usually caused by a viral infection or a
bacterial infection and affects almost everyone from time to time. It
usually clears up in a couple of days and is not serious. However it
can be serious in babies and the frail and elderly, because of the risk
of dehydration.
10
5
0
1999
2000
2001
2002
2003
2004
* Deaths registered in 1999. Deaths occurring in 2001–2004.
Place of death
'HDWKFHUWL¿FDWHVUDUHO\VSHFLI\WKHSODFHZKHUHDQLQIHFWLRQZDV
DFTXLUHG+RZHYHUWKHSODFHRIGHDWKLVUHFRUGHG%HWZHHQDQG
2004, deaths involving &GLI¿FLOH made up 0.32 per cent of all deaths
in England and Wales. Among deaths that occurred in NHS general
hospitals and NHS nursing homes deaths involving &GLI¿FLOHmade
up 0.52 per cent and 0.45 per cent of the total in these institutions
respectively, or almost 5 per thousand deaths.
Most deaths in England and Wales occur in hospital (56 per cent of all
deaths between 2001 and 2004 occurred in NHS general hospitals).
Over the period 2001 to 2004, 92.4 per cent of deaths that mentioned
&GLI¿FLOHoccurred in NHS general hospitals. Many of these deaths in
hospital will have been to patients who were admitted because they were
already seriously ill with another condition.
Pseudomembranous colitis (PMC): is a complication of antibiotic
therapy often caused by C. difficile infection. PMC causes severe
inflammation in areas of the colon (large intestine). Almost any
antibiotic can cause PMC by upsetting the balance of the bacteria in
the gut and intestines.
Age-standardised rate: Directly age-standardised rates make
allowances for differences in the age structure of the population, over
time and between sexes. The age-standardised rate for a particular
disease is that which would have occurred if the observed age-specific
rates for the disease had applied in a given standard population. In this
report we have used the European Standard Population. This is
a hypothetical population standard, which is the same for both males
and females allowing standardised rates to be compared over time,
and between males and females.
Sources: Health Protection Agency/ NHS Direct Online/ Office for
National Statistics
59
N a t i o n a l S t a t i s t i cs
H eal th Stati sti cs Q u a r t e rly 3 0
Table 6
S p r in g 2 0 0 6
Number of deaths mentioning Clostridium difficile by place of death, compared to all causes of death, 2001–2004
England and Wales
Percentage of all
C.difficile deaths
C.difficile as a
percentage of all deaths
in the establishment
All cause number of deaths
Number of deaths
England and Wales*
Own home
NHS general hospital
Non-NHS general hospital
Hospice
NHS nursing home
Non-NHS nursing home
Private residential home
Local Authority residential home
Other places
Total
387,529
1,178,776
11,561
92,116
11,077
199,924
118,138
30,586
84,988
2,114,695
48
6,168
12
13
50
133
41
16
196
6,677
0.7
92.4
0.2
0.2
0.7
2.0
0.6
0.2
2.9
100.0
0.01
0.52
0.10
0.01
0.45
0.07
0.03
0.05
0.23
0.32
England
Own home
NHS general hospital
Non-NHS general hospital
Hospice
NHS nursing home
Non-NHS nursing home
Private residential home
Local Authority residential home
Other places
Total
362,252
1,097,719
10,892
89,363
10,923
188,764
112,284
28,720
76,922
1,977,839
47
5,864
12
12
50
123
40
16
181
6,345
0.7
92.4
0.2
0.2
0.8
1.9
0.6
0.3
2.9
100.0
0.01
0.53
0.11
0.01
0.46
0.07
0.04
0.06
0.24
0.32
Wales
Own home
NHS general hospital
Non-NHS general hospital
Hospice
NHS nursing home
Non-NHS nursing home
Private residential home
Local Authority residential home
Other places
Total
25,226
77,885
273
2,641
147
11,014
5,828
1,861
7,065
131,940
1
296
0
1
0
10
1
0
15
324
0.3
91.4
0.0
0.3
0.0
3.1
0.3
0.0
4.6
100.0
0.00
0.38
0.00
0.04
0.00
0.09
0.02
0.00
0.21
0.25
* England and Wales data include non-residents who died in England and Wales. Data for England and Wales on their own exclude deaths of non-residents.
REFERENCES
1. Knoop F C, Owens M and Crocker I C (1993) &ORVWULGLXPGLI¿FLOH:
clinical disease and diagnosis. &OLQLFDO0LFURELRORJ\5HYLHZV 6, 251.
2. Bartlett J G (1990) &ORVWULGLXPGLI¿FLOH: clinical considerations.
5HYLHZVLQ,QIHFWLRXV'LVHDVHV 12 Suppl 2, S243–51.
+DOO,&DQG2¶7RROH(,QWHVWLQDOÀRUDLQQHZERUQLQIDQWV
with a description of a new pathogenic anaerobe, %DFLOOXVGLI¿FLOXV
$PHULFDQ-RXUQDORI'LVHDVHVLQ&KLOGKRRG 49, 390–402.
4. Bartlett J G, Chang T W, Gurwith M, Gorbach S L and Onderdonk
A B (1978) Antibiotic-associated 3VHXGRPHPEUDQRXVFROLWLVdue to
toxin producing clostridia. 1HZ(QJODQG-RXUQDORI0HGLFLQH 298,
531–534.
*HRUJH5+6\PRQGV-0'LPRFN)%URZQ-'$UDEL<
6KLQDJDZD1.HLJKOH\05$OH[DQGHU:LOOLDPV-DQG%XUGRQ
':,GHQWL¿FDWLRQRI&ORVWULGLXPGLI¿FLOHas a cause of
3VHXGRPHPEUDQRXVFROLWLV. %ULWLVK0HGLFDO-RXUQDO 1, 695.
6. George W L, Sutter V L, Goldstein E J C, Ludwig S L and Finegold
S M (1978) Aetiology of antimicrobial-agent-associated colitis.
Lancet 1, 802–803.
7. Larson H E, Price A B, Honour P and Borriello S P (1978)
&ORVWULGLXPGLI¿FLOH and the aetiology of 3VHXGRPHPEUDQRXVFROLWLV.
/DQFHW 1, 1063–1066.
8. Health Protection Agency, 4XHVWLRQVDQGDQVZHUV± &ORVWULGLXP
GLI¿FLOH at www.hpa.org.uk/infections/topics_az/clostridium_
GLI¿FLOHJHQBLQIRKWP
Nati o n a l S t a t ist ic s
60
9. Department of Health, $VLPSOHJXLGHWR&ORVWULGLXPGLI¿FLOHat
ZZZGKJRYXNDVVHW5RRWSGI
10. Department of Health (2003) :LQQLQJ:D\V :RUNLQJWRJHWKHUWR
UHGXFH+HDOWKFDUH$VVRFLDWHG,QIHFWLRQLQ(QJODQG5HSRUWIURPWKH
&KLHI0HGLFDO2I¿FHU, Department of Health: London.
11. Health Protection Agency, 1DWLRQDO&ORVWULGLXPGLI¿FLOH6WDQGDUGV
*URXS5HSRUWWRWKH'HSDUWPHQWRI+HDOWKat www.hpa.org.uk/
LQIHFWLRQVWRSLFVBD]FORVWULGLXPBGLI¿FLOH),1$/&GLIIUHSRUWSGI
12. Health Protection Agency, 0DQGDWRU\&GLI¿FLOHDVVRFLDWHGGLVHDVH
&$'VXUYHLOODQFHVFKHPH at www.hpa.org.uk/infections/topics_az/
FORVWULGLXPBGLI¿FLOHPDQGDWRU\KWP
13. Department of Health, 5HVXOWVRIWKH¿UVW\HDURIPDQGDWRU\
&ORVWULGLXPGLI¿FXOHUHSRUWLQJ±-DQXDU\WR'HFHPEHU at
ZZZGKJRYXNDVVHW5RRWSGI
2I¿FHIRU1DWLRQDO6WDWLVWLFV0RUWDOLW\6WDWLVWLFV&KLOGKRRG
,QIDQWDQG3HULQDWDO6HULHV'+1R2I¿FHIRU1DWLRQDO
Statistics: London.
H e a l t h S t a t i s t i cs Q u a r t e r ly 3 0
Summer 2006
Other population and health articles, publications and data
Population Trends 124
Health Statistics Quarterly 31
Publication 29 June 2006
Planned
articles:
Reports:
•
•
•
•
•
•
Publication 24 August 2006
Net cohort migration in England and Wales: Low past
birth trends may influence net migration
Planned
articles:
Population definitions and the future of statistical
provision – what do users want
Administrative sources and population statistics
Estimates of the population by ethnic group in England
Live births in England and Wales, 2005: area of
residence
Death registrations in England and Wales, 2005: area
of residence
Reports:
Annual
Update
•
•
•
•
•
•
•
•
•
Suicide trends and geographical variations in the
United Kingdom, 1991–2004
Trends in premature mortality, England and Wales
1950–2004
Trends in deaths related to drug misuse, England
and Wales, 1993–2004
2001 Carstairs index of deprivation for England and
Wales
Residents and staff in communal establishments:
data quality issues in the 2001 Census
Infant and perinatal mortality, 2005: health areas,
England and Wales
Unexpected deaths in infancy, 2005
Death registrations in England and Wales, 2005:
area of residence
Mortality statistics: injury and poisoning, England
and Wales, 2004
Forthcoming Annual Reference Volumes
Title
Mortality statistics: injury and poisoning 2004, DH4 no. 29*
Planned publication
June 2006
* Available through the National Statistics website only; www.statistics.gov.uk
61
N a t i o n a l S t a t i s t i cs
H e al th Stati sti cs Q u a r t e rly 3 0
Nati o n a l S t a t ist ic s
Summer 2006
62