Health
statistics 03
Autumn 1999
Quarterly
IN THIS ISSUE
Page
In brief
2
Health indicators
4
Recent trends in deaths from homicide in England and Wales
Examines trends in deaths from homicide using routine death registration data
and compares these to data from the Home Office
Cleo Rooney and Tim Devis
5
Road traffic deaths: trends and comparison with DETR figures
Compares ONS and DETR data and explores trends in road traffic mortality
between 1982 and 1997
Olivia Christophersen, David Dix and Cleo Rooney
14
Multiple congenital anomalies in England and Wales 1992–97
Presents new data on multiple congenital anomalies and describes how these
data will be used for international comparisons
Beverley Botting, Rolv Skjaerven, Eva Alberman and Carole Abrahams
24
Social patterning of health and mortality: children, aged 6–15 years,
followed up for 25 years in the ONS Longitudinal Study
Examines the relationship between health and socio-economic circumstances at
different stages of the life course of children aged 6-15 years, followed up
for 25 years in the ONS Longitudinal Study
Seeromanie Harding, Michael Rosato, Joanna Brown and Jillian Smith
Annual Update: 1997 Mortality statistics: injury and poisoning
(England and Wales)
30
35
Tables
List of tables
Notes to tables
Tables 1.1–6.3
38
39
40
Reports:
Infant and perinatal mortality 1998: health areas, England and Wales
Sudden infant deaths 1998
Death registrations in England and Wales, 1998: area of residence
62
66
70
Recent ONS publications
76
London: The Stationery Office
A publication of the
Government
Statistical Service
Health Statistics Quar terl y 03
Autumn 1999
in brief
Changes to boundaries
of Regional Offices
The boundaries of the NHS Executive Regional Offices (ROs) changed on 1 April
1999.The former Regions of Anglia and Oxford, North Thames and South Thames
were replaced by a new regional structure, as follows:
●
●
●
a London RO, which covers the 16 health
authorities in Greater London;
a South East RO, which covers the 14
health authorities of East Kent, West Kent,
East Sussex Brighton and Hove, West
Sussex, East Surrey, West Surrey (all
formerly in the South Thames RO), Isle of
Wight, Southampton and South West
Hampshire, Portsmouth and South East
Hampshire, North and Mid Hampshire
(formerly in the South and West RO),
Berkshire, Buckinghamshire, Oxfordshire
and Northamptonshire (all formerly in the
Anglia and Oxford RO);
an Eastern RO, comprising the eight health
authorities of West Hertfordshire, East and
North Hertfordshire, South Essex, North
Essex (formerly part of North Thames RO),
Bedfordshire, Cambridgeshire*, Norfolk*
and Suffolk (all formerly part of the Anglia
and Oxford RO).
As a result of these changes, the South West
RO now excludes the Isle of Wight and the
three Hampshire health authorities (noted
above).
* Norfolk and Cambridgeshire health
authorities were created from 1 April 1999,
replacing the three former health authorities of
Cambridge and Huntingdon, East Norfolk and
North West Anglia.
Number of births
in 1997
Since publication of 1997 births data, an error
has been discovered on the births database. A
technical problem resulted in 1,002 records
being excluded from the published analysis.
The revised total number of births for 1997 is
646.5 thousand of which 3.4 thousand were
stillbirths. The total fertility rate remains
unchanged at 1.73.
Reference tables 2.1, 2.2, 3.1 and 3.2 have
been revised to show the correct figures and
more information will appear in Births
statistics 1998 (Series FM1 no. 27) which will
be published in December 1999.
Published 1998 births data are unaffected by
this problem.
2
Other topics covered in the study included the
use of emergency contraception, condom use
in relation to sexual health, and knowledge of
sexually transmitted diseases. The data form
one of the main sources of information on
contraceptive use and sexual health. Questions
were put to 7,500 adults at randomly selected
addresses in Britain and a report has been
published by Social Survey under the title
‘Contraception and Sexual health, 1997’.
For further information about the Omnibus
Survey contact Olwen Rowlands on 0171 533
5310.
Use of contraception:
Great Britain, 1997
Figure A
Pill
Sterilisation
Condom
Intrauterine
device
Withdrawal
Cap
Safe period
Other methods
None
No sexual
relationship
0
5
10
15
20
25
30
Percentage of women aged 16–49
Contraception and Psychiatric
morbidity among
health
prisoners
The ONS Omnibus Survey was used to mount
a series of questions on contraception for
several months in 1997/8. The results show
that one in seven women aged 16 to 49 were
not in a sexual relationship and one in eight
were not using a regular form of contraception,
but for those who were using contraception
three methods predominated. The
Office for National Statistics
contraceptive pill was the most popular
method, mentioned by a quarter of women in
the age group. The condom was the next most
common method but the permanent method of
sterilisation was just as popular.
Two new reports based on further analysis of
data from the Survey of Psychiatric Morbidity
among Prisoners in England and Wales were
published by ONS on 27th July 1999.
The survey, which was carried out by the
Social Survey Division of ONS on behalf of
Health Statistics Quar terly 03
the Department of Health, covered all prisons
in the country and involved interviews with
about 3,200 prisoners during the last quarter of
1997. The main report of the survey was
published in October 1998.*
The two new reports contain the results of
additional analyses which focus in more depth
on two topics of particular importance within
the prison population: substance misuse and
non-fatal suicidal behaviour.
Substance misuse among prisoners in
England and Wales (by Nicola Singleton,
Michael Farrell and Howard Meltzer) brings
together information on substance misuse from
the main report with the results of a range of
additional analyses such as smoking, age of
initiation of drug use and more details of
treatment for drug use. In addition, it considers
the co-occurrence of use of tobacco, alcohol
and illicit drugs and their association with
mental disorder.
High rates of substance misuse before coming
to prison were found among all sample groups.
The survey found very high levels of smoking
among the prison population: 85 per cent of
male remand, 78 per cent of male sentenced,
83 per cent of female remand and 81 per cent
of female sentenced prisoners were current
smokers. These rates are much higher than
seen in the general population and closer to
levels reported in surveys of homeless people
and residents of institutions catering for those
with mental illness.
A large proportion of both male and female
respondents reported a hazardous pattern of
drinking in the year before coming to prison.
Among the men, 58 per cent of remand
prisoners and 63 per cent of sentenced
prisoners reported hazardous drinking. The
equivalent figures for the women in the sample
were 36 per cent of remand and 39 per cent of
sentenced prisoners.
Very high rates of drug use and dependence
prior to coming to prison were also found, with
rates among remand prisoners being slightly
higher than among sentenced prisoners.
Among male remand prisoners, 10 per cent
reported moderate drug dependence and a
further 40 per cent severe drug dependence
(three or more symptoms of dependence),
while 11 per cent of male sentenced prisoners
reported moderate and 32 per cent severe
dependence in the year before coming to
prison. Among the women the equivalent
figures were 7 per cent of remand prisoners
reporting moderate dependence and 47 per
cent severe dependence with 8 per cent
reporting moderate and 34 per cent severe
dependence among sentenced prisoners.
Among male remand prisoners, 38 per cent
reported having used drugs during their current
prison term as did 48 per cent of male
sentenced, 25 per cent of female remand and
34 per cent of female sentenced prisoners. The
drug most frequently used was cannabis,
followed by heroin – other drugs were
mentioned far less frequently.
Respondents reported starting to use drugs at a
young age, with more than half starting to use
one of the six drugs considered in detail in the
survey before the age of 16. The median age
for starting cannabis use was the lowest (about
15), followed by amphetamines, then heroin
and cocaine powder, with crack use
commencing later at around 21 years.
About one in five of the men in the sample
who had used at least one of the six drugs
covered in detail in the questionnaire at some
time, reported having first used one of them in
prison. Women were less likely to report
starting to use drugs in prison – less than one
in ten remand prisoners and about one in seven
sentenced prisoners said a first episode of use
had occurred in prison.
The vast majority of respondents (over 85 per
cent) reported either smoking, hazardous
drinking or drug dependence in the year before
coming to prison. The co-occurrence of
substance misuse was also very common: 73
per cent of male remand, 68 per cent of male
sentenced and female remand and 55 per cent
of female sentenced prisoners reporting two or
more out of smoking, hazardous drinking or
drug dependence. The survey also found high
rates of co-occurrence of mental disorder and
substance misuse.
The section of the questionnaire on drug use
included questions on treatment, help or
advice for drug problems received both
within and outside prison. A third of the men
and half of the women assessed as being
dependent on drugs in the year prior to
coming to prison reported receiving some sort
of help for their drug problem in that year
before imprisonment. Considerably lower
proportions reported receiving help during
their current prison term (ranging from 20 per
cent of male remand prisoners to 32 per cent
of female sentenced prisoners). The exception
to this was among the male sentenced group
but this may be an artefact of the time spent
in prison. Those dependent on opiates were
more likely than those dependent on other
drugs to report receiving help or treatment
both outside and in prison.
The most common sources of help for drug
problems outside prison were Community
Drugs Teams and GPs or other practice staff.
Within prison, remand prisoners usually cited
prison medical staff as their source of help but
sentenced prisoners mentioned outside
agencies as the source of help as frequently as
they mentioned prison staff.
Women were more likely than their male
counterparts to report having been prescribed
methadone both before and in prison, but there
was no difference between remand and
sentenced respondents. About one in three
women and one in six men reported receiving
methadone treatment in the year before prison
and nearly one in four women in the month
before prison. These proportions decreased
slightly to about one in ten men and one in
four women when treatment in the month
before coming to prison was considered. In
general a smaller proportion reported receiving
treatment with methadone while in prison for
the current offence than had been receiving it
in the month before coming to prison. The
impact of coming to prison on continuity of
treatment for drug problems is illustrated by
the finding that less than a third of those who
reported receiving methadone treatment in the
month before coming to prison had received
methadone in the month immediately after
coming to prison.
Autumn 1999
Overall, the report indicates very high levels of
morbidity associated with tobacco, alcohol and
drug consumption. Given the high rates of
problems, the levels of help reported are
limited both within the community and the
prison setting.
The report on Non-fatal suicidal behaviour
among prisoners (by Howard Meltzer, Rachel
Jenkins, Nicola Singleton, John Charlton and
Mohammed Yar) identifies various factors
which distinguish those prisoners who had
attempted suicide in the past year from those
who had not. Within the analysis male and
female, remand and sentenced prisoners were
considered separately. Since the majority of
prisoners had been in prison for less than a
year at the time they were interviewed, most of
these suicide attempts will have occurred
outside prison. Therefore it is not surprising
that most of the factors associated with nonfatal suicide attempts are personal rather than
prison characteristics.
Eight factors emerged as distinguishing
between prisoners who had and had not
attempted suicide in the past year. Prisoners
who had attempted suicide tended to be
younger, white, suffer from a psychotic disorder
or have a severe neurotic disorder, take
psychotropic medication, have had a stay in
hospital for a mental illness, have poor social
support and have experienced several, stressful
lifetime events. The data analysis also showed
that different factors were relevant for men and
women and for remand and sentenced prisoners.
Prisoners who attempted suicide in the past
year tended to be young, white, single, born in
the UK and to have left school early and be
poorly educated. Ethnicity and age were the
most significant of these relationships.
Psychosis was found in about 5 per cent of the
non-suicidal group, but its prevalence was
substantially increased to between a quarter
and a half of those who had attempted suicide
in the last year. Neurotic disorder and alcohol
abuse, while both being fairly common among
prisoners were both much more common in
prisoners who had tried to kill themselves in
the last year.
Current psychotropic medication was three
times more likely in male prisoners and two to
three times more likely in female prisoners who
had attempted suicide in the previous year
compared with those who had not. Previous
admission to a mental hospital was two to three
times more likely in male prisoners and five to
six times more likely in female prisoners who
had attempted suicide in the previous year
compared with those who had not.
Suicide attempters were more likely to have
very small primary support groups and to have
a severe lack of social support. Suicide
attempters were also much more likely to have
experienced a variety of adverse life events,
both in the last six months and over the course
of their lifetime, particularly violence or
sexual abuse.
These two reports are available through ONS
Direct on 01633 812078, price £15 each.
* Singleton et al, Psychiatric morbidity among
prisoners in England and Wales, ISBN 0 11
621045 1, price £45, is available from The
Stationery Office.
3
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
Health indicators
Figure A
England and Wales
Population change (mid-year to mid-year)
Thousands
200
100
0
Net migration and
other changes
Natural change
Total change
8
7
–9
97
6
–9
96
5
–9
95
4
–9
94
3
–9
93
2
–9
92
1
–9
91
0
–9
9
–9
90
89
8
–8
7
–8
88
87
6
–8
86
–8
5
85
4
–8
–8
84
3
–8
82
83
2
1
–8
81
0
–8
80
79
–8
9
8
–7
78
7
–7
77
6
–7
76
5
–7
–7
74
75
3
–7
–7
73
72
72
1–
7
19
4
-100
Mid-year
Figure B
Age-standardised mortality rate
Rate per million population
20,000
15,000
10,000
5,000
0
1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998*
Year
* Provisional data.
Figure C
Infant mortality (under 1 year)
Rate per 1,000 live births
20
15
10
5
0
1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998*
Year
* Provisional data.
Figure D
Quarterly abortion rates – residents
Rate per 1,000 women 14–49
15
14
13
12
11
10
Abortion rate
9
8
1981
1982
1983
1984
1985
Office for National Statistics
1986
4
1987
1988
1989
1990
Year
Moving average rate
1991
1992
1993
1994
Provisional rate
1995
1996
1997
1998
1999
Recent trends in deaths
from homicide in England
and Wales
Cleo Rooney and
Tim Devis,
ONS
DATA ON HOMICIDES FROM DEATH
There are difficulties in using
data from routine death
registration to study mortality
from causes which are subject
to lengthy investigation.
However, once the effects of
adjourned inquests, delayed
registration and re-coding have
been overcome, it is apparent
that there has been an increase
in homicide rates in young men
over the last 20 years. Despite
some decline in homicide rates
at other ages, the highest rates
are still in infants while the
lowest rates in both sexes are in
children aged 5–14. The
increases in homicides in young
men and the decrease in older
men are similar to recent
trends in suicides.
REGISTRATIONS
Timely statistics on the annual number of homicides are difficult to
produce, if these are based on death registrations. Information about
these deaths only becomes available after legal processes which may
take many months to complete. Devis and Rooney found that in 1994
the median time to register a death eventually coded to homicide after
its occurrence was 3.2 months, compared with 2.6 months for all deaths
from external causes of injury and poisoning and only one day for
deaths from natural causes.1 However, this was an analysis of deaths
occurring in 1994 which had been registered by November 1995, and at
that point there were still many possible homicides yet to be assigned
their correct underlying cause of death. Five per cent of eventual
homicides were not registered within a year of the death occurring.
Thus a median delay of 3.2 months for homicides is almost certainly an
underestimate.
In England and Wales, all suspicious deaths, including all those due to
accidents or violence, must be reported to the coroner for investigation
before they can be registered.2,3 The coroner will usually order a post
mortem examination before opening an inquest. If the police report at
this point that charges are to be brought against anyone or that the death
is being investigated as homicide but the perpetrator has not been
identified, the coroner adjourns the inquest to await the results of
investigation and legal proceedings.
Since 1978 it has been possible to register deaths at this point – the so
called ‘accelerated registrations’.4 The coroner sends the registrar a
‘certificate of cause of death after inquest adjourned’. This gives
information on the injuries found at autopsy, and may give the
mechanism of injury (eg crushing, fire) but no verdict. ONS assigns a
temporary underlying cause code of E9888 (injury by other specified
5
Office for National Statistics
Health Statistics Q uar terly 03
Autumn 1999
means, undetermined whether accidentally or purposely inflicted)5 to
these deaths. Since 1993 ONS has also coded coroner’s verdicts or
‘manner of death’. Adjourned inquest deaths are assigned a code
indicating that the verdict is still ‘pending investigation’. Injuries are
coded as normal to chapter XVII of ICD–9. The coroner will normally
update ONS with the final verdict and cause of death when these are
known, which may be months or years later. ONS then updates the
coding on its dynamic national mortality database3 which holds
information on deaths since the beginning of January 1993.
Convictions for murder, manslaughter, and offences under the Children
Act, or Health and Safety at Work Act are used by ONS to assign the
underlying cause of death to homicide (ICD9 code E960–E969) (Box
One). A conviction for causing death by dangerous driving, and even a
manslaughter verdict for a motor vehicle death, will result in coding to
a motor vehicle traffic accident (E810–E819). ONS, like most
compilers of vital statistics, uses an epidemiological definition of
homicide (that one person has been killed by another, not accidentally)
rather than a strict legal definition. ONS would still code a death as
homicide, for example, if the perpetrator was found not guilty by reason
of insanity or could not be prosecuted. If ONS is informed that the
court or coroner has found that the death was in fact an accident or
suicide, the underlying cause of death is re-coded to reflect this.
In other cases, where legal proceedings have already been completed or
the death is known to have been homicide but no prosecution is
possible, the coroner completes the inquest before issuing a certificate
of cause of death. The certificate then includes the injuries, external
cause and coroner’s verdict or verdict of a higher court, if there has
been one, as to the intent of the perpetrator. Where the perpetrator has
Box one
HOMICIDE: VERDICTS, DEFINITIONS AND ICD–9 CODES
Verdicts used in ONS to code deaths to homicide (E960–E969)
Unlawfully killed
Homicide
Murder
Manslaughter (except in motor vehicle deaths - see text)
Causing death by: Cruelty under the Children and Young Persons Act
Negligence under the Health and Safety at Work Act
Broad cause groups
Definite homicide
Accelerated registration/probable homicide
Total homicide (definite and probable homicide)
ICD–9
E960–E969
E9888 with verdict ‘pending investigation’
E960–E969 and E9888 with verdict ‘pending
investigation’
External cause groups – homicide mechanism
Struck
Fire or scald
Poisoning
Suffocation
Drowning
Firearms
Cutting/piercing
Pushed
Other specified
Unspecified
ICD–9
E9600, E9682
E961, E9680, E9683
E962
E963
E964
E9650–E9654
E966
E9681
E9601, E965, E967, E9684, E9688
E9689, E969 and E9888 with verdict pending
Injury groups
Skull fracture
Intracranial injury, including haemorrhage
Injury to heart, lung and intra-thoracic organs
Open wounds and injuries to blood vessels of:
head and neck
chest
other and unspecified sites
Poisoning
Asphyxiation
Other specified injuries
ICD–9
800–804
850–854
860–862
Unspecified injuries, including ‘multiple injuries’
Office for National Statistics
6
870–874, 900, 920, 921, 925
875, 876, 901, 911, 922, 926
879
960–989
994
880–882, 884, 890–891, 903–908, 914, 863–868, 878,
902, 930–939, 924, 952, 958, 991, 993, 995, 997, 998,
9941, 805–848, 940–949
869, 919, 929, 959
Health Statistics Quar terly 03
Figure 1
Autumn 1999
Deaths from homicides in England and Wales 1950–97: original and updated numbers from ONS and Home Office
Number of deaths
800
700
600
500
400
300
200
100
0
1950 1952 1954 1956 1958 1960 1962 1964 1966 1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996
Year
ONS E960–E969 as published
ONS total – E960–E969 and E9888 'pending'
ONS E960–E969 latest from database
HO initially recorded
died, by suicide or other means, ONS uses the coroner’s inquest verdict
(usually ‘unlawful killing’) to assign the death to homicide. These
processes are described in detail in the latest ONS annual publication
on deaths from injury and poisoning.6
1
The number coded to ICD9 E960–E969 (homicide). This is the
basic ICD classification, to which all homicides should eventually
be assigned.
2
The number coded to E960–E969, plus those coded to E988.8. This
takes account of accelerated registrations, most of which are
eventually coded to a homicide code. This is a simple adjustment,
using published figures by underlying cause, without requiring
knowledge of the progress of inquest proceedings. It will include a
handful of deaths which were almost certainly not homicides, since
the inquest verdict was ‘open’.
3
The number coded to E960–E969, plus those coded to E988.8
where the ‘verdict’ is pending. This allows more exactly for
accelerated registrations which are likely to finish up coded to
homicide.
Deaths on the dynamic database coded to E988.8 at any given time will
include:
1
Deaths where an inquest has been adjourned and which have been
assigned this code, and a ‘pending’ manner of death, as a temporary
measure (as described above). Most of these will eventually be re–
coded on receipt of further information, and all but a few will be re–
coded either to homicide or to motor vehicle traffic accidents.
2 A very small number of deaths registered after a completed inquest
which delivered an ‘open’ verdict, and a cause of death of injury or
poisoning which could not be assigned to any more precise code for
death by injury and poisoning of undetermined intent (E980–E989).
These deaths will retain the E9888 code for underlying cause of
death.
When the 1995 annual extract was taken from this dynamic database (in
September 1996) 361 deaths were assigned to code E988.8 in total, of
which 28 had received an open verdict at an inquest and 333 were
adjourned ‘pending investigation’. By May 1998 the total number of
1995 deaths coded to E988.8 had fallen to 178, of which 32 had
received an open verdict and 146 were still ‘pending’ two and a half
years after the end of the data year. 6 When other (minor) re-coding was
taken into account it was found that 205 deaths for 1995 had been
reassigned from code E988.8 – of which about nine out of every ten
were eventually coded to homicide.
We can thus make three separate estimates of the number of annual
deaths from homicide:
HO currently recorded
For some purposes it might be appropriate to include deaths coded to
motor vehicle traffic accidents with a manslaughter verdict, or even a
serious driving offence. ONS is examining these alternatives at present,
and may present annual statistics for homicides in an amended form in
the future. 6
Homicides estimated by including deaths on which we do not have final
information may appear too uncertain to be of much use. However,
comparing these figures with those produced by the Home Office
provides some reassurance. Unlike ONS, the Home Office uses a legal
definition of homicide in their statistics. Home Office figures are based
on the year in which the offence was first recorded by the police, which
may not be the year that the death occurred or was registered. The
initial number recorded for the year may subsequently be reduced as a
result of decisions by the police or the courts that no offence of
homicide took place. 7 It cannot ever increase. Revised figures which
take account of these changes are published regularly by the Home
Office.
7
Office for National Statistics
Health Statistics Q uar terly 03
Figure 2
Autumn 1999
Average age-specific mortality rates from
homicide and probable homicide (E960–E969
and E988.8 ‘pending’ combined) in England
and Wales 1993–97 by sex
Figure 3
Method of homicide: England and Wales
1993–97 from Home Office as currently
recorded*
Percentage
Rate per million
100
50
45
80
40
60
35
30
Male
40
25
20
20
15
Female
10
0
5
Women
Men
Persons
Not known
Shooting
Blunt instrument
Burning
Strangluation
Sharp instrument
Other
Hitting kicking etc
–<
01 1
–0
05 4
–0
10 9
–1
15 4
–1
20 9
–2
25 4
–2
30 9
–3
35 4
–3
40 9
–4
45 4
–4
50 9
–5
55 4
–5
60 9
–6
65 4
–6
70 9
–7
75 4
–7
80 9
–8
4
0
00
85
us
pl
Age group
ONS deaths data are tabulated by the year in which they occurred, and
figures for homicides which occurred in a given year are now revised
upwards to take account of late registration, re–coding or reregistration. Though the figures cannot therefore be matched exactly,
they do show very similar patterns and trends since about 1960. In the
1950s numbers from death registrations were considerably lower than
homicides recorded by the Home Office, and may have been
incomplete. The closest correspondence is between Home Office
figures for deaths initially recorded as homicide, and ONS ‘total’ figure
– that is the sum of deaths certified as homicide, and coded to E960–
E969 in time for routine annual publication, plus deaths certified after
adjourned inquest coded to E9888 with verdict ‘pending’ (Box One,
Figure 1).
Figure 1 also illustrates the variation which may occur in ONS annual
figures due to differences in how long after the end of the data year the
data are extracted and analysed. The number of deaths coded to
homicide in the 1993 annual publication was the highest ever, whereas
the total including E9888 ‘pending’ was similar to the surrounding
years. The reason is that the annual extract for 1993 was taken 15
months later than usual, because of changes in our computer systems.
By that time, ONS had received updates on a much larger proportion of
accelerated registrations than usual.
A previous article by Noble and Charlton8 looked at trends in homicides
in England and Wales up to 1992, and discussed some of the problems
of using routine registration data. They showed that there had been
substantial increases in crude homicide rates between 1950 and 1980,
after which rates were largely stable up to 1992. We have taken this
opportunity to re-examine homicide mortality by year of death since
1979 using all available data, including late registrations and
corrections to the cause of death codes. Because the number of deaths is
fairly small we grouped them into five-year periods. One period, 1989
to 1992, is only four years. We chose to split the data between 1992 and
1993 because of the major changes in handling and processing which
began in 1993.9
Office for National Statistics
8
*
Source: Criminal Statistics, England and Wales 1997. TSO, 1998. Includes all
currently recorded homicides – 85 per cent of those initially recorded.
THE CURRENT PICTURE OF HOMICIDE IN ENGLAND AND
WALES
Homicide is a rare cause of death in England and Wales accounting for
about one in every 800 deaths, and about 4.4 per cent of deaths from
any form of injury or poisoning (accidents and violence, E800–E999).
Because the overall numbers are small and vary from year to year, we
have combined data on deaths which occurred in the five years 1993 to
1997 to describe the current pattern of deaths from homicide. Box One
shows the ICD–9 code groupings and definitions used in this article.
Death rates due to homicide are generally higher in males than in
females, the male to female ratio being highest in young adults and
lowest in children and the elderly (Figure 2). By far the highest
homicide rates in both sexes are in infants, with 44 homicides per
million per annum in males and 35 per million in females. Once past
infancy, rates fall rapidly so that they are lowest in both sexes between
the ages of 5 and 14. They rise again in young adults, with a plateau
around 12–15 per million in women from age 20 to 49, falling to
around 5 per million in middle age then rising in those over 80 to
around 12 per million. Men show a second peak around 33 per million
in their twenties which gradually falls to a low of 10 per million around
70 years of age, then rises again to 14 in those aged 85 and over.
METHODS OF HOMICIDE AND TYPE OF INJURY SUFFERED
Because we have included deaths for which final information was not
available, a remarkably large proportion of all homicides and probable
homicides combined are assigned to ‘unspecified’ codes as their
underlying cause. Adjourned inquests (E9888 ‘pending’) make up 27
per cent of all definite and probable homicides in the five years
between 1993 and 1997, and E9689 (homicide by unspecified means)
and E969 (homicide due to late effects of any type of injury
purposefully inflicted) together a further 22 per cent. For deaths before
Health Statistics Quar terly 03
Figure 4
Autumn 1999
Injury type by age group: total homicides (E960–E969 and E988.8 ‘pending’), England and Wales 1993–97
Percentage of all homicides in age group
Males
100
80
60
40
20
0
Under 1
1–14
15–24
25–34
35–44
45–54
Age group
55–64
65–74
75–84
85 plus
Total
55–64
65–74
75–84
85 plus
Total
Females
Percentage of all homicides in age group
100
80
60
40
20
0
Under 1
1–14
15–24
25–34
35–44
45–54
Age group
Unspecified injury including 'multiple'
Open wound and injuries to blood vessels, chest
Other specified injury
Open wound and injuries to blood vessels, head and neck
Asphyxiation
Injury intrathoracic organs
Poisoning
Intracranial injury and haemorrhage
Open wound and injuries to blood vessels, other and unspecified
Skull fracture
1993 this is even worse – for most years since 1979, 50–60 per cent of
all homicides were registered without an external cause being specified
(coded to E9888). Though some of these were updated later, and the
numbers assigned to homicide were published, the data are no longer
available for analysis in any detail.
However, figures published by the Home Office on criminal statistics7
do include methods of homicide. 98.6 per cent of deaths currently
recorded as homicides by the police and Home Office have an apparent
method reported (this represents approximately 85 per cent of those
initially recorded as homicide) (Figure 3). Assault with a sharp
instrument (stabbing) is the commonest method in males (38 per cent in
1993–97), followed by hitting or kicking (19 per cent), shooting (12 per
cent) and blunt instruments (11 per cent). In females, stabbing (28 per
cent) and strangulation or asphyxiation (27 per cent) together account
for more than half of homicides while hitting and kicking and blunt
instruments each make up about 11 per cent.
Information on the ‘secondary cause’ or main injury to the victim is
much better than that on method in ONS data – only about 10 per cent
are assigned to unspecified injuries or ‘multiple injuries’. Figure 4
shows the distribution of main injury by age and sex.
Over 60 per cent of all infant killings are due to skull fracture or
intracranial injury, including haemorrhage. About 10 per cent are from
suffocation or strangulation, and one in five due to other or unspecified
9
Office for National Statistics
Health Statistics Q uar terly 03
Figure 5
Autumn 1999
TRENDS FROM 1979 TO 1997
Infant homicide rates (total homicides,
including neonates) in England and Wales
1979–97 by sex
In infants there is considerable year to year variation because of the
small numbers, but no evidence of any trend between 1979 and 1997
(Figure 5). Average age-specific rates in women up to 69 years old are
very similar in the four periods since 1979 (Figure 6). Rates in men
however have risen in age groups between 15 and 44 and in those aged
50–54, while remaining steady in those aged 60–74 (Figure 6). There
was a 55 per cent increase in men aged 30–34, from 18 to 28 homicides
per million annually. In men aged 20–24 the average rates rose from 23
to 33 per million (a 47 per cent increase). Rates have actually fallen in
both men and women aged 75 and over. The greatest fall is 51 per cent
in men over 85, who were at higher risk of homicide than men at any
other age in the earlier period, but are now at lower risk than men aged
15–49. The figures for 1997, and to a lesser extent 1996, which are
based on data as at the end of December 1998 may not yet be complete.
However the expected further increase based on past experience would
not be more than 1.5 per cent for 1996 deaths and 4 per cent for 1997.
Thus the average rates for 1993–97 are not likely to underestimate the
increase, or overestimate the fall, in these age-specific rates by a
significant amount compared to the size of the observed changes.
Deaths per million infants
70
60
Male
50
40
30
20
Female
10
0
1979 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97
Year of death
kinds of injury. The pattern of injury at other ages is very different. In
older children there are very few head injuries, while poisoning,
asphyxia and ‘other specified’ causes account for over 60 per cent in
both girls and boys. In young men about a third of all homicides are due
to open wounds and injuries to blood vessels of head, neck and trunk,
and about 15 per cent to injuries to heart, lung and intrathoracic organs,
injuries which are consistent with stabbing as the commonest method.
In young women, a slightly smaller proportion (and therefore a much
smaller number) are attributable to open wounds, considerably less to
intrathoracic injuries and far more to asphyxiation, consistent with the
higher proportion due to strangulation or suffocation as method.
Figure 6
Rate per million
50
The higher rates of death from homicide in men than women are similar
to the pattern of deaths from injury and poisoning as a whole. Deaths
from disease are infrequent in young adults, so injury and poisoning
comprise a large proportion of deaths. Overall mortality rates from all
causes at ages 15–44 have fallen between 15 and 20 per cent in women
since 1979, but in men falls have been much more modest. Rates of all
cause mortality have actually risen in 30–34 year old men.10 Deaths
from many causes contribute to these changes. In particular, suicide,
including injury and poisoning of undetermined intent, rose by 30 per
cent in men aged 25 to 34 between 1983 and 1995. Rises in suicides in
men aged 15–24 and 35–44 were more modest, while those in older
men and women were falling or stable.11 Similarly, drug-related deaths
(poisoning with drugs whatever the intent, drug dependence and drug
abuse) have risen markedly in young men since the mid-1980s, but
fallen in young women.12 Motor vehicle traffic deaths, however, are
lower in young men now than in 1979, though rates in age groups 15–
44 appear to have risen slightly in 1996 and 1997.13
Age-specific homicide rates in England and Wales by quinnquenia
Rate per million
50
Males
45
1979–83
1989–92
45
40
1984–88
1993–97
40
35
35
30
30
25
25
20
20
15
15
10
10
5
5
0
Females
1979–83
1989–92
1984–88
1993–97
Age group
Office for National Statistics
–<
01 1
–0
05 4
–0
10 9
–1
15 4
–1
20 9
–2
25 4
–2
30 9
–3
35 4
–3
40 9
–4
45 4
–4
50 9
–5
55 4
–5
60 9
–6
65 4
–6
70 9
–7
75 4
–7
80 9
–8
4
00
85
85
00
–<
01 1
–0
05 4
–0
10 9
–1
15 4
–1
20 9
–2
25 4
–2
30 9
–3
35 4
–3
40 9
–4
45 4
–4
50 9
–5
55 4
–5
60 9
–6
65 4
–6
70 9
–7
75 4
–7
80 9
–8
4
0
s
u
pl
Age group
10
us
pl
Health Statistics Quar terly 03
Figure 7
Autumn 1999
Total homicides in men aged 15–44, 1979–97 by year of death and nature of injury
Number of deaths
350
300
250
200
150
100
50
0
1979
80
81
82
83
84
85
86
87
88
89
Year of death
90
91
92
93
94
95
96
Unspecified injury including 'multiple'
Open wound and injuries to blood vessels, chest
Other specified injury
Open wound and injuries to blood vessels, head and neck
Asphyxiation
Injury intrathoracic organs
Poisoning
Intracranial injury and haemorrhage
Open wound and injuries to blood vessels, other and unspecified
Skull fracture
Changes in homicide rates, particularly the falling death rates in older
men and rising rates in young men, are very similar to those reported
for suicide by Kelly and Bunting.11 The age and sex distribution and
time trends in deaths from homicides are also similar to those from
other sorts of injury and poisoning except motor vehicle traffic
accidents. The actual numbers of deaths though are much smaller. Even
in 20–24 year old men, homicide (including E9888 ‘pending’)
accounted for only 5.2 per cent of injury and poisoning deaths in 1991–
95 (3.5 per cent of all deaths) whereas 27 per cent were suicide, 11 per
cent undetermined intent, 36 per cent motor vehicle traffic accidents
and 20 per cent other accidents.
INJURIES AND METHODS OF HOMICIDE OVER TIME
As for other types of external causes of death, information on injuries
for homicides has been slightly less precise since 1993. This probably
reflects changes in the coroner’s certificate of cause of death after
inquest. 9 The cause of death section is now in the same format as in the
medical certificate of cause of death, and the coroner is no longer asked
to list the types of injury and the body parts affected. This seems to
have led to coroners recording less detail on injuries. As would be
expected, a larger proportion of deaths certified after adjourned inquest
and not yet updated (E9888 ‘pending’) do not have details of main
injury. Despite this, a main injury is coded for 90 per cent of homicides
and probable homicides combined.
Figure 7 shows a shift from skull fracture to intracranial injury in young
male homicides, with no apparent overall increase. This shift has also
been seen in motor vehicle traffic accident (MVTA) and other external
causes of death 13 and is probably due to a change in certification
practice by coroners and their pathologists using the new forms. There
97
is also an apparent shift from injuries of intrathoracic organs to open
wounds of head and trunk. Whether this is a real change in the pattern
of injuries, or another change in certification practice, is not clear.
We are unable to say which mechanisms of homicide have risen on the
basis of ONS data, because of the problems outlined above. Home
Office data 7,14 (Figure 8), show rises in the average number of
homicides by sharp instrument, blunt instrument, hitting or kicking and
shooting in 1993–97 compared to 1979–83, and falls in strangulation
and burning. The largest absolute rise is in homicides from sharp
instruments, from an average 175 per year in 1979–83 to 211 per year
in 1993–97. The greatest relative rise is in shooting, up 66 per cent.
However, shooting still accounts for only about 10 per cent (up from 6
per cent) of all recorded homicides (on average 61 deaths per year in
1993–97). The changes in the pattern of method, particularly the
increase in stabbings and shootings, are consistent with the rise in death
rates from homicide in young men who are most often killed through
open wounds and injuries to intrathoracic organs.
SOCIAL CLASS
Drever, Bunting and Harding15 showed a steep social class gradient in
standardised mortality ratios (SMRs) for homicide in England and
Wales. In 1991–93 men aged 20–64 in Social Class V (unskilled, SMR
300) were 12 times as likely to be killed as those in Social Class I
(professional and managerial, SMR 25). Though this was based on only
482 definite homicides (E960–E969 only), the differences from the
England and Wales figure were significant. 15 Deaths from accidents,
suicide and undetermined injury all have an inverse relationship with
social class, though that for homicide is much steeper than other
external causes except for deaths from accidental poisoning.15
11
Office for National Statistics
Health Statistics Q uar terly 03
Figure 8
Autumn 1999
Average numbers of recorded homicides* in
England and Wales 1979–83 and 1993–97 by
method
Figure 9
Average annual homicide rates by method of
homicide: selected recent years for countries
participating in ICE on injury
Number of homicides
United States 1995
250
Scotland 1986–95
Annual average 1979–83 HO (average total
532 homicides per year)
Israel 1993–95
New Zealand 1984–93
Annual average 1993–97 HO (average total
619 homicides per year)
200
Australia 1993–95
Cut/
pierce
Canada 1994–95
England and Wales 1993–95
Denmark 1994–95
150
Firearm
The Netherlands 1995
All
other
Norway 1990–94
France 1992–94
100
0
10
20
30
40
50
60
70
80
90
100
Deaths rate per million
Source: ICE on Injury.16
50
Figure 10
Age-specific homicide rates* per hundred
thousand population in England and Wales
and in the USA
n
ow
th
N
ot
O
kn
s
er
cle
hi
ug
or
or
ot
n
D
ve
ni
w
ro
dr
ng
g
in
rn
Bu
M
E
n
io
os
l
xp
iso
g
in
ot
o
Sh
Po
Bl inst S
un ru ha
t i me rp
ns n
H
tr t
itt
um
in
en
gk
t
i
ck
St
in
ra
ng g e
as lula tc
ph ti
yx on
iat o
io r
n
0
Rate per 100,000 population per year
25
England and Wales
1986–95
Method
Source:
Criminal Statistics, England and Wales 1997. TSO, 1998, and
same for 1989, HMSO, 1990.
* Includes all currently recorded homicides – 85 per cent of those initially
recorded.
20
USA 1995
15
Ratio USA:
England and Wales
INTERNATIONAL COMPARISONS
DATA ISSUES AND WHAT ONS CAN DO ABOUT THEM
The most serious problem with data on homicides from death
registrations is timeliness. This is because these deaths cannot be
registered until the coroner has completed an inquest, or adjourned it
Office for National Statistics
12
10
5
19
4
–2
4
25
–3
4
35
–4
4
45
–5
4
55
–6
4
65
–7
4
75
–8
4
20
15
–
9
–0
1
10
–1
05
01
–<
–0
4
0
00
ONS participates in an International Collaborative Effort on Injury
Statistics, aimed at assessing and improving the comparability of
routine vital and health statistics from a variety of countries. Recent
comparisons of homicide rates in participating countries16 (Figure 9)
show that mortality rates from homicide in England and Wales are
lower than those in Scotland, New Zealand, Israel, Australia and
Canada, even after including adjourned inquest deaths. They were
higher than Denmark, the Netherlands, Norway and France16 (though
French death registration figures almost certainly underestimate
homicides and other injury deaths because the Institut National de la
Santé et de la Recherche Médicale (INSERM) does not have access to
cause of death information on deaths subject to forensic
investigation). 17 The homicide rate in the USA is six and a half times
that in England and Wales. Firearm homicides alone accounted for an
extra 55 deaths per million population in the USA, 75 per cent of the
total difference, reflecting the enormous differences in the accessibility
of guns between the two countries. The difference between homicide
death rates in these two countries varies markedly with age. Infants are
only twice as likely to be killed in the USA as here, whereas the ratio in
15 to 19 year olds is 12.5 (Figure 10).
Age group
us
85
pl
* Males and females combined (note changed denominator to fit higher rates in USA).
when legal proceedings in a higher court are likely. For deaths subject
to inquest the delay from occurrence to registration has increased
considerably from a few days or weeks in the 1960s to several months
now.1 Even registration after adjournment usually involves weeks of
delay, and can take years (unpublished data). In Scotland all deaths are
registered within a few days using information from the medical
certificate of cause of death. Any later investigation or legal conclusion
is used to correct the data when it becomes available. A similar system
would only be possible in England and Wales if the law governing
death registration was changed. Civil registration is currently under
review by ONS with a view to modernising the service provided to the
public. This and other changes may be possible at some stage.
Health Statistics Quar terly 03
In the meantime, many people need to make use of these data and
cannot wait the two or three years needed to be sure that they are
complete. At any given time, the best estimate of homicide mortality in
preceding years is given by using deaths coded to E988.8 with verdict
‘pending’ in addition to those coded to the homicide range. This may
include a very small number of non-homicides but, depending on the
length of time since the data year, it may also be short by a few deaths
not yet registered. Unfortunately, this also means using data which are
still missing information about cause of death, particularly the methods
of injury. Since 1993, because the data are stored in a dynamic
database, we can update them at any time. We now publish updated
figures each year in the annual volumes of statistics on deaths from
injury and poisoning. We are also able to provide current data extracts
for users whose needs are not met by the routine publications.
ACKNOWLEDGEMENTS
The authors wish to acknowledge the International Collaborative Effort
(ICE) on Injury Statistics for contributions to this research. The ICE is
sponsored by the National Center for Health Statistics, UK Centers for
Disease Control and Prevention, with funding from the National
Institute of Child Health and Development, National Institutes of
Health. We also thank Professor Lois Appleby for his helpful comments
on an earlier draft.
REFERENCES
1
2
3
CONCLUSIONS
Despite the difficulties with these data, we have shown some interesting
trends and patterns which warrant further investigation. The similarities
over the past two decades in changes in homicide rates with suicide
rates (rising in young men while falling in the elderly), suggest areas
for further research. The methods used for homicide and suicide are
very different, but the social class pattern is similar. ONS plans further
study of the geographic and temporal patterns of injury deaths. We are
currently involved in further international studies aimed at improving
data comparability, and exploring the differences in risk for particular
population groups within countries, the variations in method or
mechanism of injury and the determinants of the differing risks for
various population groups between and within countries.
Key findings
●
●
●
●
●
The risk of dying from homicides is highest in babies
and lowest in children aged 5–14.
Males are at greater risk of being killed than females
at all ages.
Death rates from homicides have fallen in the
elderly over the past 20 years.
While in younger men they have risen by about 50
per cent on average .
Stabbings and shootings have both increased but
shootings still account for only 10 per cent of
recorded homicides.
Autumn 1999
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Devis T and Rooney C. The time taken to register a death.
Population Trends 88 (1997), 48–55.
Coroners Act 1988.
Devis T and Rooney C. Death Certification and the epidemiologist.
Health Statistics Quarterly 01 (1999), 21–33.
Office of Population Censuses and Surveys. Mortality statistics
England and Wales; Deaths from injury and poisoning 1978.
HMSO (London: 1980).
World Health Organisation. International Classification of
Diseases, Ninth Revision. WHO (Geneva: 1977).
Office for National Statistics. Mortality statistics: injury and
poisoning 1996, series DH4 no 21, pp xii–xxi. TSO (London:
1998).
Home Office. Criminal Statistics England and Wales: 1997. TSO
(London: 1998).
Noble B and Charlton J. Homicides in England and Wales.
Population Trends 75 (1994), 26–29.
Rooney C and Devis T. Mortality trends by cause of death in
England and Wales 1980–94: the impact of introducing automated
cause coding and related changes in 1993. Population Trends 86
(1996), 29–35.
Aylin P, Dunnell K and Drever F. Trends in mortality of young
adults aged 15–44 in England and Wales. Health Statistics
Quarterly 01 (1999), 35–39.
Kelly S and Bunting J. Trends in Suicide in England and Wales,
1982–96. Population Trends 92 (1998), 29–41.
Christophersen C, Rooney C and Kelly S. Drug related mortality:
methods and trends. Population Trends 86 (1996), 29–35.
Christophersen C, Dix D and Rooney C. Trends in motor vehicle
deaths in England and Wales. Health Statistics Quarterly 03 (1999),
in press.
Home Office. Criminal Statistics England and Wales: 1989. HMSO
(London: 1990).
Drever F, Bunting J and Harding S. Male mortality from major
causes of death. In Drever F and Whitehead M (Eds) Health
Inequalities. TSO (London: 1997).
Fingerhut L, Cox C and Warner M. International Comparative
analysis of injury mortality: Findings from the ICE on Injury
Statistics. NCHS Advance Data No 303, October 1998. NCHS,
CDC, US Department of Health and Human Services.
Lecomte D, Hatton F, Renaud G, et Le Toullec A. Les suicides en
Ile-de-France chez les sujets de 15 à 44 ans; resultats d’une étude
coopérative. Bulletin épidémiologique hebdomadaire 2 (1994), 5–6.
13
Office for National Statistics
Road traffic deaths: trends
and comparison with DETR
figures
Olivia Christophersen,
David Dix and Cleo Rooney,
ONS
INTRODUCTION
Road traffic mortality data
published by the Office for
National Statistics (ONS) are
compared with figures
produced independently by the
Department of the
Environment, Transport and
the Regions (DETR) to ensure
the quality of both datasets.
Trends in road traffic mortality
between 1982 and 1997 are
then explored according to age,
sex and mode of transport and
discussed with reference to
possible risk factors.The
geographical distribution by
place of accident and place of
usual residence of the deceased
are also compared and the
potential advantages of linking
ONS and DETR datasets are
examined.
Road traffic mortality in England and Wales is among the lowest in the
developed world and has been declining steadily since the 1960s.
However, in recent years this decline has halted and it is still an
important cause of death, particularly at younger ages. This article
presents trends in road traffic deaths between 1982 and 1997 by age,
sex, mode of transport and injury type. These trends are discussed with
reference to changes in possible risk factors over time. In addition, the
geographic distribution of deaths by place of accident and place of
residence of the deceased is examined and the rates for England and
Wales are compared with other countries. In order to ensure the quality
of the data published by ONS, they are compared with equivalent
figures compiled independently by DETR.
DEFINITIONS
In this article, road traffic deaths are defined as those deaths where the
underlying cause of death, according to the Ninth Revision of the
International Classification of Diseases (ICD9), is given as ‘motor
vehicle traffic accident’ (E810–E819) or ‘other road vehicle accident’
(E826–E829). This set of codes covers approximately the same deaths
as DETR’s definition of road traffic accidents.
Most road traffic deaths for which someone is found guilty of an
offence (such as causing death by reckless driving, driving without due
care and attention or even manslaughter) are included in this definition,
but the small number of crash deaths which are given a verdict of
suicide or natural causes are excluded. The latter includes cases where,
for example, a driver dies from a heart attack and so causes an accident.
Office for National Statistics
14
Health Statistics Quar terly 03
Figure 1
Autumn 1999
Comparison of ONS and DETR road traffic mortality data, 1982–97, England and Wales
Number of deaths
Number of deaths
1,800
1,800
Males
1,600
1,600
1,400
1,400
1,200
1,200
1,000
1,000
800
800
600
600
400
400
200
200
0
Females
0
1982
1984
1986
1988
1990
Year
1992
1994
1996
1982
1984
1986
1988
1990
Year
1992
1994
Motor vehicle DETR
Pedestrian DETR
Motor cycle DETR
Pedal cycle DETR
Motor vehicle ONS
Pedestrian ONS
Motor cycle ONS
Pedal cycle ONS
In the analysis presented here, modes of transport are grouped into four
main categories: ‘pedestrian’, ‘pedal cycle’ and ‘motor cycle’ which
covers all two-wheeled motor vehicles, and ‘motor vehicle’ which
includes all other motor vehicles. Data up to 1992 include all road
traffic deaths which occurred in each year and were registered by 1994.
Data from 1993 onwards include all deaths which had been registered
and entered onto the ONS mortality database when the annual extract of
deaths was taken, generally during the autumn of the following year. 1
The median time delay between occurrence and registration for road
traffic deaths is approximately 4.5 months, so most road traffic deaths
are included within the data used in this analysis, although a small
number will be excluded.2
Figure 2
Crude road traffic mortality rate for England
and Wales and number of licensed vehicles in
Great Britain, 1926/30–1991/95
Crude rate per million population
180
100,000 licensed vehicles
300
Road traffic mortality,
England and Wales
J
160
Licensed vehicles, Great Britain
J
250
J
140
J
120
200
J
COMPARISON OF ONS AND DETR MORTALITY DATA
J
100
J
150
80
J
100
60
J
40
J
0
30
–
26
19
J
J
J
0
35
–4
0
41
–4
5
46
–5
0
51
–5
5
56
–6
0
61
–6
5
66
–7
0
71
–7
5
76
–8
0
81
–8
5
86
–9
0
91
–9
5
J
50
J
36
20
31
–
In 1993, when ONS introduced an automated system for coding the
cause of death, there were some initial problems relating to the coding
of deaths attributed to external causes, including road traffic deaths.
These problems were corrected and revised figures for 1993 were
published. 3 However, to confirm the quality of ONS statistics, they are
compared here with figures on road traffic accidents compiled by
DETR. These are based on the accident report forms completed by the
police when they attend or are notified of a road accident involving a
personal injury. The routine statistics on road traffic accidents published
by DETR cover Great Britain as a whole3; so, for this analysis, figures
for England and Wales only were derived from DETR’s database.
There are various differences between the two datasets in terms of the
definitions employed and methods of data collection, but for the
purposes of comparing the overall trends in road traffic mortality, two
main differences need to be taken into account:
1996
Calendar period
Source: ONS 4 and DETR3
15
Office for National Statistics
Health Statistics Quar terly 03
Figure 3
Autumn 1999
Road traffic mortality by mode of transport, 1982–97, England and Wales
Age-standardised rates* per million
Age-standardised rates* per million
160
160
Males
140
140
120
Pedestrian
Motor cycle
Pedal cycle
Motor vehicle
120
100
100
80
80
60
60
40
40
20
20
0
Year
7
6
–9
95
5
–9
94
4
–9
93
3
–9
92
2
–9
91
1
–9
90
0
–9
89
9
–9
88
8
–8
87
7
–8
86
6
–8
85
5
–8
–8
84
82
19
83
7
6
4
–8
–9
95
5
–9
94
4
–9
93
3
–9
92
2
–9
91
1
–9
90
0
–9
89
9
–9
88
8
–8
87
7
–8
86
6
–8
85
–8
–8
83
84
5
0
84
–
82
19
Females
Year
* Three-year moving average.
●
●
ONS data are classified according to the date of death, whereas
DETR figures are based on the date of the accident.
ONS figures include all deaths certified as due to a road traffic
incident, no matter how long the period between the accident and
the death, while DETR include deaths which take place within 30
days of the accident, whatever the certified cause.
VARIATIONS BY AGE, SEX AND VEHICLE TYPE
Figure 3 gives European age-standardised road traffic mortality rates
for males and females from 1982 to 1997. Mortality from road traffic
incidents has declined by over 40 per cent among both sexes since the
early 1980s but it is still approximately three times higher among males
than females.
In view of the differences between the two datasets, the number of
deaths would not be expected to be exactly the same but they should be
broadly similar. Figure 1 gives the number of road traffic deaths for
men and women from 1982 to 1997 by vehicle type according to both
ONS and DETR data. There is very close agreement between the two
sets of figures suggesting that the quality of both datasets is reliable.
The slight differences can largely be explained by the differences in the
definitions and data collection methods described above. Most of the
remaining analysis is based on ONS data.
Deaths to motor vehicle drivers and passengers currently account for
around half the road traffic mortality among males, with pedestrians
accounting for about a quarter. The proportion of road traffic deaths
among men which involved motor cycles has fallen to less than a fifth
in 1997. Among women, motor vehicles and pedestrians account for
over 90 per cent of road traffic mortality, although the distribution
between these two groups has changed over time as pedestrian
mortality has fallen more than motor vehicle deaths. Pedal cyclists
account for only a small proportion of all road traffic accident deaths
among both males and females.
HISTORICAL PERSPECTIVE
Among men the most striking declines have occurred in pedestrian and
motor cycle mortality rates, both of which have halved since the early
1980s. Mortality among female pedestrians has also fallen dramatically,
by around 60 per cent over this period. For both men and women
mortality rates for motor vehicle occupants were more stable during the
1980s but started to decline in the 1990s. In recent years, agestandardised mortality rates for most vehicle types appear to have
levelled off or begun to increase slightly.
The number of deaths due to road traffic incidents in England and
Wales peaked in the late 1930s and again in the 1960s (Figure 2). Since
the mid 1960s, the crude rate has fallen by more than 60 per cent to 62
per million population in 1997. The decline in mortality in the 1940s
may be partly related to a fall in the number of licensed vehicles
together with limited availability of fuel at this time, although the later
decline, from the 1960s onwards, has been accompanied by a steady
increase in the number of licensed vehicles.4
Office for National Statistics
16
Health Statistics Quar terly 03
Figure 4
Autumn 1999
Age-specific road traffic mortality rates, 1982–97, England and Wales
Rate* per million
Rate* per million
350
350
Males
300
300
250
250
200
200
150
150
100
100
50
50
Females
Year
0–14
15–24
25–34
35–44
7
6
–9
95
5
–9
94
4
–9
93
3
–9
92
2
–9
91
1
–9
90
0
–9
89
9
–9
88
8
–8
87
7
–8
86
6
–8
85
–8
–8
84
2–
8
19
83
84
7
6
–9
95
5
–9
94
4
–9
93
3
–9
92
2
–9
91
1
–9
90
0
–9
89
9
–9
88
8
–8
87
7
–8
86
6
–8
85
5
–8
–8
84
2
8
19
83
4
–8
5
0
0
Year
45–54
55–64
65–74
75+
* Three-year moving average.
Figure 4 reveals declines in road traffic mortality at all ages for both
males and females between 1982 and 1997. Rates are highest among
the elderly (75 years and over) and men aged 15–24, although mortality
at these ages has declined substantially since the late 1980s. Mortality
at other ages has declined steadily since the early 1980s but at a slower
rate. The majority of the deaths among the elderly are to pedestrians,
although there are also a significant number among motor vehicle
occupants at older ages. High mortality rates among the elderly may be
partly because they are more likely to die than younger casualties
suffering the same severity of injury.
Figure 5
Road traffic mortality by age group, 1995–97,
England and Wales
Age-specific rate per million
The current pattern of mortality by age is given in Figure 5, which
shows a peak in the 15–24 age group for men which is more than three
times as high as the peak at ages 15–19 among women. Mortality rates
are lower among adults up to approximately retirement age but they
increase noticeably with age among the elderly. As road traffic
mortality is high at younger ages, road traffic accidents account for a
disproportionately large number of years of life lost. Road traffic
incidents currently account for around 3 per cent of the years of
working life lost among men and 1 per cent among women,
approximately 100,000 and 30,000 years respectively. This is lower
than the years of working life lost due to suicide, but higher than the
number due to drug-related deaths among males. In view of the high
rates at younger ages and the policy and health implications of this, data
for those aged 15 to 24 were analysed in more detail.
VARIATIONS BY VEHICLE TYPE AMONG 15–24 YEAR OLDS
350
300
250
Males
200
150
100
Females
50
Figure 6 shows the numbers of road traffic deaths aggregated over two
five-year periods, 1982–86 and 1993–97, for males and females. Data
are presented by single year of age for 15 to 24 year olds and by vehicle
type. The most striking feature is the sharp peak in motor cycle deaths
among 17 year old males and the steady decline in the number of deaths
with age in the earlier time period. Deaths to other motor vehicle
drivers on the other hand are much lower among men in their late teens
and more stable over this age range. By 1993–97 the number of deaths
among male motor cyclists in this age group had fallen dramatically, by
77 per cent, to well below the number among drivers of other motor
vehicles, and the peak at age 17 was no longer evident. The fall in
motor cycle deaths among young men was not accompanied by an
increase in other motor vehicle deaths, which declined slightly over this
period. A close inverse relationship between age and mortality was
observed for motor vehicle passengers during the later period, with a
peak at age 17 followed by a steady decline to age 24.
0–
4
5–
10 9
–1
15 4
–1
9
20
-2
4
25
–2
30 9
–3
35 4
–3
40 9
–4
45 4
–4
50 9
–5
55 4
–5
60 9
–6
65 4
–6
70 9
–7
75 4
–7
80 9
–8
4
85
+
0
Age
The pattern for women is very different over both time periods. In
1982–86 deaths generally decline with each year of age from about 18
17
Office for National Statistics
Health Statistics Quar terly 03
Figure 6a
Autumn 1999
Road traffic deaths by vehicle and occupant type, males aged 15–24 years, 1982–86 and 1993–97, England and Wales
Number of deaths
Number of deaths
500
1982–86
500
450
450
400
400
350
350
300
300
250
250
200
200
150
150
100
100
50
50
1993–97
0
0
15
16
17
18
19
20
Age in years
Motor vehicle driver
Figure 6b
21
22
23
15
24
Motor vehicle passenger
16
Motor cyclist
17
18
19
20
Age in years
Motor cycle passenger
21
22
23
Cyclist
24
Pedestrian
Road traffic deaths by vehicle and occupant type, females aged 15–24 years, 1982–86 and 1993–97, England and Wales
Number of deaths
Number of deaths
100
100
1982–86
90
90
80
80
70
70
60
60
50
50
40
40
30
30
20
20
10
10
0
1993–97
0
15
16
17
18
19
20
Age in years
Motor vehicle driver
Office for National Statistics
21
22
23
Motor vehicle passenger
18
24
15
Motor cyclist
16
17
18
19
20
Age in years
Motor cycle passenger
21
Cyclist
22
23
24
Pedestrian
Health Statistics Quar terly 03
Figure 7
Numbers of road traffic deaths by type of
injury, 1982–97, England and Wales
Number of deaths
6,000
Autumn 1999
GEOGRAPHICAL VARIATION
Figure 8 is based on DETR data and shows the place of accident for all
road traffic accidents between 1993 and 1997. The fatal accidents are
clustered in metropolitan areas, where road density is high. For males
there were also large numbers throughout the South East and the
Midlands. There were fewer fatal accidents in the North, South West
and Wales for both males and females.
5,000
The geographic distribution of road traffic deaths according to place of
usual residence of the deceased, derived from ONS data, shows a very
different picture. Figure 9 shows European age-standardised road traffic
mortality rates by local authorities, according to whether the rate for
residents was significantly higher or lower than the rate for England
and Wales as a whole, using 95 per cent confidence intervals. Mortality
rates were low in many metropolitan areas showing that, although a
large number of accidents take place in cities, people living in cities
have a lower risk of dying from road traffic deaths than for England and
Wales as a whole. Low rates were also observed in parts of South
Wales, while rates were above average in East Anglia and in the
Midlands.
4,000
3,000
2,000
1,000
0
1982
1984
1986
1988
1990
Year
1992
1994
1996
Skull fracture
(ICD9 800–804)
Internal injury – unspecified
(ICD9 869)
Neck/trunk fracture
(ICD9 805–809)
Internal injury – other
(ICD9 860–868)
Limb fracture
(ICD9 810–829)
Other
Intracranial injury
(ICD9 850–854)
years for most vehicle types. This pattern was particularly marked
among motor vehicle passengers who account for the highest number of
female deaths at each age except among 15 year olds. By 1993–97 this
decline in mortality with age was no longer apparent. Motor vehicle
passengers aged 16–18 years still accounted for the largest number of
deaths, although the number had fallen by a third since the earlier time
period and was still significantly lower than the corresponding figures
for male drivers and passengers.
This difference between place of death and place of residence is partly
due to high population densities in cities which result in a larger
number of accidents but lower population based rates. There is also
evidence that many road traffic accidents do not take place close to the
place of residence of the deceased. It is not currently possible to link
individual records from the ONS and DETR datasets, but the
relationship between the place of death and the area of usual residence
can be analysed based on the information collected at death registration.
The place of death is not necessarily the same as the place of accident,
but comparing area of death and area of residence can nevertheless give
some indication of whether or not fatal accidents tend to take place near
the home of the deceased. Table 1 gives the percentage of deaths to
residents in each Health Regional Office area in 1996 which occurred
outside these areas. This shows that a high proportion of deaths, over
one third on average, occurred outside the area covered by the NHS
Regional Office where the deceased lived.
NHS Regional Offices cover large areas, so this suggests that the deaths
took place at some distance from the homes of the deceased. However,
we cannot tell from these data how many were in fact short distances
across borders between two regions or how often injured patients are
transferred long distances for care.
Some of the fall in the number of deaths may be related to the fall in the
population aged 15–24 over this time period. However, this would not
account for all the decline, particularly the dramatic fall in motor cycle
deaths among young men. Other possible explanations are discussed
below.
Table 1
NATURE OF INJURY
The most striking feature revealed by the data on the nature of the
injuries responsible for road traffic deaths is the apparent decline in the
number of deaths attributed to skull fractures (ICD9 800–804) in the
early 1990s (Figure 7). This was observed for all vehicle categories,
including pedestrians, for both males and females. There was also a fall
in neck, trunk and limb fractures. Some of the decline in deaths due to
fractures may be associated with a change in the coroner’s form in 1993
which led to less detailed information on injuries being recorded.5 It
appears that many of the deaths previously attributed to fractures are
now classified as being due to internal injuries of the chest, abdomen
and pelvis (ICD9 860–869), which includes a large number of deaths
due to multiple injuries. The proportion attributed to intracranial injury
without mention of skull fracture (ICD9 850–854) has also increased
slightly.
Road traffic deaths to residents of Health Regional
Office areas who die elsewhere as a percentage of
all road traffic deaths of residents in each area,
1996
Health Regional Office area
Percentage of deaths
Northern and Yorkshire
Trent
Anglia and Oxford
North Thames
South Thames
South and West
West Midlands
North West
Wales
England and Wales
19
Males
Females
35
39
35
55
39
30
34
42
24
37
30
46
33
45
38
25
38
36
27
35
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
Figure 8a
Road traffic deaths by place of accident, males, 1993–97
Figure 8b
Road traffic deaths by place of accident, females, 1993–97
Office for National Statistics
20
Health Statistics Quar terly 03
Figure 9a
Autumn 1999
Road traffic mortality rates by local authority according to place of usual residence, males, 1993–97
Age-standardised rates
High (49)
Average (270)
Low (57)
Figure 9b
Road traffic mortality rates by local authority according to place of usual residence, females, 1993–97
Age-standardised rates
High (15)
Average (320)
Low (41)
21
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
INTERNATIONAL COMPARISONS
Figure 11
Road traffic mortality in England and Wales, as for injury and
poisoning deaths in general, is low compared with other similar
countries. A recent comparison of injury mortality in 11 developed
countries revealed that during the early 1990s, England and Wales had
the lowest rates from motor vehicle traffic accidents at all age-bands
considered (1–14 years, 15–24, 65 and over, and all ages).6 The notable
exception is pedestrian mortality which is about average compared with
other countries. There has been concern that pedestrian deaths among
children were higher in England and Wales than in most other countries
but ONS data suggest that these have declined along with other road
traffic deaths. The other countries covered by the study included
Scotland, where road traffic mortality is higher than in England and
Wales.
POSSIBLE RISK
FACTORS
There has been a sharp fall in the number of motor cycle and pedal
cycle miles travelled in recent years (Figure 10). Since the early 1980s
the estimated motor cycle mileage in Great Britain has roughly halved,
while pedal cycle mileage has fallen by around one third. 3 Similarly, the
distance walked per person has fallen by nearly 20 per cent since the
mid 1980s.7 These trends probably account for much of the long-term
reduction in deaths among users of these modes of transport. Over the
same time period the distance travelled using other motor vehicles has
increased dramatically. This increase may have contributed to a decline
in road traffic accidents in some areas where traffic speeds have been
reduced owing to increased volumes of traffic. Recent sales figures
reveal an increase in the popularity of motor cycles in recent years,8
which may partly explain the slight increase in motor cycle deaths in
1997.
Licensed vehicles and vehicle kilometres
travelled by mode of transport, 1982–97
Log scale
100,000
10,000
100m vehicle kilometres – Other motor vehicles
1,000
Licensed vehicles – Two-wheeled motor vehicles
100m vehicle kilometres – Two-wheeled motor vehicles
100m vehicle kilometres – Pedal cycles
10
1
1982
1984
1986
Fatal accidents involving
alcohol *
1988
1990
Year
Source: DETR 3
Office for National Statistics
22
1992
1994
Roadside screening breath
tests (thousands)
1,000
Positive/refused breath tests (thousands)
100
Percentage of breath tests positive/refused (thousands)
1
1982
1984
1986
1988
1990
Year
1992
1994
1996
* Estimated.
Source: DETR 3
Various legislative changes have also probably contributed to the
decline in mortality. In particular, the striking decline in motor cycle
deaths at young ages is likely to have been partly due to the
introduction of a two-part motor cycle test and the restriction of
provisional motor cycle licenses to two years in 1982, and to the change
in 1983 which limited learner motor cyclists to riding machines of up to
125cc. Stricter drink driving controls are likely to have contributed to
falls in mortality from all modes of transport. DETR figures show a
steady decline between 1982 and 1997 in the number of fatal road
traffic accidents in Great Britain involving alcohol, and in the
proportion of breath tests which are positive or refused4 (Figure 11).
The introduction of speed cameras may be a further contributory
factor, 9 although the impact of the introduction of seat-belt legislation
in 1983 is less clear. 10 Various other safety measures have been
introduced, including improvements in car design and engineering
measures on roads, which have been found to reduce road traffic
injuries at all ages.11
Improvement in treatment may also account for some of the
improvements in road traffic mortality.12 Data on hospital admissions
supplied by the Department of Health reveal that in the early 1990s the
number of admissions due to road traffic accidents was relatively
stable. The fact that the decline in deaths in the early 1990s was not
accompanied by a fall in hospital admissions may suggest that the
chances of surviving an accident improved as a result of improved
treatment or safety measures which have reduced the severity of
accidents. Another possible explanation is that a higher proportion of
patients with less severe injuries are now being admitted to hospital
following road traffic accidents. Data for 1995/6 to 1997/8 suggest
there has been an increase in hospital admissions following road traffic
incidents in recent years, but as the data currently available for these
years are provisional and are coded according to ICD10, comparisons
with earlier years are difficult.
Licensed vehicles – Other motor vehicles
100
Log scale
10,000
10
The clear decline in road traffic mortality may be related to various
possible risk factors and prevention measures, probably acting in
combination. It is likely that the explanatory factors vary between
modes of transport and at different ages. A major factor is changes in
the population at risk, in this case the number of people using different
modes of transport.
Figure 10
Drink driving statistics, 1982–96
1996
A DVANTAGES OF LINKING DETR AND ONS DATASETS
There are marked differences in the type of information recorded by
ONS and DETR so that linking the two sets would yield some useful
Health Statistics Quar terly 03
information. Until now this has not been possible as the only common
variables were age and sex. In 1999, DETR started to record the
postcode of the usual residence of casualties, which may make linkage
between the two datasets feasible, although other identifiers, such as
name and NHS number, would facilitate comprehensive linkage.
REFERENCES
As all road traffic deaths should be referred to a coroner, ONS receives
all the details of the deceased recorded on the coroner’s certificate, such
as marital status, occupation, place of usual residence and place of
death. The accident report forms from which DETR figures are derived
contain more detailed information on the circumstances of the accident,
such as the light, road and weather conditions, but geographical
information is limited to the place of the accident. As all vehicle and
casualty records relating to an accident are linked by a common
accident reference number, it is much easier to analyse accidents
involving multiple vehicles or casualties using DETR rather than ONS
data.
3
One notable advantage of linking DETR and ONS records is that it
would be possible to determine the length of time between an accident
and any death resulting from it. This has important policy implications
in terms of allocating resources to emergency treatment, hospital care
or safety measures to reduce the severity of accidents. Linking the
datasets would also make it possible to analyse the relationship between
the nature of injury, which is not recorded by DETR, and certain
accident details which are not collected by ONS at death registration.
These include more specific descriptions of the vehicles involved in an
accident, whether or not alcohol was involved, the time of day and, in
the case of casualties to motor vehicle passengers, whether they were
sitting in the front or rear seat.
SUMMARY
The close agreement between DETR and ONS data on road traffic
deaths indicates that both sources are probably reliable. The figures
reveal declines in mortality rates for most modes of transport and at
most ages between 1982 and 1997. There has been a particularly
marked fall in motor cycle deaths among young men; the number of
motor cycle deaths among 17 year olds in the 1990s was around one
tenth of the number in the early 1980s. There has also been a dramatic
decline in pedestrian deaths, particularly among the elderly. However,
in recent years mortality has levelled off or begun to increase for some
modes of transport, and road traffic incidents remain a major cause of
death at younger ages.
1
2
4
5
6
7
8
9
10
11
12
Autumn 1999
Office for National Statistics. Mortality Statistics: cause 1993
(revised) and 1994, Series DH2 no 21. HMSO (London: 1996).
Devis T and Rooney C. The time taken to register a death.
Population Trends 88 (1997), 48–55.
Department of the Environment, Transport and the Regions. Road
Accidents Great Britain: 1997 The Casualty Report. TSO (London:
1998).
Office for National Statistics. Mortality statistics: injury and
poisoning 1996, Series DH4 no 21. TSO (London: 1998).
Rooney C and Devis T. Mortality trends by cause of death in
England and Wales 1980–94; the impact of introducing automated
cause coding and related changes in 1993. Population Trends 86
(1996), 29–35.
Fingerhut et al. International Comparative Analysis of Injury
Mortality: Findings from the ICE on Injury Statistics. Advance data
from Vital and Health Statistics for Disease Control and
Prevention/National Center for Health Statistics 303. Department
of Health and Human Services (Maryland, USA: 1998).
Department of Transport. Transport Statistics Great Britain 1996
Edition. HMSO (London: 1996).
Griffiths J. ‘Grey’ imports drive up motorcycle sales. Financial
Times, 2.2.99.
West R. The effect of speed cameras on injuries from road
accidents. British Medical Journal 316 (1998), 5–6.
McCarthy M. The benefit of seat belt legislation in the United
Kingdom. Journal of Epidemiology and Community Health 43
(1989), 218–222.
Munro et al. Can we prevent accidental injury to adolescents? A
systematic review of the evidence. Injury Prevention 1(4) (1995),
249–255.
Roberts et al. Reducing accident death rates in children and young
adults: the contribution of hospital care. British Medical Journal
313 (1996), 1239–1241.
Key findings
●
●
●
●
●
There is close agreement between ONS and DETR
figures on road traffic deaths.
Road traffic mortality is around three times higher
among males than females.
Mor tality rates have fallen by over 40 per cent
among both men and women since the early 1980s.
The decline in mortality among young male motor
cyclists over this period is particularly dramatic .
In recent years the long-term decline in mortality
among users of all the main modes of transport has
halted or reversed.
23
Office for National Statistics
Multiple congenital
anomalies in England and
Wales 1992–97
Beverley Botting, ONS
Rolv Skjær ven, Section for
Medical Statistics,University
of Bergen, Norway
Eva Alberman, Wolfson
Institute and Carole
Abrahams, ONS
Many known human teratogens
result in groups of seemingly
unrelated anomalies, rather
than in a single anomaly. At the
Office for National Statistics
(ONS) we currently monitor
individual anomalies. Our
current methods of surveillance
would not be able to detect the
small increase in a combination
of anomalies resulting from a
teratogen which can cause
multiple congenital anomalies.
This analysis presents new data
on multiple congenital
anomalies. It also describes how
these data will be used for
international comparisons.
INTRODUCTION
Congenital anomalies are one of the leading causes of childhood death
and morbidity in the developed world. During the last 50 years there
has been a growing public awareness of congenital anomalies and their
possible connection with environmental hazards. Many known human
teratogens, however, result in groups of seemingly unrelated anomalies,
rather than in a single anomaly. The prevalence of each associated
anomaly may only show a small increase in the presence of such a
teratogen. The prevalence of the resulting combination of these
anomalies, however, would show a significant increase.
In 1994 the National Congenital Anomaly System was reviewed by a
working group of the Registrar General's Medical Advisory
Committee.1 One of their recommendations was that ONS should
improve the sensitivity of its surveillance procedures. At ONS we
currently monitor individual anomalies. If exposure to a teratogen can
result in a single anomaly, this type of surveillance is sufficiently
powerful to detect quickly a small increase in that anomaly. It would
not, however, be able to detect the small increase in a combination of
anomalies resulting from a teratogen which can cause multiple
congenital anomalies (MCAs). We have therefore decided to
incorporate a separate monitoring of MCAs into our routine
surveillance.
The aim of this paper is to estimate the current incidence of babies with
two or more seemingly unrelated anomalies in England and Wales. We
have calculated Odds Ratios for combinations of anomalies and discuss
our results. These results will be used to set baselines for future
monitoring and to compare with international data.
Office for National Statistics
24
Health Statistics Quar terly 03
BACKGROUND
Many known human teratogens result in groups of anomalies which
were previously not known to be related.2 One example is rubella
infection, which can result in cataracts, deafness, and/or patent ductus
arteriosus (a cardiovascular anomaly). Another example is isotretinoin,
a drug used for acne. This drug can lead to anomalies of the ear, the
central nervous system, and the heart.
Identifying and monitoring MCAs is therefore an important part of
surveillance. Methods have been developed in recent years to analyse
groups of anomalies occurring in a single child. The aim is to discover
whether particular combinations are occurring more frequently than
would be expected by chance. If so, research can then investigate
whether any particular combination might be associated with a given
teratogen.
An MCA can simply be defined as the presence of two or more
anomalies in one child. ONS previously analysed data about such cases
in 1984.3 The main problem will always be how to decide which
groups of anomalies to monitor in order to detect an increase which
could be the result of a new teratogen. On the one hand one wishes to
retain as many separate categories as possible to identify specific new
combinations. On the other hand there are advantages in limiting the
number of defect categories so that the number of combinations is
manageable. We need a procedure to analyse all combinations of
anomalies and select those which occur more often than would be
expected by chance.
Multiple anomalies are monitored in several countries worldwide, as
well as by the two principal international organisations working on
congenital anomaly surveillance - The International Clearinghouse for
Birth Defect Monitoring Systems4 (the Clearinghouse) and EUROCAT
(a concerted action project of the EU for the Epidemiological
Surveillance of Congenital Anomalies).5 The Clearinghouse has devised
a list of anomalies that have been observed to occur in combination
with other seemingly unrelated defects. This list was discussed
extensively to take into account as much as possible accepted biological
and teratological knowledge and it is presented in the Appendix. We
have used this list as the basis for classifying our data from England
and Wales.
Autumn 1999
teratogen which does not affect one specific organ, but will affect any
organ or process if exposed during its sensitive period of development.
Also, exposure to different teratogens may be correlated. This could
result in the same infant being affected by several anomalies of
different etiology more often than expected by chance.
NATIONAL CONGENITAL ANOMALY SYSTEM
In England and Wales, as in many other parts of the world, we routinely
collect and analyse information on congenital anomalies. Since 1964
ONS has run the National Congenital Anomaly System which depends
on voluntary notification from Health Authorities. ONS set up the
notification system in the wake of the thalidomide epidemic and has
always had surveillance as its first priority. Its aim has been to pick up
early warnings of increased rates of congenital anomalies. These could
result from a new teratogen in the environment or an increase in
exposure to an existing one.
Notification to the England and Wales National Congenital Anomaly
System is not complete. 1 The level of ascertainment varies for different
anomalies, largely depending on how easily the anomaly can be
identified at birth. Those which are easily recognised at birth, such as
limb reduction defects, tend to be well notified, whereas others, such as
heart anomalies, tend to be less well reported. 6
DATA
USED
For these analyses we have used notifications to the England and Wales
National Congenital Anomaly System for 1992–1997. We receive
written descriptions of anomalies which are coded centrally. On the
database prior to 1995 we hold only coded information for notified
conditions, coded using the Ninth Revision of the International
Classification of Diseases (ICD9). From 1 January 1995 we began to
use ICD10 7 and all the text provided is also held on the database.
The Clearinghouse list described above is designed for use with text
descriptions of the anomalies. We did not re-examine the text on our
original notification forms for this analysis, however, as this would
have been too labour intensive. Instead, after considering the text
descriptions of the appropriate ICD codes, we defined a mapping which
converted ICD codes as closely as possible to appropriate
Clearinghouse multiple defects categories.
OCCURRENCE OF MULTIPLE ANOMALIES
We might expect that the chance of a baby having any given anomaly is
independent of their having any other anomaly if each anomaly is due
to an independent etiologic agent. If this were so, then the chance of
having a combination of two different anomalies would be the two
separate probabilities multiplied together. In reality, the probability of
many combinations of two anomalies occurring together is greater than
the product of their separate probabilities.
There are many reasons for this phenomenon. A given group of
anomalies may be due to a common single etiologic agent. Such groups
include chromosomal and single gene syndromes (for example Down’s
syndrome). Alternatively, the combinations may be a sequence, which
means that the defects affect the same system or simultaneously
damage more than one system. An example of a sequence is spina
bifida plus hydrocephaly and clubfoot, the last two defects resulting
from the first one.
Alternatively, the etiology of a given grouping may not yet be
explained. These are the groupings of particular interest in this analysis.
The given anomalies may have been caused by an environmental
All conditions notified in the period 1992–94 had been coded using
ICD9. Notifications from 1995–97 had been coded using ICD10. We
therefore derived two versions of the mapping, one for use with each
ICD revision. We compared trends over the change in classification to
test whether the mapping was robust across the two ICD revisions. We
mapped the ICD codes onto the Clearinghouse list, ensuring that each
child had no more than one mention of each defect category on the list.
For example, if a baby was notified as having two different
cardiovascular conditions, which both mapped to ‘congenital heart
defects’, the record would only hold one occurrence of that mapping.
For each record we then counted the number of multiple defect
categories. All babies with chromosomal anomalies were removed from
the analysis. Our definition of a baby with MCA was a child with
anomalies which mapped to two or more codes from the list. These
data, which included sequences and same system anomalies, as well as
those of unknown etiology, were used for the remainder of this paper.
Odds Ratios (ORs) were calculated. This statistic measures whether the
particular combination occurs more often than would be expected by
chance. The ORs were calculated based on the limited population of
25
Office for National Statistics
Health Statistics Quar terly 03
Table 1
Autumn 1999
Numbers of babies notified to ONS by number of anomalies, 1992–97, England and Wales
Number of anomalies
Year
Total number
of babies
1992
1993
1994
1995
1996
1997
6,096
5,750
5,611
5,576
5,568
5,630
1
2
3
5,330
4,989
4,883
4,736
4,703
4,686
540
541
508
600
611
681
130
144
140
146
149
166
4
5
52
38
36
49
61
49
16
19
18
13
21
16
6
7
8
Number with
2+ anomalies
Percentage of all
babies with
2+ anomalies
13
9
11
19
14
14
7
4
10
7
4
8
8
6
5
6
5
10
766
761
728
840
865
944
12.6
13.2
13.0
15.1
15.5
16.8
Source: National Congenital Anomaly System as at 11 June 1999.
Table 2
Numbers of babies notified by number of defect categories, 1992–97, England and Wales
Number of defect categories
Year
1992
1993
1994
1995
1996
1997
Total
Total
number of excluding
babies chromosomal
6,096
5,750
5,611
5,576
5,568
5,630
5,582
5,329
5,185
5,152
5,110
5,191
0
1
722
688
734
698
756
753
4,423
4,221
4,053
3,983
3,885
3,969
2
331
339
300
357
362
385
3
4
5
6
7
Number with 2+
defect categories
Percentage of all
babies with
2+ defect categories
69
53
59
76
78
63
22
19
23
24
18
12
9
4
12
9
9
7
6
4
4
4
2
2
0
1
0
1
0
0
437
420
398
471
469
469
7.2
7.3
7.1
8.4
8.4
8.3
Source: National Congenital Anomaly System as at 11 June 1999.
babies with multiple congenital anomalies. Limiting the population in
this way improves our ability (reflected in the statistical power
calculations) to detect exposure to a teratogen, if the exposure of
interest is primarily associated with multiple defects rather than with
isolated defects.8
The period 1992–97 has been chosen because prior to this date there
was a major change which affected the data. We introduced an
exclusion list for notifiers on 1 January 1990. This list was based on
that used by EUROCAT and stated that notifiers did not need to report
minor anomalies such as small haemangiomas and positional talipes
unless they occurred in combination with other major anomalies. After
we introduced the exclusion list the National Congenital Anomaly
System saw a fall in the number of notifications for these excluded
conditions. It took some time for notifiers to become familiar with these
changes, however, so numbers of notifications continued to fall through
both 1990 and 1991. Therefore the analysis here has been confined to
the period 1992–97, a period of relative stability after the rapid
decrease in the number of notifications.
The definition of a stillbirth was altered on 1 October 1992, to be a
baby born showing no sign of life after 24 completed weeks of
gestation. The previous definition was based on 28 completed weeks of
gestation. In reality we think that this change will only have had a
limited effect on our analysis since we know that stillbirths with
anomalies tend to be less well notified than live births.
RESULTS
Number of anomalies notified
Table 1 shows the original number of anomalies notified for each baby
in the years 1992–97. These were based on the data as notified to ONS
without any subsequent classification. Between 1994 and 1995 the
proportion of all notifications with two or more conditions notified
Office for National Statistics
26
increased from 13 to 15 per cent, subsequently reaching 17 per cent in
1997. This may be a real increase, or due to better ascertainment or
notification of multiple anomalies. It is probably, however, largely the
result of the introduction of ICD10 in 1995.
In ICD10 it has been possible to provide more precise coding for
several anomalies. Some conditions, which it was not possible to
distinguish under ICD9, can now be coded uniquely using ICD10.
Examples include omphalocele (an abdominal wall defect) and
transverse limb reduction defects (such as the complete absence of a
foot or arm). As a result, more of the conditions notified have been able
to be uniquely coded with the corresponding increase in number of
conditions coded. Over the period there have also been increases in
notification rates for some conditions which were not affected by the
ICD revision. One notable increase was for the eye anomalies,
anophthalmia and microphthalmia. This increase is likely to be due to
improved notification after the media concerns about these anomalies
and hypothesised associations with a pesticide, Benomyl.
Table 2 shows the number of babies with anomalies from two or more
of the defect categories on the Clearinghouse list. Some anomalies
reported for a given child affect the same body organ or system, so two
or more ICD codes may map to the same defect category. Therefore,
once the ICD codes have been reclassified to the Clearinghouse
multiple defect categories, there are fewer babies with anomalies from
two or more categories than in Table 1. Indeed, some babies only have
minor anomalies which are not included in the Clearinghouse defect
categories. These babies are shown in Table 2 as having ‘0’ anomaly
codes. The proportion of notified babies who have two or more
anomalies from this list is smaller than in Table 1, but shows a similar
change over the period. In each year 1992–97 there were 400–500
babies notified as having two or more anomalies from the list. Over 80
per cent of these babies had just two anomalies from the list. In 1995–
97, 8.4 per cent of all notifications related to babies with two or more
anomalies, an increase from 7.2 per cent in the earlier period, again
largely due to the change in ICD revision.
Health Statistics Quar terly 03
Table 3
Autumn 1999
Combination of defect categories which occurred more often than would be expected (OR >= 1.96) 1992–97,
England and Wales
Odds ratio
Same system
Other small intestinal atresias
A-microtia
Ano/microphthalmia
Anencephaly
Renal a/dysgenesis
Encephalocele
Gut malrotation
CHD anomalies and other structural heart defects
Holoprosencephaly
Spina bifida
Encephalocele
Other severe genitalia defects
Syndactyly
Limb reduction defects, transverse
Hydrocephaly
Encephalocele
Hypospadias
Limb reduction defects, transverse
Cystic kidney
Limb reduction defects, preaxial
Anorectal atresia
Microcephaly
Duodenal atresia
Renal a/dysgenesis
Spina bifida
Lung laringo-tracheal
Limb reduction defects, transverse
Other small intestinal atresias
Limb reduction defects, other types
Spina bifida
Oesophageal atresia
Gut malrotation
Other ear defects
Other eye anomalies
Spina bifida
Cystic kidney
Microcephaly
Other intestinal defects
Laterality situs inversus
Other brain defects
Encephalocele
Other brain defects
Bladder extrophy
Polydactyly
Limb reduction defects, preaxial
Other brain defects
Hydrocephaly
Other severe genitalia defects
Limb reduction defects, other types
Other urinary tract infections
Limb reduction defects, other types
Duodenal atresia
Other brain defects
Other intestinal defects
Other urinary tract infections
Other brain defects
Bronco-pulmonary (including lung hypoplasia)
Syndactyly
Other intestinal defects
Syndactyly
Microcephaly
Duodenal atresia
64.30
53.00
42.70
27.80
17.70
9.06
8.93
8.73
8.69
8.27
8.27
7.95
7.90
7.88
7.87
5.72
5.11
4.43
4.40
3.73
3.71
3.44
3.39
2.61
2.60
2.52
2.42
2.39
2.35
2.18
2.02
Sequence
Laterality situs inversus
Holoprosencephaly
Hypospadias
CHD anomalies and other structural heart defects
Diaphragmatic hernia
Holoprosencephaly
Other intestinal defects
Spina bifida
CHD anomalies and other structural heart defects
Bronco-pulmonary (including lung hypoplasia)
Holoprosencephaly
Spina bifida
A-polysplenia
Other severe cranio-facial defects
Bladder extrophy
Vessel anomalies
Bronco-pulmonary (including lung hypoplasia)
Cleft lip with cleft palate
Gastroschisis
Hydrocephaly
A-polysplenia
Renal a/dysgenesis
Cleft palate
Limb deformities (including clubfoot and hip anomalies)
86.10
20.50
17.30
15.10
8.56
8.31
5.16
4.73
4.36
3.93
3.51
2.72
Multiple congenital anomalies
Duodenal atresia
Cleft palate
Esophageal atresia
Microcephaly
Encephalocele
Oesophageal atresia
Anencephaly
Choanal atresia
Anorectal atresia
Other eye anomalies
Neck anomalies
Other eye anomalies
Ano/microphthalmia
Omphalocele
Omphalocele
Other axial skeleton defects
Other brain defects
Gut malrotation
Cleft palate
Anorectal atresia
Other small intestinal atresias
Duodenal atresia
Cleft lip (and palate)
Lung laringo-tracheal
Microcephaly
Duodenal atresia
Encephalocele
Microcephaly
Other brain defects
Other urinary tract infections
Anencephaly
Microcephaly
Other eye anomalies
Anencephaly
Laterality situs inversus
Craniostenosis
Lung laringo-tracheal
A-polysplenia
Duodenal atresia
Anorectal atresia
Omphalocele
CHD anomalies and other structural heart defects
Other severe genitalia defects
Other severe cranio-facial defects
Polydactyly
Other ear defects
Other severe cranio-facial defects
Diaphragmatic hernia
CHD anomalies and other structural heart defects
Limb reduction defects, other types
Other severe cranio-facial defects
CHD anomalies and other structural heart defects
Choanal atresia
Limb reduction defects, preaxial
Cystic kidney
CHD anomalies and other structural heart defects
Choanal atresia
CHD anomalies and other structural heart defects
Other severe cranio-facial defects
Gastroschisis
Other eye anomalies
Other eye anomalies
Other small intestinal atresias
A-polysplenia
Gastroschisis
Lumbo/sacral axial skeleton defects
Cleft lip with cleft palate
Cleft lip with cleft palate
28.50
17.60
14.30
10.30
7.57
6.57
6.07
5.82
4.78
4.74
4.56
4.48
3.87
3.73
3.19
3.03
2.92
2.89
2.80
2.79
2.73
2.70
2.47
2.47
2.45
2.43
2.35
2.22
2.16
2.12
2.08
2.07
2.02
1.96
27
Office for National Statistics
Health Statistics Quar terly 03
Appendix
Autumn 1999
Total occurrences of multiple defect categories in all records with two or more codes, 1995–97, England and Wales
Anencephaly
Spina bifida
Encephalocele
Hydrocephaly
Microcephaly
Holoprosencephaly
Other brain defects
Ano/microphthalmia
Other eye anomalies
A-microtia
Other ear defects
Cleft lip with cleft palate
Cleft palate
Other severe cranio-facial defects
Choanal atresia
Craniostenosis
Neck anomalies
Oesophageal atresia
Anorectal atresia
Duodenal atresia
Other small intestinal atresias
Gut malrotation
Other intestinal defects
Gastroschisis
Omphalocele
Diaphragmatic hernia
Lung laringo-tracheal
Bronco-pulmonary (including lung hypoplasia)
CHD anomalies and other structural heart defects
Vessel anomalies
Hypospadias
Other severe genitalia defects
Renal a/dysgenesis
Cystic kidney
Other urinary tract infections
Bladder extrophy
Lumbo/sacral axial skeleton defects
Other axial skeleton defects
Limb reduction defects, transverse
Limb reduction defects, preaxial
Limb reduction defects, other types
Syndactyly
Polydactyly
Limb deformities (including clubfoot and hip anomalies)
Ring constriction or fibrotic band
Laterality situs inversus
A-polysplenia
Teratoma, sirenomelia
Total births
Observed
Rate per
10,000 births
Clearinghouse
baseline rates
per 10,000 births
Expected
number
1995–97
16
40
7
40
27
9
59
25
57
23
148
143
109
60
7
14
0
48
84
17
22
5
95
29
34
29
30
60
284
171
132
125
93
82
137
31
68
122
122
20
227
173
162
334
0
4
10
0
1995–97
0.08
0.21
0.04
0.21
0.14
0.05
0.30
0.13
0.29
0.12
0.76
0.73
0.56
0.31
0.04
0.07
0.25
0.43
0.09
0.11
0.03
0.49
0.15
0.17
0.15
0.15
0.31
1.46
0.88
0.68
0.64
0.48
0.42
0.70
0.16
0.35
0.63
0.63
0.10
1.16
0.89
0.83
1.71
0.02
0.05
-
1992–96
0.18
0.40
0.20
0.93
0.44
0.17
0.72
0.53
0.47
0.62
0.24
1.16
0.83
0.24
0.19
0.13
0.27
0.96
1.25
0.18
0.11
0.13
0.42
0.18
0.49
0.54
0.06
0.43
3.64
0.35
0.83
0.65
0.74
0.43
1.33
0.12
0.11
1.20
0.25
0.37
0.44
0.52
1.07
1.78
0.03
0.12
0.12
0.04
1995–97
35.94
77.32
39.29
182.23
86.52
33.86
140.44
103.24
91.12
120.37
47.65
225.70
161.75
46.81
36.36
24.66
52.25
188.08
243.67
35.11
21.32
25.91
82.34
35.11
94.88
104.91
12.54
83.59
710.12
68.13
161.75
125.81
145.03
84.01
259.56
22.57
21.32
233.22
49.32
72.73
85.68
101.98
208.98
346.91
6.69
23.82
23.41
7.94
0.45
0.52
0.18
0.22
0.31
0.27
0.42
0.24
0.63
0.19
3.11
0.63
0.67
1.28
0.19
0.57
0.26
0.34
0.48
1.03
0.19
1.15
0.83
0.36
0.28
2.39
0.72
0.40
2.51
0.82
0.99
0.64
0.98
0.53
1.37
3.19
0.52
2.47
0.28
2.65
1.70
0.78
0.96
0.17
0.43
-
1,949,056
Odds Ratios
Table 3 shows ORs which were significantly higher than expected
(greater than 1.96). The ORs have been calculated from data with
anomalies from two or more defects categories from the Clearinghouse
list for 1992–97 combined. The data are shown separately for those
combinations which are within the same body system, those which are
known to be sequences and those which are not known to be related. As
Office for National Statistics
O/E ratio
28
expected, there were strong associations amongst combinations
affecting closely related body organs or systems. For example, amicrotia (small or missing external ear organ) and ‘other ear defects’
had a high OR of 53. Similarly several sequences had raised ORs, but
this would be expected given our knowledge that they are more likely
to occur together. Among combinations of anomalies not known to be
related there were several with high ORs. Duodenal atresia and
laterality situs inversus had an OR of 28.50.
Health Statistics Quar terly 03
Autumn 1999
DISCUSSION AND THE WAY FORWARD
Key points
We plan to begin regular monitoring of multiple congenital anomalies,
so it is important to know how complete notification is to the National
Congenital Anomaly System. Khoury found more complete
ascertainment of congenital anomalies in regional registers compared
with the national programme in the USA.9 We plan to compare our data
with those notified to regional registers in England and Wales.
●
●
1
The review of the national system in 1994 recommended that ONS
could improve the quality of congenital anomaly data by exchanging
data with local congenital anomaly registers. We began to do this from
January 1999 using two volunteer registers - in Trent and in Wales. One
implication of this exercise is that in the future we would hope to
achieve more complete ascertainment both in terms of the number of
babies notified and in clinical accuracy. We would expect this to
increase the number of notifications of babies with two or more
anomalies from the Clearinghouse list. We expect to find that we can
improve ascertainment by exchanging information with the regions. As
a result we will need to alter our baselines for future monitoring.
One aim of this type of analysis is to detect increases in combinations
of anomalies which may give rise to hypotheses about potential new
teratogens. The national system does not include exposure data other
than limited occupation data. If the results of any analysis lead to a
hypothesis of exposure to a teratogen, however, it is always possible to
go back to the local notifiers. We can then seek additional exposure
information for all or for a sample of affected and control cases (for
example births which occurred in the same area and month).
●
ACKNOWLEDGEMENTS
Thanks are due to Pierpaolo Mastroiacovo and Aldo Rosano at the
International Centre for Births Defects in Rome for their advice.
REFERENCES
1
2
From 1999 we plan to submit our MCA data to the Clearinghouse on a
quarterly basis, thus facilitating international comparisons. The
Clearinghouse list, however, was designed for use with text descriptions
not coded material. Since 1995 we have held text on our computer
records as well as ICD10 codes. We will use ICD codes as an initial sift
to extract potential MCAs. We can then extract the relevant text to
select the true MCAs and forward these to the Clearinghouse.
3
4
5
6
CONCLUSION
We have shown that we can identify notifications of babies with two or
more seemingly unrelated congenital anomalies. In 1995–97, 8 per cent
of all notifications fell into this category. Since we can now also
retrieve the text descriptions we can extract appropriate cases and
submit details on these internationally. This is important, because even
in a large population such as ours, small numbers of multiple anomalies
require international collaborations to detect small increases in given
combinations of conditions and to search for possible teratogens. As our
data become more complete through data exchange we will be in an
even better position to help monitor this aspect of public health.
17 per cent of congenital anomaly notifications
describe more than one anomaly.
For 1998 data onwards ONS has started to monitor
multiple congenital anomalies (MCAs).
8 per cent of notifications related to babies with
two or more seemingly unrelated congenital
anomalies (MC As).
7
8
9
Office of Population Censuses and Surveys. The OPCS Monitoring
Scheme for Congenital Malformations. A Review by a Working
Group of the Registrar General's Medical Advisory Committee.
Occasional Paper 43. OPCS (London: 1995).
Khoury M J et al. Monitoring For Multiple Congenital Anomalies:
An International Perspective. Epidemiologic reviews 16, (2) (1994),
335–350.
OPCS Monitor. Monitoring Multiple Malformations MB3 84/3.
OPCS (London: 1984).
International Clearinghouse for Birth Defects Monitoring Systems.
Annual Report 1998 with data for 1996. International Centre for
Birth Defects (Rome: 1998).
EUROCAT Newsletter Vol. 5 no. 6 August 1991.
Payne J N. Limitations of the OPCS Congenital Malformation
Notification System illustrated by examination of congenital
malformations of the cardiovascular system in Districts within the
Trent region. Public Health 106 (1992), 437–448.
World Health Organisation. International Classification of Disease
and related health problems, tenth revision. World Health
Organisation (Geneva: 1992).
Friedman J M. The use of dysmorphology in birth defects
epidemiology. Teratology 45(2) (1992), 187–193.
Khoury M J, Waters G D and Erickson J D. Patterns and trends of
multiple congenital anomalies in birth defects surveillance systems.
Teratology 44 (1991), 57–64.
29
Office for National Statistics
Social patterning of health
and mortality: children, aged
6–15 years, followed up for
25 years in the ONS
Longitudinal Study
Seeromanie Harding, Michael
Rosato, Joanna Brown and
Jillian Smith,
ONS
Children aged 6–15 years in
1971 were followed up in the
ONS Longitudinal Study for 25
years.The relationship between
health and socio-economic
circumstances at different
stages of the life course was
examined. Measures of socioeconomic position in childhood
and adulthood were all
associated with health and
survival but the relationship
appeared strongest with the
most recent measure of socioeconomic position. This could
be because of the young age of
this sample as accidents and
injuries accounted for most of
the deaths. Health and survival
was poorest among those who
had experienced persisting
socio-economic disadvantage.
BACKGROUND
Several studies have examined the relationship between socioeconomic conditions in childhood and health in adult life.1,2,3 Recently
research has focused on the relative importance of influences at
different stages of the life course on adult health and disease risk.4,5,6
The notion of cumulative exposure over the life course has direct
relevance to policies that aim to arrest or reverse social deprivation.7 In
this study we use the ONS Longitudinal Study to assess the influence of
socio-economic position at different stages in life on health and
survival.
S TUDY SAMPLE AND METHOD OF ANALYSIS
The Longitudinal Study is a record linkage study that contains
information on individuals and households from censuses and routinely
registered vital events. Details of the study can be found elsewhere. 8 It
began in 1971 and is based on a representative 1 per cent sample (about
550,000) of the population of England and Wales. The current followup period extends to the end of 1995.
Children aged 6–15 years at the 1971 Census and living in a private
household were included in the analysis. This age restriction allowed
children to be at least 16 in 1981 (school leaving age), so that they
could be classified by their own socio-economic position in the 1981
and 1991 Censuses.
Socio-economic position was measured using three established
indicators 9,10 – occupation based social class, housing tenure and access
to cars as reported at the census. Own social class in 1981 was not used
as more than 25 per cent could not be classified. By 1991 however, the
proportion unclassified reduced to 8 per cent. In comparison, less than 5
Office for National Statistics
30
Health Statistics Quar terly 03
per cent could not be classified by access to cars or by housing tenure at
the three Censuses. Two outcome measures were used – death from any
cause which occurred between Census day 1991 and the end of 1995,
and the prevalence of limiting long-term illness in the 1991 Census.
The relative importance of childhood and of own socio-economic
position in later life on premature mortality during 1991–95, and on
morbidity was examined by fitting these measures individually and
simultaneously. Cumulative adverse exposure was measured by
summing the number of occasions an individual was included in a
particular socio-economic group at the 1971, 1981 and 1991 Censuses.
Age and sex adjusted relative risks of mortality were measured using
Cox regression, and of prevalence of limiting long-term illness using
logistic regression.
Table 1
Autumn 1999
Intergenerational mobility of children aged 6–15
years in 1971: parental socio-economic position in
1971 by own socio-economic position in 1981* and
1991
Own socio-economic position
1981/91 Census
Parental socio-economic position 1971
Social Class*
Non-manual 1991
Manual 1991
Unclassified 1991
Non-manual
%
50
26
25
Manual
%
44
66
62
Yes
%
77
61
37
24
No
%
23
39
63
76
Owner
occupied
%
75
69
23
15
Privately
rented
%
8
10
17
17
Unclassified All=100%
%
6
50,409
8
39,389
13
8,559
Car access
Conventionally in Longitudinal Study analyses, those who are not
found at a subsequent census or by registration of a vital event are
assumed to be lost to follow-up. Among all children who should have
been aged at least 16 in 1981, 5 per cent were not found at the 1981
Census or by the end of follow-up. Loss to follow-up of study members
was higher among children whose fathers were not classified to a social
class (8 per cent) or were living in privately rented housing (7 per cent).
This could introduce a small bias depending on whether they would
have remained in the same social grouping or not had they been
followed up. The numbers were small, however, and their exclusion is
unlikely to have had any significant effect on the results.
FINDINGS
Access 1981 and 1991
Access 1981, no access 1991
No access 1981, access 1991
No access 1981 and 1991
All=100%
39,891
4,243
9,959
5,584
Housing tenure
Owner occupied 1981 and 1991
Owner occupied 1981, rented 1991
Rented 1981, owner occupied 1991
Rented 1981 and 1991
*
Local
authority
%
17
21
60
68
All=100%
29,142
4,514
15,221
10,800
Own social class in 1981 was not used because a large proportion was not classified to a
class.
Trajectories of socio-economic position from
childhood to later life
Table 1 and Figure 1 show parental socio-economic position at the 1971
Census and own socio-economic position at the 1991 Census. All three
indicators show very similar patterns. There is a high degree of
similarity between parental and own circumstances. Those in the least
advantaged socio-economic position in 1981 and 1991 were more than
twice as likely to come from a disadvantaged than an advantaged
background. Of all those who were in a manual social class in 1991, 66
per cent had a parent in a manual occupation. Similarly, of those
without access to cars at both censuses, 76 per cent came from
households with no car access and, of those living in rented housing at
both censuses, 85 per cent were living in rented housing as children.
Figure 1
Intergenerational mobility of children aged
6–15 years in 1971: parental socio-economic
position in 1971 by own socio-economic
position in 1981* and 1991
Percentage
100
90
80
The influence of socio-economic circumstances in
childhood and in later life on mortality and limiting
long-term illness
70
Table 2 shows mortality by parental and own socio-economic position.
With the exception of housing tenure in 1981, consistent gradients in
mortality were seen for both parental and own socio-economic
positions, which suggest that childhood and later circumstances
contributed separately to mortality differences. For example, by
parental car access, mortality was 43 per cent higher among those with
no access to a car compared with that of those with access. By own car
access in 1981 the differential increased to 63 per cent, and by 1991 it
was more than twofold. However, after adjustment for both parental
and own car access, the differentials attenuated. The earlier measures of
car access were no longer significantly associated with mortality.
Mortality was therefore much more strongly associated with current
than with parental or earlier car access. Housing tenure showed a
similar pattern; the most recent measure of housing tenure showed the
strongest association with mortality differences after adjustment for
parental housing.
40
60
50
30
20
10
0
NonManual
class
Manual
class
Car
access
No car
access
Owner Privately Local
occupied rented Authority
Socio-economic cirumstances in childhood
Most disadvantaged socio-economic position in adulthood
Most advantaged socio-economic position in adulthood
*
Own social class in 1981 was not used because a large proportion was not
classified to a class.
31
Office for National Statistics
Health Statistics Quar terly 03
Table 2
Autumn 1999
Age and sex adjusted relative risks of mortality,
1991–95, of children aged 6–15 years in 1971:
parental socio-economic position in 1971 and own
socio-economic position in 1981* and 1991 by
socio-economic status
Table 3
Relative risks of limiting long-term illness in 1991
of children aged 6–15 years in 1971: parental socioeconomic position in 1971 and own socioeconomic position in 1981* and 1991
Unadjusted
Unadjusted
Adjusted †
Adjusted †
Parental Social Class 1971*
Non-manual
Manual
Unclassified
1.00
1.30
1.93 **
(0.96-1.75)
(1.19-3.12)
1.00
1.23
1.72 **
(0.90-1.69)
(1.06-2.81)
Own Social Class 1991*
Non-manual
Manual
Unclassified
1.00
1.08
2.57 **
(0.80-1.47)
(1.71-3.86)
1.00
1.01
2.35 **
(0.74-1.40)
(1.55-3.56)
Parental car access 1971
Yes
No
1.00
1.43 **
(1.09-189)
1.00
1.12
(0.82-1.52)
Own car access 1981
Yes
No
Non-private households
1.00
1.63 **
1.74
(1.22-2.19)
(0.89-3.43)
1.00
1.15
1.40
(0.82-1.61)
(0.70-2.79)
Own car access 1991
Yes
No
Non-private households
1.00
2.72 **
5.26 **
(2.02-3.66)
(2.32-11.94)
1.00
2.50 **
4.79 **
(1.81-3.46)
(2.07-11.06)
Parental housing tenure 1971
Owner occupied
1.00
Privately rented
1.14
Local authority
1.16
(0.73-1.76)
(0.87-1.56)
1.00
1.06
0.97
(0.67-1.69)
(0.68-1.40)
Own housing tenure 1981
Owner occupied
Privately rented
Local authority
Non-private households
1.00
0.94
1.32
1.63
(0.59-1.49)
(0.97-1.78)
(0.83-3.23)
1.00
1.86
1.16
1.35
(0.53-1.39)
(0.78-1.72)
(0.67-2.71)
Own housing tenure 1991
Owner occupied
Privately rented
Local authority
Non-private households
1.00
1.34
1.59 **
4.67 **
(0.83-2.17)
(1.14-2.23)
(2.06-10.61)
1.00
1.34
1.50 **
4.37 **
(0.83-2.18)
(1.04-2.17)
(1.89-10.08)
Total number of deaths
202
202
Parental Social Class 1971*
Non-manual
Manual
Unclassified
1.00
1.37**
1.83**
(1.26-1.49)
(1.59-2.10)
1.00
1.10 **
1.29 **
(1.01-1.20)
(1.11-1.49)
Own Social Class 1991*
Non-manual
Manual
Unclassified
1.00
1.62**
6.82**
(1.48-1.78)
(6.15-7.56)
1.00
1.57 **
6.56 **
(1.43-1.73)
(5.90-7.29)
Parental car access 1971
Yes
No
1.00
1.44**
(1.33-1.55)
1.00
1.10 **
(1.01-1.20)
Own car access 1981
Yes
No
Non-private households
1.00
1.72**
2.25**
(1.59-1.89)
(1.88-2.69)
1.00
1.23 **
1.70 **
(1.12-1.35)
(1.41-2.05)
Own car access 1991
Yes
No
Non-private households
1.00
2.79**
11.85 **
(2.57-3.04)
(9.58-14.66)
1.00
2.52 **
10.51 **
(2.30 - 2.76)
(8.46-13.06)
1.00
1.25**
1.42**
(1.10-1.41)
(1.31-1.54)
1.00
1.04
0.97
(0.91-1.19)
(0.88-1.08)
1.00
1.06
1.77**
2.37**
(0.93-1.21)
(1.63-1.93)
(1.97-2.83)
1.00
0.89
1.25 **
1.69 **
(0.77-1.02)
(1.11-1.39)
(1.40-2.05)
1.00
1.50**
2.95**
12.60 **
(1.31-1.73)
(2.71-3.21)
(10.18-15.61)
1.00
1.49 **
2.70 **
11.42 **
(1.30-1.72)
(2.46-2.98)
(9.18-14.21)
Parental housing tenure 1971
Owner occupied
Privately rented
Local authority
Own housing tenure 1981
Owner occupied
Privately rented
Local authority
Non-private households
Own housing tenure 1991
Owner occupied
Privately rented
Local authority
Non-private households
* Own social class in 1981 was not used because a large proportion was not classified to a
class.
† Adjusted for own and parental socio-economic circumstances.
** p<0.05
*
Own social class in 1981 was not used because a large proportion was not classified to
a class.
† Adjusted for own and parental socio-economic circumstances.
** p<0.05
With occupational social class the mortality of those who were
unclassified remained significantly associated with parental and own
class after adjustment but the effect was greater with own class in 1991.
A breakdown of the causes of death revealed that of the 418 deaths, 38
per cent (157) were due to accidents and injuries, 19 per cent (81) to all
malignant neoplasms, 12 per cent (52) to circulatory diseases, and 6 per
cent (23) to respiratory disease. Deaths from accidents and injuries may
explain why current socio-economic position was the most important
influence.
Limiting long-term illness at the 1991 Census showed similar patterns
(Table 3). Both childhood and later circumstances were important
predictors of illness before and after adjustment. As with mortality,
morbidity appeared more strongly associated with current than with
childhood or earlier socio-economic position.
Office for National Statistics
32
Cumulative socio-economic position and health
Table 4 and Figures 2a and 2b show mortality and limiting long-term
illness by cumulative measures of socio-economic position. Mortality
increased with the extent to which people were in disadvantaged
circumstances at different times in their life. Both morbidity and
premature mortality among those who remained without access to a car
at the three Censuses was more than three times higher than that of
those who remained with access. Similarly, mortality of those who
remained in rented accommodation at the three Censuses was 71 per
cent higher than that of those who remained in owner occupied housing.
Morbidity was more than two and a half times higher. Local authority
and privately rented housing were aggregated for reasons related to
both conceptual reasoning and the small number of events in the
privately rented group. Most of the deaths in the aggregated rented
grouping were attributable to those who remained in local authority
housing, but other work (not shown) has shown that mortality is also
generally high among those who remain in privately rented housing.
Health Statistics Quar terly 03
Figure 2a
Autumn 1999
Relative risks of premature mortality using that of those in the most advantaged socio-economic circumstances at all
three censuses as the baseline
Relative risk
(log scale)
Social Class *
Non-manual 2 censuses = 1.00
4.00
Car access
Yes 3 censuses = 1.00
Housing tenure
Owner occupied 3 censuses = 1.00
2.00
1.00
Manual 1971 Manual 1971 Unclassified
or 1991
and 1991
1971 or 1991
*
Yes 2
censuses
Yes 1
census
No 3
censuses
Owner
occupied
2 censuses
Own social class in 1981 was not used because a large proportion was not classified to a class.
Figure 2b
Relative risk
(log scale)
Owner
occupied
1 census
Rented 3
censuses
Relative risks of limiting long-term illness using that of those in the most advantaged socio-economic circumstances at
all three censuses as the baseline
Social Class *
Non-manual 2 censuses = 1.00
Car access
Yes 3 censuses = 1.00
Housing tenure
Owner occupied 3 censuses = 1.00
5.00
2.00
1.00
Manual 1971 Manual 1971 Unclassified
or 1991
and 1991
1971 or 1991
*
Table 4
Yes 2
censuses
Yes 1
census
No 3
censuses
Owner
occupied
2 censuses
Own social class in 1981 was not used because a large proportion was not classified to a class.
Relative risks of mortality, 1991–95, and limiting
long-term illness in 1991, by cumulative indicator
of socio-economic position
Mortality
Limiting longterm illness
Social Class*
Non-manual 1971 and 1991 Censuses
Manual 1971/ 91 Censuses
Manual 1971 and 1991 Censuses
Unclassified either 1971/91
1.00
1.17
(0.83-1.64)
1.21
(0.86-1.72)
2.46** (1.78-3.40)
1.00
1.41** (1.25-1.60)
1.80** (1.59-2.04)
4.97** (4.41-5.59)
Car Access
Access 3 censuses
Access 2 censuses, none 1
No access 2 censuses, access 1
No access 3 censuses
1.00
1.33
(0.92-1.90)
1.45
(0.95-2.21)
3.56** (2.38-5.33)
1.00
1.38** (1.25-1.53)
1.82** (1.63-2.04)
3.30** (2.92-3.72)
Housing Tenure
Owner occupied 3 censuses
Owner occupied 2 censuses, rented 1
Rented 2 censuses, owner occupied 1
Rented 3 censuses
1.00
1.33
(0.90-1.96)
1.22
(0.82-1.80)
1.71** (1.13-2.58)
1.00
1.15** (1.02-1.29)
1.35** (1.21-1.51)
2.71** (2.43-3.02)
* Own social class in 1981 was not used because a large proportion was not classified to a
class.
** p<0.05
Owner
occupied
1 census
Rented 3
censuses
S UMMARY
Children aged 6–15 years in 1971 were aged between 31 and 40 by the
end of follow-up in 1995. Children of parents in higher socio-economic
positions were more likely than others to remain in advantaged
positions and experienced least morbidity and best survival. Persisting
disadvantage was associated with worst health and survival. Though
this study was limited to young people, these findings suggest that it is
likely that the effects of accumulating disadvantage on health would
increase at older ages.
The association between worst health and poorest socio-economic
circumstances among adults is well documented.11,12 In the past, this
reflected the assumption that exposures near to death were the most
important influences on the risk of disease. Other studies have
emphasised the influence of early environment on risk of disease in
later life.13,14 Because of a lack of relevant longitudinal data few studies
have been able to examine the impact of length of exposure to
disadvantaged circumstances on the risk of ill health or premature
mortality. The notion of accumulation of risk is based on the premise
that continued exposure to adverse environmental, behavioural or
psychological conditions over the life course increases vulnerability to
disease. A study of a Scottish cohort reported findings similar to those
33
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
of this study – those who remained in less favourable circumstances
experienced the highest mortality risk.15 The direction of mobility was
not examined in this study but from other work we know that this is not
an important influence on these differentials.16 Though this study was
based only on those aged under 40 by end of follow-up, the findings
add to the limited data available on the effect of accumulation of
socially patterned adverse exposures over the lifespan on health.
4
5
6
Key findings
Children, aged 6–15 years at the 1971 Census were
followed up for 25 years, by the end of which they
were aged 31–40 years.
●
●
●
Those from disadvantaged family backgrounds were
more likely than others to be in disadvantaged
socio-economic positions in later life .
Both childhood and adult circumstances were
important predictors of limiting long-term illness in
adulthood and premature mortality. The association
was strongest with current socio-economic position.
Accidents and injuries accounted for most of the
deaths.
Persisting disadvantage over the life course was
significantly associated with worse health and
survival.
7
8
9
10
11
12
13
14
REFERENCES
1
2
3
Vagero D and Leon D. Effect of social class in childhood and
adulthood on adult mortality. The Lancet 343 (1994), 1224–5.
Wannamethee S G, Whincup P H, Shaper G and Walker M.
Influence of father’s social class on cardiovascular disease in
middle aged men. The Lancet 348 (1996), 1259–63.
Wadsworth M E J and Kuh D J L. Childhood influences on adult
health: a review of recent work in the British 1946 national birth
Office for National Statistics
34
15
16
cohort study, the MRC National Survey of Health and Development.
Paediatric and Perinatal Epidemiology 11 (1997), 2–20.
Bartley M, Power C, Blane D and Davey Smith G. Birthweight and
later socio-economic disadvantage: evidence from the 1958 British
Cohort Study. British Medical Journal 309 (1994), 1475–9.
Kuh D and Ben-Shlomo Y (eds). A life Course Approach to
Chronic Disease Epidemiology. Oxford University Press (Oxford:
1997).
Davey Smith G, Hart C, Blane D, Gillis C and Hawthorne V.
Lifetime socio-economic position and mortality; prospective
observational study. British Medical Journal 314 (1997), 547–552.
Department of Health. Our Healthier Nation: A Contract for
Health. Consultation paper. TSO (London: 1998).
Hattersley L and Creeser R. Longitudinal Study 1971–1991:
History, organisation and quality of data. HMSO (London: 1995).
Goldblatt P (ed). Longitudinal Study, Mortality and Social
Organisation LS6. HMSO (London: 1990).
Smith J and Harding S. Mortality of women and men using
alternative social classifications. In Drever F, Whitehead M (eds),
Inequalities in Health. TSO (London: 1997).
Harding S, Brown J, Rosato M and Hattersley L. Socio-economic
differentials in health: illustrations from the Office for National
Statistics Longitudinal Study. Health Statistics Quarterly 01
(1999), 5–15.
Davey Smith G, Blane D, and Bartley M. Explanations for
socioeconomic differentials in mortality: evidence from Britain and
elsewhere. European Journal of Public Health 4 (1994), 131–144.
Barker D J P. The foetal and infant origins of inequalities in health
in Britain. Journal of Public Health Medicine 13 (1991), 64–8.
Gliksman M D, Kawachi I, Hunter D, Colditz G A, Manson J E,
Stamfer M J et al. Childhood socio-economic status and risk of
cardiovascular disease in middle aged US women: a prospective
study. Journal of Epidemiology and Community Health 49 (1995),
10–15.
Davey Smith G, Hart C, Ferrell C, Upton M, Hole D, Hawthorne V,
and Watt G. Birthweight of offspring and mortality in the Renfrew
and Paisley study: prospective observational study. British Medical
Journal 315 (1997), 1189–93.
Blane D, Harding S and Rosato M. Does social mobility affect the
size of the socio-economic mortality differential?: evidence from
the Office for National Statistics Longitudinal Study. Journal of the
Royal Statistical Society A 162 (1999), Part 1.
Health Statistics Quarterly 03
Autumn 1999
Annual Update:
1997 Mortality statistics:
injury and poisoning
(England and Wales)
Summary box
This article discusses the 1997 annual reference volume
on mortality from injury and poisoning which was
published in July 1999. It outlines the data available in
this publication and describes the main changes from
previous editions. It gives examples of the information
which can be found in this volume, including:
●
●
●
●
accidental and violent deaths by nature of injury;
coroners’ verdicts;
place of accident;
age-specific death rates.
I NTRODUCTION
The ONS annual reference volume Mortality statistics: injury and
poisoning 1997, Series DH4, no. 22 was published in July 1999. It
contains statistical information on deaths resulting from injury and
poisoning (known as ‘external causes’) in England and Wales during
1997. These deaths are coded according to the Ninth Revision of the
International Classification of Diseases (ICD9) and are assigned code
numbers in the range E800–E999.
As a volume specialising in external causes, Mortality statistics: injury
and poisoning 1997 contains details about these deaths which are not
available in other ONS publications. For example, it presents data on
accidental deaths by place of occurrence; deaths from external causes
by month of occurrence; transport deaths by place and whether the
person killed was a driver, passenger, pedestrian, etc; and deaths from
all causes by verdict.
A few changes have been made in the 1997 edition. For the first time,
all tabulations of deaths from suicide and homicide incorporate
information from the verdicts of coroners’ inquests, giving better
estimates of these deaths than can be derived using ICD9 codes alone.
A new table has been introduced which shows deaths from every code
where at least one death occurred during the year. This table includes
age-standardised rates and age-specific death rates for males and
females by nature of injury and external causes separately. Several
tables which formerly contained a large number of null entries
(resulting from the desire to show every sub-category in which at least
one death occurred) have been now been reduced in size.
Some general findings from Mortality statistics: injury and poisoning
1997 are given below. More detailed information on deaths from
homicides 1 and road traffic accidents2, including data issues and longer
term trends, are given in separate articles in this edition of Health
Statistics Quarterly. Articles on drug-related deaths3 and suicides 4,5
were published last year in Population Trends.
MAIN CAUSES OF DEATH FROM INJURY AND POISONING
There were 16,311 deaths from external causes in England and Wales in
1997, accounting for 3 per cent of all deaths in that year (Table 1). Of
these, 10,342 (or nearly two-thirds) were among males and 5,969
among females. The age-specific death rates for external causes are
higher for males at all ages although the difference is greatest among
young adults; death rates for men aged 15–44 years are approximately
four times higher than the rates for women (Table 2). The crude death
rate for external causes in 1997 was 312 per 1,000,000 population, the
same as in 1994, reversing the slight downward trend observed
throughout the 1990s.
The numbers of males and females who died from accidents were 6,183
and 4,498, respectively. Just over half the accidental deaths among
females (2,392 deaths) were due to accidental falls (E880–E888)
compared with a quarter of the male accidental deaths (1,493 deaths).
Deaths from motor vehicle traffic accidents (E810–E819) accounted for
over a third of all accidental deaths among males and just under onefifth among females.
3,744 males and 1,274 females died in 1997 from suicide (E950–E959
and E980–E989, where the verdict is open) accounting for 36 and 21
per cent of all deaths from external causes for males and females,
respectively. There were 413 male and 197 female homicides (E960–
E969 plus E988.8, where the verdict is pending) in 1997. (Figures for
suicides and homicides include both definite and probable cases.)
35
Office for National Statistics
Health Statistics Quarterly 03
Table 1
Autumn 1999
Deaths from injury and poisoning: external cause and year of registration or occurrence, 1966–1997
England and Wales *
Accidents and adverse effects
External
causes of
injury and
poisoning
(E800–E999)
External
causes of
injury and
poisoning*
(E800–E999)
Crude rate
per million
population
Numbers
Total
accidents
(E800–E949)
Road
transport
accidents
(E810–E829)
Accidental
poisoning
(E850–E869)
Accidental
falls
(E880–E888)
Accidents
caused by
fire and flames
(E890–E899)
Suicide and
self–inflicted
injury
(E950–E959)**
Homicide and
injury purposely
inflicted by
other persons
(E960–E969)***
Injury
undetermined
whether
accidentally or
purposely inflicted
(E980–E989)
1966
1971
1976
1981
1986
510
460
423
399
375
24,412
22,624
20,945
19,788
18,754
17,998
17,125
15,069
13,284
12,378
7,546
7,072
6,115
4,150
4,953
1,768
911
780
753
625
5,355
5,538
4,918
4,313
3,732
805
694
701
625
656
4,994
3,945
3,816
4,419
4,126
330
404
540
175
340
1,089
1,139
1,508
1,907
1,900
1991
1992
1993
1994
1995
335
323
318
312
310
17,122
16,547
16,354
16,091
16,049
10,824
10,366
10,418
10,245
10,176
4,364
3,951
3,481
3,327
3,175
668
791
890
948
936
3,381
3,268
3,630
3,402
3,602
498
525
446
395
437
3,990
3,902
3,719
3,619
3,570
279
271
533
373
353
2,023
2,005
1,679
1,851
1,948
1996
1997
309
312
16,061
16,311
10,502
10,681
3,242
3,232
1,089
1,058
3,637
3,885
442
436
3,445
3,424
313
290
1,798
1,914
* Data for 1966–92 are based on year of registration, 1993–97 are based on year of occurrence. Figures from 1986 onwards exclude deaths at age under 28 days.
** From 1993 a better estimate of total suicide deaths may be obtained by combining numbers assigned to codes E950–E959 with those for codes E980–E989, with inquest verdict ‘open’.
*** From 1993 a better estimate of total homicide deaths may be obtained by combining numbers assigned to codes E960–E969 and E980–E989, with inquest verdict ‘pending’.
VERDICTS
Thirty-one per cent of the total deaths from all causes in 1997 were
referred to a coroner and 4 per cent (21,024 deaths) were subject to an
inquest, either with or without a post-mortem. Figure 1 shows the
distribution of verdicts for deaths from all causes which were subject to
an inquest. Most of these deaths, with the exception of those given a
Figure 1
Deaths that occurred in 1997 by coroner‘s
inquest verdict, England and Wales
Number of deaths
7,000
Males
6,000
Females
5,000
4,000
3,000
2,000
1,000
0
Accident
Suicide
Homicide
Pending
Verdict*
Open
Natural causes
* Excluding lawful killing/war service and deaths where no verdict was stated.
Office for National Statistics
36
verdict of natural causes, were assigned an external cause as the
underlying cause of death. Ten per cent of deaths from external causes
were given an open verdict. Most of these were coded to E980–E989.
The majority of these deaths among adults are likely to be suicides,
although there is not enough evidence to prove that the deceased
deliberately intended to kill themselves. Six per cent of motor vehicle
traffic accident deaths were given a verdict of manslaughter or causing
death by a driving offence. These cases are shown under the heading of
‘homicide’ in the DH4 volume.
NATURE OF INJURY
All deaths assigned an external cause as the underlying cause of death
are also given a nature of main injury code in the range ICD9 800–999.
The DH4 volume contains tables in which deaths from external causes
are cross-tabulated by the nature of injury, allowing one to see, for any
particular range of E codes, which are the main injuries and vice versa.
For example, these tables reveal marked differences in the external
causes associated with poisoning by drugs, medicaments and biological
substances (960–979) on the one hand, and with toxic effects of
substances which are chiefly nonmedicinal (980–989) on the other.
Fifty-seven per cent of male and 74 per cent of female deaths where the
nature of injury was poisoning by drugs were suicides (E950–E959,
E980–E989 excluding E988.8). Most of the remainder of these deaths,
for both sexes, were accidental poisonings (E850–E869). However, for
deaths from nonmedicinal substances, only a third were suicides among
women compared with two-thirds among men, as exhaust fumes are a
more common method of suicide among men than women. A significant
proportion of deaths from the toxic effects of nonmedicinal substances
(15 per cent for males and 34 per cent for females) were due to
accidents caused by fire or flame (E890–E899). These deaths would be
mostly due to the inhalation of smoke, which is a more common cause
of injury than burns (940–949) in deaths from fires.
Health Statistics Quarterly 03
Table 2
Autumn 1999
Age-standardised and age–specific death rates for selected ranges of external causes, 1997
England and Wales
ICD 9
Code
Cause of death
Sex
European agestandardised
rate
Under 1
1–4
5–14
15–24
25–34
35–44
45–54
55–64
65–74
75–84
85 and
over
Death rates per million population
E800–E999
External causes
of injury and
poisoning
M
F
385
159
100
80
60
34
57
28
475
114
483
114
414
140
379
146
365
164
428
267
1,039
707
2,611
2,309
E810–E819
Motor vehicle
traffic accidents
M
F
86
28
6
6
16
11
28
18
182
48
121
26
74
20
60
20
60
24
83
47
155
79
268
89
E850–E858
Acccidental
M
poisoning by drugs, F
medicaments and
biological substances
23
8
-
1
-
-
47
9
54
12
36
15
15
10
7
6
4
7
12
6
12
4
E880–E888
Accidental falls
M
F
52
42
3
-
2
-
3
2
10
2
11
3
21
8
34
17
59
29
104
84
424
401
1,474
1,782
E890–E899
Accidents caused
by fire and flame
M
F
10
5
6
10
9
8
2
2
10
3
5
2
8
4
7
3
10
7
20
10
41
19
97
52
E950–E959, Suicide
E980–E989
with verdict
‘open’
M
F
141
45
3
6
1
2
3
2
155
35
220
55
199
70
191
68
149
58
121
61
184
61
381
62
E960–E969, Homicide
E980–E989
with verdict
‘pending’
M
F
16
7
46
19
7
5
4
3
26
8
24
9
21
10
16
6
11
5
8
5
9
9
8
14
PLACE OF ACCIDENT
Of the 6,934 non-transport accidents (E850–E869, E880–E928) that
occurred in 1997, 42 per cent (2,898) resulted from accidents that took
place in the home (1,673 males and 1,225 females), and 8 per cent in
communal establishments (216 males and 305 females). The proportions
of home accidents due to falls were 37 per cent for males (621 deaths)
and 56 per cent for females (690 deaths). There were 112 deaths in 1997
in industrial premises or places, almost all of which were among men,
and 66 at places of recreation and sport. In both cases, around one-third
of these deaths were due to accidental falls.
REFERENCES
1
2
3
4
5
Rooney C and Devis T. Recent trends in deaths from homicide in
England and Wales. Health Statistics Quarterly 03 (1999), 5–13.
Christophersen O, Dix D and Rooney C. Road traffic deaths:
trends and comparison with DETR figures. Health Statistics
Quarterly 03 (1999), 14–23.
Christophersen O, Rooney C and Kelly S. Drug-related mortality:
methods and trends. Population Trends 93 (1998), 29–37.
Kelly S and Bunting J. Trends in suicide in England and Wales,
1982–1996. Population Trends 92 (1998), 29–41.
Kelly S and Bunting J. Geographic variations in suicide mortality,
1982–1996. Population Trends 93 (1998), 7–18.
Conclusions box
●
●
●
●
●
●
There were 16,311 deaths from injur y and poisoning
in 1997, accounting for 3 per cent of all deaths.
Approximately two-thirds of all deaths from injury
and poisoning were to males.
Mor tality rates from injury and poisoning were higher
for men than women at all ages.
Fifty per cent of all accidental deaths to females were
from falls.
Just over one-third of all accidental deaths to males
were from motor vehicle traffic incidents.
Of the number of deaths to females from drug
poisoning, almost three-thirds occurred in suicide .
37
Office for National Statistics
Tables
Page
Notes to tables
39
Table
1.1
1.2
1.3
1.4
1.5
1.6
2.1
2.2
Population
International ................................................................................. Selected countries
National ........................................................................................ Constituent countries of
the United Kingdom
Subnational ................................................................................... Health Regional Office areas
of England
Subnational ................................................................................... Government Office Regions
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
Live births
4.1
4.2
Conceptions and abortions
5.1
Expectation of life
Age of mother ............................................................................... England and Wales
Outside marriage: age of mother and type of registration ............ England and Wales
Age of women at conception ........................................................ England and Wales (residents)
Abortions: age and gestation. ....................................................... England and Wales
(In years) at birth and selected age ............................................... Constituent countries of
the United Kingdom
6.3
43
44
45
48
50
52
53
54
55
56
57
Deaths
Age and sex .................................................................................. England and Wales
Subnational ................................................................................... Health Regional Office areas
of England
Selected causes and sex ................................................................ England and Wales
Symbols
..
not available
not applicable
nil or less than half the final digit shown
blank not yet available
Office for National Statistics
42
Vital statistics
3.1
3.2
6.1
6.2
40
38
58
59
60
Health Statistics Quar terly 03
Autumn 1999
Notes to tables
Changes to tables
With the introduction of Health Statistics
Quarterly, the previous Population Trends
tables have been reviewed and some small
changes introduced, in particular, a new table,
Table 2.2, showing key demographic and
health indicators for the constituent countries
of the United Kingdom.
For most tables, years start at 1971 and then
continue at five-year intervals until 1991.
Individual years are shown thereafter. If a year
is not present the data are not available.
Population
The estimated and projected populations of an
area include all those usually resident in the
area, whatever their nationality. Members of
HM forces stationed outside the United
Kingdom are excluded. Students are taken to
be resident at their term-time addresses.
Figures for the United Kingdom do not include
the population of the Channel Islands or the
Isle of Man.
The population estimated for mid-1991
onwards are final figures based on the 1991
Census of Population with allowance for
subsequent births, deaths and migration.
Live births
For England and Wales, figures relate to
numbers occurring in a period; for Scotland
and Northern Ireland, figures relate to those
registered in a period. See also Note on page
63 of Population Trends 67.
Perinatal mortality
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.
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 threeyear period, so that for instance 1986
represents 1985–87. More details may be
found in Population Trends 60, page 23.
Deaths
Figures for England and Wales represent the
numbers of deaths registered in each year up
to 1992, and the number of deaths occurring
in each year from 1993. Provisional figures
are registrations.
Figures for both Scotland and Northern
Ireland represent the number of deaths
registered in each year.
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 the observed agespecific rates for the condition 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.
Abortions
Figures relate to numbers occurring in a
period.
Marriages and divorces
Marriages are tabulated according to date of
solemnisation. Divorces are tabulated
according to date of decree absolute, and the
term ‘divorces’ includes decrees of nullity.
Government Office Regions
Figures refer to Government Office Regions
(GORs) of England which were adopted as
the primary classification for the
presentation of regional statistics from April
1997.
Health Regional Office areas
Figures refer to new health regions of
England which are as constituted on 1 April
1996.
Sources
Figures for Scotland and Northern Ireland
shown in these tables (or included in totals
for the United Kingdom or Great Britain)
have been provided by their respective
General Register Offices, except for the
projections in Table1.2 which are provided
by the Government Actuary.
Rounding
All figures are rounded independently;
constituent parts may not add to totals.
Generally numbers and rates per 1,000
population are rounded to one decimal place
(e.g. 123.4); where appropriate, for small
figures (below 10.0), two decimal places are
given (e.g. 7.62). Figures which are
provisional or estimated are given in less
detail (e.g. 123 or 7.6 respectively) if their
reliability does not justify giving the
standard amount of detail. Where, for some
other reason, figures need to be treated with
particular caution, an explanation is given as
a footnote.
Latest figures
Figures for the latest quarters and years may
be provisional (see note above on rounding)
and will be updated in future issues when
later information becomes available. Where
figures are not yet available, cells are left
blank. Population estimates and rates based
on them may be revised in the light of
results from future censuses of populations.
39
Office for National Statistics
Health Statistics Quar terly 03
Table 1.1
Year
Autumn 1999
Population and vital rates: international
United
Kingdom (1)
Austria
(2)
Belgium
(2)
Denmark
(2)
Finland
(2)
Population (thousands)
1971
55,928
1976
56,216
1981
56,352
1986
56,852
1991
57,808
1992
58,006
7,501
7,566
7,569
7,588
7,818
7,915
9,673
9,811
9,859
9,862
10,005
10,045
4,963
5,073
5,122
5,121
5,154
5,170
1993
1994
1995
1996
1997
7,989
8,028
8,047
8,059
8,072
10,085
10,116
10,137
10,157
10,170
Selected countries
France
Germany Germany
(2) (Fed. Rep (2))* (2)†
Greece
(2)
Irish
Republic (2)
Italy
(2)
Luxembourg (2)
Netherlands (2)
Portugal
(2)
4,612
4,726
4,800
4,918
5,014
5,042
51,251
52,909
54,182
55,547
57,055
57,373
61,302
61,531
61,682
61,066
64,074
64,865
78,352
78,321
78,419
77,694
80,014
80,624
8,831
9,167
9,729
9,967
10,247
10,322
2,978
3,228
3,443
3,541
3,526
3,557
54,074
55,718
56,510
56,596
56,751
56,859
342
361
365
368
387
393
13,195
13,774
14,247
14,572
15,070
15,184
8,644
9,355
9,851
10,011
9,871
9,867
5,189
5,205
5,228
5,262
5,284
5,066
5,089
5,108
5,125
5,140
57,654
57,899
58,137 ‡
58,374 ‡
58,607 ‡
65,534
65,858
66,715
81,156
81,438
81,678
82,071
10,380
10,426
10,454
10,475
10,485 ‡
3,574
3,587
3,605
3,626
3,661
57,049
57,204
57,301
57,397
57,523
398
404
410
416
418
15,290
15,383
15,459
15,531
15,604
Population changes (per 1,000 per annum)
1971–76
1.0
1.7
2.9
1976–81
0.5
0.1
1.0
1981–86
1.8
0.5
0.1
1986–91
1.7
6.1
2.9
4.4
1.9
0.0
1.3
4.9
3.1
4.9
3.9
6.5
4.8
5.0
5.4
0.7
0.5
–2.0
9.9
–0.1
0.3
–1.8
6.0
7.6
12.3
4.9
5.6
16.8
13.3
5.7
–0.8
6.1
2.8
0.3
0.5
10.7
2.5
1.8
10.2
8.8
6.9
4.6
6.8
16.5
10.6
3.2
–2.8
1991–92
1992–93
1993–94
1994–95
1995–96
1996–97
4.1
3.9
3.1
2.1
1.9
1.3
3.2
3.7
3.0
4.4
6.4
4.3
5.6
4.8
4.4
3.7
3.3
3.0
5.6
4.9
4.2
4.1 ‡
4.1 ‡
4.0 ‡
12.3
10.3
4.9
13.0
7.6
6.6
3.5
2.9
4.8
7.3
5.6
4.5
2.7
2.0
1.0
8.8
4.8
3.9
5.0
5.8
9.6
1.9
3.4
2.7
1.7
1.7
2.2
13.9
14.3
14.3
14.6
14.4
5.8
7.6
7.0
6.1
4.9
4.6
4.7
–0.4
1.4
2.2
1.4
1.1
0.7
13.4
12.5
12.0
12.1
12.6
12.4
14.6
12.0
10.2
11.5
12.5
13.1
13.1
13.6
13.4
12.7
13.0
13.3
16.0
14.1
14.2
13.8
13.3
13.0
10.8
9.7
9.8
10.9
11.3
11.1
10.5
10.5
10.7
15.8
15.6
13.3
10.6
10.1
10.1
22.2
21.3
19.2
15.8
15.0
14.4
16.0
12.6
10.6
9.8
9.9
9.7
11.6
11.2
11.6
12.2
12.9
13.1
14.9
12.6
12.2
12.8
13.2
13.0
20.3
17.9
14.5
11.9
11.8
11.6
12.0 ‡
11.5 ‡
11.4 ‡
11.4 ‡
11.4 ‡
13.0
13.4
13.4
12.9 ‡
12.8 ‡
12.8
12.8
12.3
11.8
11.5 ‡
12.3
12.3
12.5 ‡
12.6 ‡
12.4 ‡
11.0
10.5
10.2
10.6 ‡
9.8
10.0
9.7
9.6 ‡
9.7 ‡
13.8
13.4
13.5
13.9
14.3
9.6
9.3
9.2 ‡
9.2 ‡
9.2 ‡
13.4
13.5
13.2
13.7
13.1
12.8
12.7
12.3
12.2
12.2 ‡
11.5
11.0
10.8
11.1
11.4
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
11.3
10.7
1992
11.0
10.5
12.1
11.6
11.4
10.8
10.5
10.3
10.1
10.5
11.1
11.5
11.6
11.8
10.7
10.2
10.1
9.5
9.2
9.1
11.9
11.7
11.6
11.3
11.1
10.7
12.3
12.2
12.0
8.6
8.8
9.0
9.3
9.3
9.5
11.0
10.2
9.4
9.1
8.9
8.7
9.8
9.7
9.5
9.4
9.7
9.6
12.2
11.5
11.2
10.5
9.7
10.2
8.3
8.1
8.3
8.5
8.6
8.6
11.0
10.1
9.6
9.6
10.5
10.2
1993
1994
1995
1996
1997
10.7 ‡
10.4 ‡
10.5 ‡
10.4 ‡
10.2 ‡
12.1
11.7
12.1
11.6 ‡
11.3 ‡
10.9
10.7
10.6
10.7
11.1
10.9
10.8
10.8
9.4
9.4
9.6
9.6
9.6
8.7
8.6 ‡
9.0
8.8 ‡
8.6 ‡
9.7
9.7
9.5
9.5
9.6
9.0
8.7
8.8
8.9 ‡
8.7 ‡
10.7
10.0
10.4
10.8
10.5
58,191
58,395
58,606
58,801
59,009
3.4
3.2
3.5
3.6
3.3
3.5
12.3
9.3
4.9
2.4
1.6
1.6
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
13.6
11.6
1991
13.7
12.1
1992
13.5
12.1
1993
1994
1995
1996
1997
1998
*
†
‡
≠
13.1
12.9
12.5
12.5
12.3
12.1 ‡
11.3
10.7
10.9
10.9
10.8
11.9
11.5
11.0
11.0
10.4
10.3
10.0
10.1
10.0
9.8
Excluding former GDR throughout.
Including former GDR throughout.
Provisional.
Estimates prepared by the Population
Division of the United Nations.
+ Rates are for 1990–95.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
9.5
9.3
9.3
9.8
9.8
9.9
10.1
9.4
9.6
9.6
9.6
9.2
9.0
9.1 ‡
9.2 ‡
9.1 ‡
10.4
10.1
9.9
9.5
9.4
9.7 ‡
11.4
11.0
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
‡
9.8
9.4
9.3
9.4
9.4
9,881
9,902
9,917
9,927
9,934 ‡
Population estimated at 30 June each year.
Average of estimated populations at start and end of year as given in Council of Europe report Recent demographic developments in Europe 1997.
EU as constituted 1 January 1986 and including countries subsequently admitted.
Population estimated at 1 June each year.
Population estimated at 31 December each year.
Population estimated at 1 July except for 1991 (1 March).
Population estimated at 1 October. (Rates for Japan are based on population of Japanese nationality only.)
Note: Figures may not add exactly due to rounding.
Office for National Statistics
40
Health Statistics Quarterly 03
Population and vital rates: international
Table 1.1
continued
Spain
(2)
Autumn 1999
Sweden
(2)
European
Union (3)
34,190
35,937
37,742
38,537
38,920
39,008
8,098
8,222
8,321
8,370
8,617
8,668
342,631
350,384
356,511
359,543
366,256
368,033
39,086
39,150
39,210
39,270
39,323
8,719
8,781
8,827
8,841
8,847
369,706
371,005
372,122
373,331
10.2
10.0
4.2
2.0
3.1
2.4
1.2
5.9
4.5
3.5
1.7
3.7
2.3
2.0
1.6
1.5
1.5
1.3
5.9
5.8
7.1
5.3
1.6
0.7
4.9
4.5
3.5
3.0
19.2
17.1
12.8
10.8
10.2
10.2
13.5
11.6
11.3
13.2
14.3
14.2
14.7
13.1
12.2
13.3
11.7
11.5
9.9
9.5
9.3 ‡
9.1 ‡
9.2 ‡
13.5
12.8
11.7
10.8
10.2
11.2 ‡
10.9 ‡
10.7 ‡
8.5
8.0
7.7
8.2
8.6
8.5
10.5
10.9
11.0
11.1
11.0
10.9
10.8
10.6
10.4
11.4
10.2
10.0
8.7
8.6
8.8 ‡
8.9 ‡
8.9 ‡
11.1
10.5
10.6
10.6
10.5
10.2 ‡
9.9 ‡
10.0 ‡
‡
‡
‡
‡
‡
‡
‡
‡
Selected countries
Russian
Federation (2)
Australia
(1)
Canada
(4)
New
Zealand (5)
139,422
144,475
148,624
148,689
13,067
14,033
14,923
16,018
17,284
17,495
22,026
23,517
24,900
26,204
28,120
28,542
2,899
3,163
3,195
3,317
3,450
3,516
852,290
943,033
1,011,219
1,086,733
1,170,052
1,183,617
148,520
148,336
148,141
147,739
17,667
17,855
18,072
18,311
18,530
28,947
29,256
29,615
29,964 ‡
3,556
3,604
3,658
3,716
1,190,360
1,208,841
1,221,462
1,232,083
5.6
8.5
7.2
5.7
14.8
12.7
14.7
15.8
13.5
11.8
10.5
14.6
18.2
2.0
7.6
8.0
19.9
15.2
15.5
15.3
0.4
–1.1
–1.2
–1.3
–2.7
12.2
9.9
10.6
12.2
13.2
12.0
15.0
14.2
10.7
12.3
11.8 ‡
19.0
11.5
13.5
15.0
15.8
11.6
5.7
15.5
10.4
8.7
19.0
18.5
39.2
18.7
18.8
15.7
15.6
15.1
14.9
15.1
15.9
15.5
15.1
14.8
14.3
14.0
20.4
16.8
15.8
17.1
17.4
17.2
27.2
18.6
19.2
35.6
33.4
..
14.7
14.5
14.2
13.9
13.4
13.2
12.8
17.1
16.4
16.3
18.3+
28.7
28.7
28.3
8.2
7.6
7.3
7.2
6.9
7.1
7.4
7.2
7.0
7.3
7.0
6.9
8.4
8.2
8.1
8.2
7.8
7.9
7.3
6.6
6.7
15.5
13.8
..
6.8
7.1
6.9
7.0
7.1
7.1
7.1
7.2
7.7
7.5
7.6
7.6
7.2+
12.1
10.7
9.3
9.5
9.2
8.8
8.6
11.4
12.2
14.3
15.5
14.9
14.1
13.7
China
(5)
India
(6)
Japan
(7)
≠
≠
≠
≠
≠
551,311
617,248
676,218
767,199
851,661
867,818
105,145
113,094
117,902
121,672
123,102
123,476
≠
≠
≠
≠
833,910
918,570 ≠
935,744 ≠
936,000 ≠
123,788
124,069
124,299
124,709
USA
(1)
Year
Population (thousands)
207,661
1971
218,035
1976
230,138
1981
240,680
1986
252,177
1991
255,078
1992
257,783
260,341
262,755
265,284
1993
1994
1995
1996
1997
Population changes (per 1,000 per annum)
23.9
15.1
10.0
1971–76
18.8
8.5
10.9
1976–81
27.3
6.4
9.3
1981–86
22.0
2.4
9.6
1986–91
29.5
29.0
9.8
10.1
9.3
9.3
9.0
3.0
2.5
2.3
1.9
3.3
11.5
10.6
9.9
9.3
9.6
1991–92
1992–93
1993–94
1994–95
1995–96
1996–97
Live birth rate (per 1,000 per annum)
18.6
15.3
1971–75
14.9
15.2
1976–80
12.6
15.7
1981–85
10.6
16.0
1986–90
9.9
16.3
1991
9.7
16.0
1992
9.5
9.9
9.5
9.6 ‡
15.5
15.2
14.8
14.8 ‡
Death rate (per 1,000 per annum)
6.4
9.1
1971–75
6.1
8.7
1976–80
6.1
8.6
1981–85
6.4
8.7
1986–90
6.7
8.6
1991
6.9
8.5
1992
7.0
7.0
7.4
7.1
8.8
8.7
8.8
8.8 ‡
See notes opposite.
41
1993
1994
1995
1996
1997
Office f or National Statistics
1993
1994
1995
1996
1997
Health Statistics Quar terly 03
Table 1.2
Autumn 1999
Population: national
Numbers (thousands) and percentage age distribution
Mid-year
Constituent countries of the United Kingdom
United
Kingdom
Great
Britain
England
and Wales
England
Wales
Scotland
Northern
Ireland
Estimates
1971
1976
1981
1986
1991
1992
55,928
56,216
56,352
56,852
57,808
58,006
54,388
54,693
54,815
55,285
56,207
56,388
49,152
49,459
49,634
50,162
51,100
51,277
46,412
46,660
46,821
47,342
48,208
48,378
2,740
2,799
2,813
2,820
2,891
2,899
5,236
5,233
5,180
5,123
5,107
5,111
1,540
1,524
1,538
1,567
1,601
1,618
1993
1994
1995
1996
1997
58,191
58,395
58,606
58,801
59,009
56,559
56,753
56,957
57,138
57,334
51,439
51,621
51,820
52,010
52,211
48,533
48,707
48,903
49,089
49,284
2,906
2,913
2,917
2,921
2,927
5,120
5,132
5,137
5,128
5,123
1,632
1,642
1,649
1,663
1,675
6.3
14.2
40.9
20.4
10.9
7.2
6.3
14.1
40.9
20.5
10.9
7.3
6.3
14.2
40.8
20.5
10.9
7.3
6.3
14.1
41.0
20.5
10.8
7.3
6.0
14.5
38.4
21.2
12.0
7.9
6.0
13.9
41.8
20.4
11.3
6.6
7.4
17.2
41.9
18.5
9.6
5.5
59,618
60,287
60,929
61,605
62,244
57,924
58,576
59,209
59,880
60,519
52,818
53,492
54,151
54,849
55,526
49,871
50,526
51,161
51,832
52,484
2,947
2,966
2,989
3,017
3,043
5,106
5,084
5,059
5,031
4,993
1,694
1,711
1,720
1,725
1,724
5.6
12.2
35.7
27.3
10.6
8.6
5.6
12.1
35.7
27.3
10.6
8.6
5.6
12.2
35.8
27.2
10.6
8.7
5.6
12.2
35.8
27.3
10.5
8.6
5.6
12.4
35.2
26.2
11.3
9.4
5.3
11.8
34.6
28.7
11.1
8.5
5.8
13.1
36.7
27.0
9.6
7.7
of which (percentages)
0–4
5–15
16–44
45–64M/59F
65M/60F–74
75 and over
Projections≠
2001
2006
2011
2016
2021
of which (percentages)
0–4
5–15
16–44
45–64†
65–74†
75 and over
≠ These projections are based on the mid-1996 population estimates.
† 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.
Note: Figures may not add exactly due to rounding.
Office for National Statistics
42
Health Statistics Quarterly 03
Table 1.3
Population: subnational
Numbers (thousands) and percentage age distribution
Mid-year
Autumn 1999
Health Regional Office areas of England*
Northern and
Yorkshire +
Trent +
Anglia and
Oxford
North
Thames
South
Thames
South and
West
West
Midlands
North
West
Estimates
1971
1976
1981
1986
1991
1992
6,482
6,512
6,238
6,207
6,285
6.309
4,483
4,557
4,921
4,945
5,035
5,060
4,272
4,531
4,745
4,979
5,174
5,206
6,914
6,695
6,598
6,652
6,744
6,766
6,642
6,567
6,489
6,567
6,679
6,696
5,569
5,789
5,988
6,224
6,426
6,459
5,146
5,178
5,187
5,197
5,265
5,278
6,903
6,832
6,657
6,570
6,600
6,603
1993
1994
1995
1996
1997
6,323
6,332
6,337
6,338
6,336
5,081
5,096
5,109
5,121
5,128
5,226
5,261
5,315
5,361
5,410
6,795
6,830
6,872
6,934
6,988
6,715
6,749
6,782
6,819
6,865
6,486
6,529
6,569
6,594
6,639
5,290
5,295
5,306
5,317
5,321
6,617
6,616
6,614
6,605
6,598
6.1
14.4
40.4
20.6
11.3
7.1
6.1
14.1
40.3
20.9
11.3
7.3
6.4
14.3
41.5
20.8
10.2
6.8
6.9
13.8
44.1
19.2
9.6
6.5
6.4
13.5
41.6
20.1
10.6
7.9
5.8
13.7
39.1
21.1
11.8
8.6
6.4
14.6
40.0
20.9
11.1
7.0
6.3
14.9
40.2
20.6
11.0
7.1
6,365
6,382
6,405
6,435
6,464
5,184
5,232
5,277
5,324
5,371
5,568
5,747
5,906
6,057
6,198
7,088
7,220
7,352
7,487
7,614
6,955
7,077
7,198
7,326
7,455
6,786
6,958
7,122
7,291
7,456
5,343
5,358
5,372
5,391
5,411
6,582
6,553
6,530
6,521
6,515
4.5
12.8
37.6
26.6
12.8
8.6
4.4
12.7
37.4
23.7
12.9
8.9
4.6
13.1
37.8
23.6
12.5
8.5
5.1
13.4
40.8
22.8
10.8
7.1
4.7
12.9
38.3
23.5
12.0
8.6
4.2
12.2
35.8
23.7
13.9
10.3
4.6
13.3
37.1
23.5
12.8
8.7
4.6
13.2
37.8
23.5
12.5
8.4
of which (percentages)
0–4
5–15
16–44
45–64M/59F
65M/60F–74
75 and over
Projections≠
2001
2006
2011
2016
2021
of which (percentages)
0–4
5–15
16–44
45–64†
65–74†
75 and over
* Areas as constituted in 1996. Population figures for years before 1981 may relate to different areas where boundaries have changed.
≠ These projections are based on the mid-1996 population estimates.
+ From 1 April 1996 boundary changes due to local government reorganisation have led to changes in the constitution of the Northern and Yorkshire and Trent Regional Office areas. South
Humber Health Authority with 311.3 thousand people – mid-1996 is now included in the Trent Regional Office area rather than in the Northern and Yorkshire area.
† 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.
Note: Figures may not add exactly because of rounding.
43
Office f or National Statistics
Health Statistics Quar terly 03
Table 1.4
Autumn 1999
Population: subnational
Numbers (thousands) and percentage age distribution
Mid-year
Government Office Regions of England
North
East
North
West and
Merseyside
North
West
Merseyside
Yorkshire
and the
Humber
East
Midlands
West
Midlands
East
London
South
East
South
West
Estimates
1971
1976
1981
1986
1991
1992
2,679
2,671
2,636
2,601
2,603
2,609
7,108
7,043
6,940
6,852
6,885
6,890
5,446
5,457
5,418
5,381
5,436
5,444
1,662
1,586
1,522
1,471
1,450
1.446
4,902
4,924
4,918
4,906
4,983
5,002
3,652
3,774
3,853
3,919
4,035
4,062
5,146
5,178
5,187
5,197
5,265
5,278
4,454
4,672
4,854
5,012
5,150
5,175
7,529
7,089
6,806
6,803
6,890
6,905
6,830
7,029
7,245
7,492
7,679
7,712
4,112
4,280
4,381
4,560
4,718
4,746
1993
1994
1995
1996
1997
2,612
2,610
2,605
2,600
2,594
6,903
6,902
6,900
6,891
6,885
5,462
5,468
5,473
5,471
5,471
1,441
1,434
1,427
1,420
1,413
5,014
5,025
5,029
5,036
5,037
4,083
4,102
4,124
4,141
4,156
5,290
5,295
5,306
5,317
5,321
5,193
5,223
5,257
5,293
5,334
6,933
6,968
7,007
7,074
7,122
7,737
7,784
7,847
7,895
7,959
4,768
4,798
4,827
4,842
4,876
6.0
14.5
40.3
20.6
11.7
6.9
6.2
14.8
40.1
20.6
11.0
7.1
6.3
14.8
40.1
20.8
10.9
7.1
6.1
15.0
40.3
19.9
11.5
7.2
6.3
14.4
40.6
20.4
11.0
7.3
6.1
14.2
40.3
21.1
11.1
7.2
6.4
14.6
40.0
20.9
11.1
7.0
6.3
13.9
40.3
21.1
11.0
7.4
7.1
13.6
46.1
18.2
8.9
6.2
6.2
13.9
40.4
21.0
10.8
7.8
5.8
13.5
38.5
21.1
12.1
9.0
2,579
2,555
2,536
2,521
2,509
6,871
6,843
6,820
6,813
6,808
5,485
5,490
5,497
5,514
5,530
1,386
1,353
1,323
1,299
1,278
5,071
5,098
5,130
5,165
5,200
4,234
4,312
4,384
4,455
4,523
5,343
5,358
5,372
5,391
5,411
5,448
5,582
5,702
5,823
5,941
7,215
7,337
7,470
7,609
7,736
8,134
8,344
8,534
8,722
8,905
4,977
5,098
5,213
5,333
5,452
4.4
12.7
37.3
23.9
13.1
8.6
4.6
13.2
37.6
23.6
12.6
8.5
4.6
13.2
37.6
23.6
12.6
8.4
4.5
13.1
37.8
23.2
12.7
8.7
4.5
12.9
38.0
23.5
12.5
8.5
4.4
12.8
37.3
23.7
12.9
8.8
4.6
13.3
37.1
23.5
12.8
8.7
4.5
13.0
36.7
23.5
13.1
9.3
5.3
13.3
43.1
22.6
9.7
6.1
4.5
12.9
37.0
23.7
12.7
9.2
4.1
12.1
35.1
23.9
14.3
10.7
of which (percentages)
0–4
5–15
16–44
45–64M/59F†
65M/60F–74†
75 and over
Projections≠
2001
2006
2011
2016
2021
of which (percentages)
0–4
5–15
16–44
45–64†
65–74†
75 and over
≠ These projections are based on the mid-1996 population estimates.
† 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.
Note: Figures may not add exactly because of rounding.
Office for National Statistics
44
Health Statistics Quarterly 03
Table 1.5
Population: age and sex
Numbers (thousands)
Autumn 1999
Constituent countries of the United Kingdom
Age group
Mid-year
All ages
United Kingdom
Persons
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
55,928
56,216
56,352
56,852
57,808
58,006
58,191
58,395
58,606
58,801
59,009
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
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
899
677
730
749
794
787
759
759
734
719
736
3,654
3,043
2,725
2,893
3,092
3,124
3,129
3,117
3,102
3,044
2,977
8,916
9.176
8,147
7,163
7,175
7,289
7,417
7,483
7,526
7,595
7,665
8,144
8.126
9,019
9.283
8,247
7,969
7,723
7,554
7,450
7,325
7,219
6,971
7,868
8,010
8,048
9,057
9,199
9,295
9,375
9,409
9,420
9,362
6,512
6,361
6,774
7,717
7,955
7,818
7,787
7,837
7,931
8,093
8,296
10,202
9,836
9,540
9,210
9,500
9,814
10,070
10,277
10,445
10,582
10,702
3,222
3,131
2,935
3,067
2,888
2,868
2,839
2,808
2,784
2,772
2,783
4,764
5,112
5,195
5,017
5,067
5,104
5,169
5,223
5,127
5,058
5,006
2,159
2,348
2,675
2,986
3,136
3,100
3,020
2,952
3,054
3,125
3,175
358
390
428
516
639
662
688
703
719
728
732
127
147
174
203
257
274
294
308
325
339
356
14,257
13,797
12,541
11,679
11,741
11,850
11,965
12,075
12,106
12,098
12,104
32,548
32,757
33,780
34,846
35,469
35,533
35,589
35,689
35,848
36,035
36,214
9,123
9,663
10,031
10,328
10,597
10,623
10,637
10,630
10,652
10,668
10,691
27,167
27,360
27,409
27,698
28,246
28,362
28,474
28,592
28,727
28,856
28,990
461
348
374
384
407
403
389
389
376
369
377
1,874
1,564
1,399
1,484
1,588
1,602
1,603
1,596
1,589
1,560
1,526
4,576
4,711
4,184
3,682
3,688
3,744
3,808
3,840
3,861
3,897
3,932
4,137
4,145
4,596
4,747
4,227
4,087
3,965
3,879
3,825
3,760
3,705
3,530
3,981
4,035
4,063
4,591
4,670
4,723
4,767
4,793
4,805
4,780
3,271
3,214
3,409
3,871
3,986
3,917
3,904
3,929
3,984
4,072
4,182
4,970
4,820
4,711
4,572
4,732
4,889
5,017
5,118
5,201
5,270
5,329
1,507
1,466
1,376
1,462
1,390
1,384
1,374
1,363
1,358
1,355
1,361
1,999
2,204
2,264
2,205
2,272
2,297
2,333
2,363
2,330
2,310
2,299
716
775
921
1,063
1,151
1,143
1,117
1,096
1,147
1,185
1,215
97
101
105
128
167
176
186
193
201
206
211
29
31
35
38
47
51
55
58
62
67
71
7,318
7,083
6,438
5,999
6,033
6,084
6,140
6,194
6,208
6,205
6,209
17,008
17.167
17,646
18,266
18,576
18,611
18,642
18,687
18,779
18,882
18,984
2,841
3,111
3,325
3,433
3,637
3,666
3,692
3,710
3,740
3,768
3,796
28,761
28,856
28,943
29,153
29,562
29,645
29,718
29,803
29,878
29,946
30,019
437
330
356
365
387
384
370
370
358
350
359
1,779
1,479
1,326
1,409
1,505
1,522
1,526
1,521
1,513
1,484
1,450
4,340
4,465
3,963
3,480
3,487
3,545
3,609
3,643
3,665
3,698
3,733
4,008
3,980
4,423
4,536
4,021
3,882
3,758
3,674
3,625
3,565
3,514
3,441
3,887
3,975
3,986
4,466
4,530
4,572
4,608
4,616
4,615
4,581
3,241
3,147
3,365
3,846
3,968
3,900
3,883
3,908
3,947
4,020
4,114
5,231
5,015
4,829
4,638
4,769
4,925
5,054
5,159
5,244
5,312
5,374
1,715
1,665
1,559
1,605
1,498
1,484
1,466
1,444
1,427
1,418
1,422
2,765
2,908
2,931
2,813
2,795
2,807
2,836
2,861
2,797
2,748
2,707
1,443
1,573
1,755
1,923
1,986
1,957
1,903
1,856
1,907
1,940
1,960
261
289
322
388
472
486
502
510
518
522
521
97
116
139
164
210
223
239
249
262
273
285
6,938
6,714
6,103
5,679
5,708
5,766
5,826
5,881
5,898
5,893
5,895
15,540
15,590
16,134
16,580
16,893
16,922
16,946
17,002
17,069
17,153
17,229
6,282
6,552
6,706
6,894
6,961
6,957
6,946
6,920
6,911
6,900
6,894
England and Wales
Persons
1971
49,152
1976
49,459
1981
49,634
1986
50,162
1991
51,100
1992
51,277
1993
51,439
1994
51,621
1995
51,820
1996
52,010
1997
52,211
782
585
634
655
702
694
670
671
649
636
651
3,170
2,642
2,372
2,528
2,728
2,760
2,764
2,752
2,739
2,688
2,632
7,705
7,967
7,085
6,243
6,281
6,385
6,504
6,568
6,613
6,683
6,751
7,117
7,077
7,873
8,134
7,237
6,985
6,768
6,612
6,521
6,411
6,332
6,164
6,979
7,086
7,088
8,008
8,137
8,219
8,293
8,329
8,342
8,290
5,736
5,608
5,996
6,863
7,056
6,924
6,887
6,925
7,003
7,146
7,325
9,034
8,707
8,433
8,136
8,407
8,695
8,929
9,118
9,272
9,397
9,503
2,853
2,777
2,607
2,725
2,553
2,534
2,507
2,478
2,458
2,447
2,456
4,228
4,540
4,619
4,470
4,506
4,538
4,596
4,644
4,554
4,490
4,440
1,926
2,093
2,388
2,673
2,810
2,777
2,704
2,642
2,734
2,800
2,844
323
351
383
465
576
598
623
636
651
658
661
115
135
157
184
233
249
268
281
297
311
327
12,334
11,973
10,910
10,190
10,303
10,407
10,515
10,618
10,653
10,655
10,672
28,710
28,894
29,796
30,759
31,351
31,402
31,445
31,530
31,676
31,851
32,018
8,108
8,593
8,928
9,213
9,446
9,467
9,480
9,473
9,491
9,505
9,522
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
23,897
24,089
24,160
24,456
24,995
25,099
25,198
25,304
25,433
25,557
25,684
402
300
324
336
360
356
343
344
333
327
334
1,626
1,358
1,218
1,297
1,401
1,416
1,416
1,410
1,403
1,378
1,350
3,957
4,091
3,639
3,211
3,231
3,282
3,341
3,371
3,394
3,430
3,463
3,615
3,610
4,011
4,156
3,710
3,583
3,476
3,396
3,348
3,291
3,249
3,129
3,532
3,569
3,579
4,065
4,137
4,184
4,225
4,252
4,265
4,243
2,891
2,843
3,024
3,445
3,539
3,472
3,456
3,475
3,523
3,602
3,700
4,414
4,280
4,178
4,053
4,199
4,343
4,458
4,551
4,626
4,689
4,740
1,337
1,304
1,227
1,302
1,234
1,228
1,218
1,209
1,204
1,201
1,206
1,778
1,963
2,020
1,972
2,027
2,049
2,082
2,109
2,078
2,059
2,048
637
690
825
954
1,035
1,028
1,004
985
1,032
1,066
1,094
86
91
94
115
151
160
170
175
183
188
192
26
29
32
35
43
46
51
53
57
61
66
6,334
6,148
5,601
5,236
5,296
5,346
5,397
5,448
5,465
5,466
5,475
15,036
15,169
15,589
16,143
16,442
16,470
16,495
16,533
16,619
16,716
16,810
2,527
2,773
2,970
3,076
3,257
3,283
3,306
3,323
3,349
3,375
3,399
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
25,255
25,370
25,474
25,706
26,104
26,178
26,241
26,317
26,387
26,453
26,527
380
285
310
319
342
339
326
327
316
310
317
1,544
1,284
1,154
1,231
1,328
1,345
1,348
1,342
1,335
1,310
1,282
3,749
3,876
3,446
3,032
3,050
3,104
3,163
3,197
3,219
3,253
3,287
3,502
3,467
3,863
3,978
3,527
3,403
3,293
3,216
3,172
3,120
3,083
3,036
3,447
3,517
3,509
3,943
4,001
4,035
4,069
4,076
4,077
4,046
2,845
2,765
2,972
3,418
3,517
3,452
3,431
3,449
3,480
3,544
3,625
4,620
4,428
4,255
4,083
4,208
4,352
4,471
4,567
4,646
4,709
4,763
1,516
1,473
1,380
1,422
1,319
1,306
1,289
1,270
1,254
1,246
1,250
2,450
2,577
2,599
2,498
2,479
2,488
2,514
2,536
2,477
2,430
2,392
1,289
1,403
1,564
1,718
1,775
1,749
1,700
1,656
1,702
1,733
1,750
236
261
289
349
425
439
453
461
468
471
470
89
106
126
149
191
203
218
228
240
250
262
6,000
5,826
5,309
4,953
5,007
5,062
5,117
5,170
5,188
5,188
5,196
13,673
13,725
14,207
14,616
14,908
14,932
14,950
14,997
15,058
15,134
15,208
5,581
5,820
5,958
6,137
6,189
6,184
6,173
6,150
6,141
6,130
6,123
45
Office f or National Statistics
Health Statistics Quar terly 03
Table 1.5
continued
Autumn 1999
Population: age and sex
Numbers (thousands)
Constituent countries of the United Kingdom
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
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
46,412
46,660
46,821
47,342
48,208
48,378
48,533
48,707
48,903
49,089
49,284
739
551
598
618
663
657
633
634
615
603
616
2,996
2,491
2,235
2,385
2,574
2,606
2,611
2,601
2,589
2,543
2,490
7,272
7,513
6,678
5,885
5,916
6,014
6,125
6,186
6,231
6,298
6,364
6,731
6,688
7,440
7,692
6,840
6,601
6,394
6,246
6,158
6,054
5,980
5,840
6,599
6,703
6,717
7,599
7,724
7,803
7,873
7,909
7,922
7,873
5,421
5,298
5,663
6,484
6,665
6,541
6,508
6,545
6.622
6,761
6,933
8,515
8,199
7,948
7,672
7,920
8,193
8,415
8,593
8,738
8,856
8,956
2,690
2,616
2,449
2,559
2,399
2,381
2,356
2,329
2,310
2,299
2,308
3,976
4,274
4,347
4,199
4,222
4,252
4,308
4,355
4,270
4,210
4,164
1,816
1,972
2,249
2,518
2,645
2,612
2,541
2,481
2,568
2,629
2,670
306
332
362
438
543
564
587
600
613
620
623
109
127
149
174
220
235
253
265
280
293
308
11,648
11,293
10,285
9,608
9,711
9,811
9,913
10,012
10,048
10,053
10,071
27,128
27,275
28,133
29,070
29,627
29,678
29,720
29,803
29,946
30,114
30,275
7,636
8,092
8,403
8,665
8,870
8,889
8,899
8,893
8,909
8,922
8,939
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
22,569
22,728
22,795
23,086
23,588
23,688
23,782
23,882
24,008
24,129
24,251
380
283
306
317
340
337
325
326
315
309
316
1,537
1,280
1,147
1.224
1,322
1,336
1,338
1,332
1,327
1,304
1,278
3,734
3,858
3,430
3,026
3,043
3,091
3,146
3,175
3,198
3,233
3,265
3,421
3,413
3,790
3,931
3,507
3,385
3,282
3,207
3,160
3,106
3,067
2,965
3,339
3,377
3,392
3,859
3,928
3,974
4,012
4,039
4,051
4,030
2,733
2,686
2,856
3,255
3,344
3,281
3,267
3,286
3,333
3,410
3,504
4,161
4,031
3,938
3,822
3,957
4,093
4,202
4,289
4,360
4,420
4,468
1,261
1,228
1,154
1,224
1,159
1,154
1,145
1,136
1,132
1,129
1,134
1,671
1,849
1,902
1,853
1,900
1,920
1,951
1,977
1,948
1,931
1,921
599
649
777
900
975
968
945
926
969
1,002
1,027
107
85
89
109
143
151
160
166
173
177
181
25
27
30
33
41
44
48
50
54
58
62
5,982
5,798
5,280
4,937
4,991
5,039
5,089
5,137
5,155
5,158
5,168
14,209
14,320
14,717
15,254
15,539
15,566
15,590
15,626
15,709
15,803
15,893
2,377
2,610
2,798
2,895
3,058
3,082
3,103
3,119
3,144
3,167
3,191
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
23,843
23,932
24,026
24,257
24,620
24,691
24,751
24,825
24,896
24,960
25,033
359
269
292
301
324
320
309
309
300
293
300
1,459
1,211
1,088
1,161
1,253
1,270
1,273
1,268
1,262
1,239
1,213
3,538
3,656
3,248
2,859
2,873
2,923
2,979
3,010
3,033
3,065
3,099
3,310
3,275
3,650
3,761
3,333
3,215
3,111
3,039
2,998
2,948
2,913
2,875
3,260
3,327
3,325
3,739
3,795
3,829
3,862
3,871
3,872
3,843
2,688
2,612
2,807
3,229
3,322
3,260
3,241
3,259
3,289
3,351
3,429
4,354
4,168
4,009
3,850
3,964
4,100
4,212
4,304
4,378
4,437
4,488
1,429
1,387
1,295
1,335
1,239
1,227
1,211
1,193
1,178
1,170
1,174
2,305
2,425
2,445
2,346
2,323
2,332
2,357
2,378
2,322
2,279
2,244
1,217
1,323
1,472
1,618
1,670
1,644
1,597
1,555
1,598
1,627
1,643
309
246
273
330
400
413
427
434
441
443
442
85
100
119
141
179
191
205
214
226
235
246
5,666
5,495
5,004
4,671
4,720
4,772
4,824
4,874
4,893
4,894
4,903
12,918
14,968
13,416
13,816
14,088
14,112
14,131
14,177
14,237
14,311
14,382
5,259
5,481
5,605
5,770
5,812
5,807
5,796
5,774
5,765
5,755
5,748
Wales
Persons
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
2,740
2,799
2,813
2,820
2,891
2,899
2,906
2,913
2,917
2,921
2,927
43
33
36
37
39
38
36
36
35
34
35
173
151
136
143
154
154
153
151
149
145
141
433
453
407
358
365
372
379
382
383
385
387
386
388
434
441
397
385
375
367
363
357
352
325
379
383
371
409
413
416
420
420
420
417
315
309
333
378
391
383
379
379
380
385
392
519
509
485
464
486
501
514
525
534
541
547
164
161
158
166
154
152
151
149
148
148
148
252
267
272
271
284
286
288
289
284
280
276
110
121
139
155
165
165
163
161
166
171
174
16
19
21
26
33
34
36
36
37
38
39
6
7
8
10
13
14
15
16
17
18
19
686
680
626
582
592
596
602
606
605
602
601
1,582
1,618
1,663
1,690
1,724
1,724
1,725
1,727
1,730
1,737
1,743
472
501
525
548
576
578
580
580
581
582
583
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1,329
1,361
1,365
1,370
1,407
1,411
1,417
1,422
1,425
1,428
1,433
22
17
18
19
20
19
19
19
18
17
18
89
78
70
73
79
79
78
77
76
74
72
222
233
209
185
188
191
195
196
196
197
198
194
197
221
225
203
198
193
190
188
185
182
164
193
193
187
206
208
210
213
214
214
214
158
157
168
190
195
191
189
189
190
192
196
253
249
240
231
242
250
256
262
266
269
272
76
75
73
79
74
74
73
72
72
72
72
107
114
118
119
128
129
131
131
130
128
127
38
41
48
54
60
60
60
60
62
65
67
6
5
5
7
8
9
9
10
10
10
11
1
2
2
2
2
3
3
3
4
4
4
352
350
321
300
305
306
309
311
310
308
308
827
849
871
889
904
904
905
907
910
913
917
150
162
173
181
199
201
203
204
206
207
208
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1,412
1,438
1,448
1,450
1,484
1,488
1,490
1,491
1,491
1,493
1,494
21
16
18
18
19
19
18
18
17
16
17
85
73
66
70
75
75
75
74
73
71
69
211
220
199
173
177
181
185
186
187
188
189
191
191
213
217
194
187
181
177
175
172
170
161
187
190
184
203
205
206
207
206
206
204
157
153
165
188
195
192
190
190
190
193
196
265
260
246
233
244
252
258
263
268
272
275
88
86
85
87
80
79
78
77
76
76
76
146
152
154
152
156
157
157
158
154
151
148
73
80
91
101
105
105
103
101
104
106
107
16
14
16
20
25
25
26
27
27
28
28
4
6
6
8
11
12
13
13
14
15
15
335
330
305
282
288
290
293
295
295
294
293
755
770
791
800
820
820
819
820
820
824
826
322
339
352
367
377
377
377
376
376
375
375
Office for National Statistics
46
Health Statistics Quarterly 03
Table 1.5
continued
Population: age and sex
Numbers (thousands)
Autumn 1999
Constituent countries of the United Kingdom
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
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
5,236
5,233
5,180
5,123
5,107
5,111
5,120
5,132
5,137
5,128
5,123
86
67
69
66
66
67
64
63
61
59
60
358
291
249
257
259
260
260
261
261
255
247
912
904
780
657
634
641
648
651
649
647
649
781
806
875
870
754
727
705
690
677
663
651
617
692
724
742
809
817
825
829
827
821
809
612
591
603
665
699
692
694
703
715
728
744
926
897
880
849
853
873
888
902
911
919
924
294
282
260
273
265
264
262
260
258
256
255
430
460
460
435
441
445
451
456
450
446
443
183
202
232
251
259
256
249
243
250
255
259
29
31
35
41
50
51
52
53
55
56
56
9
11
14
15
19
20
21
21
22
23
24
1,440
1,352
1,188
1,063
1,023
1,025
1,032
1,038
1,036
1,028
1,021
2,986
3,023
3,110
3,171
3,174
3,174
3,176
3,183
3,187
3,185
3,185
810
858
882
889
910
912
912
911
914
915
917
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
2,516
2,517
2,495
2,474
2,470
2,473
2,479
2,486
2,489
2,486
2,484
44
34
35
34
34
34
33
32
31
30
31
184
149
128
131
133
133
133
133
133
130
126
467
463
400
337
325
328
332
333
332
331
332
394
408
445
445
385
371
360
353
346
339
333
306
347
364
375
407
412
415
418
416
413
407
299
290
298
332
348
344
345
350
356
362
371
440
429
424
410
415
426
434
441
446
450
453
134
128
118
127
124
124
123
122
121
121
121
176
193
194
184
192
194
197
200
198
197
196
60
65
77
86
91
90
88
86
90
92
95
8
8
8
10
12
13
13
14
14
15
15
2
2
3
3
3
4
4
4
4
4
5
738
693
610
545
524
525
528
531
530
526
522
1,530
1,556
1,603
1,647
1,646
1,646
1,648
1,651
1,653
1,651
1,651
247
269
282
283
299
301
302
304
307
309
311
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
2,720
2,716
2,685
2,649
2,637
2,638
2,642
2,646
2,647
2,642
2,638
42
32
33
32
32
33
32
31
30
29
29
174
142
121
126
126
126
127
128
128
125
121
445
440
380
320
309
313
316
318
317
316
317
387
398
430
425
369
356
345
337
331
324
318
311
345
359
368
402
406
409
412
411
408
403
313
301
305
334
351
348
349
353
359
366
374
485
468
456
439
437
447
454
461
465
469
471
160
154
142
146
141
141
139
138
136
135
135
254
267
265
250
249
251
254
256
252
249
247
122
137
155
165
168
165
161
157
160
163
164
20
23
27
32
37
38
39
40
40
41
41
7
8
11
12
16
16
17
17
18
19
19
701
659
579
518
499
500
504
507
506
502
498
1,455
1,468
1,506
1,525
1,528
1,527
1,528
1,532
1,534
1,534
1,534
563
589
600
606
611
611
609
607
607
606
605
Northern Ireland
Persons
1971
1,540
1976
1,524
1981
1,538
1986
1,567
1991
1,601
1992
1,618
1993
1,632
1994
1,642
1995
1,649
1996
1,663
1997
1,675
31
26
27
28
26
26
25
25
24
24
25
126
111
104
108
104
104
105
104
102
101
99
299
306
282
262
260
263
265
265
264
264
265
247
243
271
280
256
256
250
251
252
251
236
189
198
200
218
240
245
251
253
253
257
262
165
163
175
189
200
202
205
209
213
218
227
243
231
227
225
241
247
253
257
261
266
275
74
73
68
69
70
70
70
70
69
69
72
106
111
116
113
119
121
123
123
123
123
123
51
53
55
62
67
67
67
68
69
71
72
7
8
9
10
12
13
13
13
14
14
14
2
2
4
4
5
5
5
5
5
5
5
483
471
442
426
415
417
419
419
417
416
412
853
840
874
915
945
957
968
976
985
999
1,011
205
212
221
226
241
244
246
246
247
249
252
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
755
754
754
768
781
791
797
802
805
812
821
16
13
14
14
13
13
13
12
12
12
13
64
58
53
55
54
53
54
53
52
51
51
152
157
145
134
133
134
135
136
135
136
136
127
127
140
146
132
132
129
130
130
129
123
95
102
102
109
119
121
124
125
125
127
130
81
81
87
94
100
101
102
104
105
108
112
116
111
109
109
118
121
124
126
128
131
136
36
34
32
32
32
32
33
33
32
33
34
45
47
50
48
52
53
54
54
54
54
55
19
19
20
22
24
24
25
25
26
26
27
2
3
3
3
3
3
3
4
4
4
4
1
0
1
1
1
1
1
1
1
1
1
246
242
227
218
213
214
214
214
214
213
211
441
442
454
476
487
495
500
504
508
515
523
67
70
73
74
81
82
83
83
84
85
86
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
786
769
783
798
820
828
835
840
844
851
854
15
13
13
13
13
13
12
12
12
12
12
62
53
51
52
51
51
51
51
50
49
48
147
149
137
128
127
128
129
129
129
129
129
119
116
130
133
125
124
121
121
122
121
113
95
96
98
108
121
124
127
128
128
130
132
84
81
88
95
100
101
103
105
107
111
115
126
120
118
116
123
126
129
131
133
135
139
39
38
37
37
38
38
38
37
36
36
37
61
64
66
64
67
68
69
69
69
69
68
32
33
36
40
43
43
43
43
44
45
46
5
6
7
7
9
9
10
10
10
10
11
2
2
3
3
4
4
4
4
4
4
4
237
229
215
208
203
204
204
205
203
203
200
411
398
420
439
457
463
468
472
477
484
487
138
143
148
152
160
162
163
163
163
164
166
47
Office f or National Statistics
Health Statistics Quar terly 03
Table 1.6
Autumn 1999
Population: age, sex and legal marital status
Numbers (thousands)
Total
population
Mid-year
England and Wales
Males
Single
Married
Divorced
Females
Widowed
Total
Single
Married
Divorced
Widowed
Total
Aged
16 and over
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
36,818
37,486
38,724
39,887
40,796
40,869
40,925
41,003
41,167
41,356
41,540
4,173
4,369
5,013
5,673
6,024
6,089
6,147
6,221
6,345
6,482
6,622
12,522
12,511
12,238
11,886
11,745
11,663
11,580
11,492
11,415
11,339
11,256
187
376
611
919
1,200
1,269
1,342
1,413
1,480
1,543
1,604
682
686
698
695
731
732
732
730
729
728
726
17,563
17,941
18,559
19,173
19,699
19,753
19,801
19,855
19,968
20,091
20,209
3,583
3,597
4,114
4,613
4,822
4,871
4,906
4,958
5,058
5,171
5,292
12,566
12,538
12,284
11,994
11,838
11,749
11,661
11,583
11,488
11,406
11,319
296
533
828
1,164
1,459
1,533
1,610
1,684
1,754
1,819
1,882
2,810
2,877
2,939
2,943
2,978
2,963
2,946
2,922
2,898
2,870
2,838
19,255
19,545
20,165
20,714
21,097
21,116
21,124
21,147
21,199
21,265
21,331
16–19
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
2,666
2,901
3,310
3,144
2,680
2,539
2,421
2,360
2,374
2,436
2,517
1,327
1,454
1,675
1,601
1,372
1,301
1,242
1,212
1,220
1,251
1,291
34
28
20
10
8
5
4
3
3
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1,362
1,482
1,694
1,611
1,380
1,306
1,246
1,215
1,222
1,253
1,293
1,163
1,289
1,523
1,483
1,267
1,209
1,157
1,131
1,139
1,171
1,212
142
129
93
49
32
24
18
14
13
12
11
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1,305
1,419
1,616
1,533
1,300
1,233
1,175
1,145
1,152
1,183
1,224
20–24
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
3,773
3,395
3,744
4,203
3,966
3,879
3,770
3,625
3,495
3,329
3,177
1,211
1,167
1,420
1,794
1,764
1,760
1,742
1,699
1,658
1,597
1,536
689
557
466
322
249
214
182
152
127
105
87
3
4
10
14
12
10
8
7
6
5
4
0
0
1
0
0
0
0
0
0
0
0
1,904
1,728
1,896
2,130
2,025
1,984
1,933
1,858
1,791
1,707
1,628
745
725
1,007
1,382
1,421
1,434
1,432
1,416
1,404
1,369
1,333
1,113
925
811
658
490
434
381
330
282
238
204
9
16
27
32
29
26
23
20
17
15
12
2
2
2
1
1
1
1
1
0
0
0
1,869
1,667
1,847
2,072
1,941
1,895
1,838
1,767
1,703
1,622
1,549
25–29
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
3,267
3,758
3,372
3,724
4,246
4,256
4,220
4,168
4,094
4,045
3,972
431
533
588
841
1,183
1,232
1,263
1,293
1,326
1,368
1,401
1,206
1,326
1,057
956
894
852
807
754
696
639
577
16
39
54
79
85
83
80
76
70
64
58
1
2
1
1
1
1
1
1
1
1
1
1,654
1,900
1,700
1,877
2,163
2,169
2,152
2,124
2,092
2,071
2,037
215
267
331
527
800
848
880
908
936
977
1,014
1,367
1,522
1,247
1,204
1,158
1,112
1,062
1,011
947
887
818
29
65
89
113
123
124
124
122
116
109
101
4
5
4
4
2
2
2
2
2
2
2
1,614
1,859
1,671
1,847
2,083
2,087
2,069
2,044
2,002
1,975
1,935
30–34
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
2,897
3,220
3,715
3,341
3,762
3,882
3,999
4,126
4,235
4,296
4,318
206
236
318
356
535
596
662
732
799
855
903
1,244
1,338
1,451
1,200
1,206
1,202
1,194
1,187
1,177
1,155
1,125
23
55
97
125
160
167
174
179
182
181
177
3
3
3
2
2
2
2
2
2
2
3
1,475
1,632
1,869
1,683
1,903
1,968
2,032
2,100
2,160
2,194
2,207
111
118
165
206
335
375
418
467
518
560
598
1,269
1,388
1,544
1,292
1,330
1,336
1,338
1,340
1,333
1,316
1,287
34
75
129
154
189
198
205
213
218
221
222
8
8
9
6
5
5
5
5
5
5
5
1,422
1,588
1,846
1,658
1,859
1,914
1,967
2,025
2,075
2,103
2,111
35–44
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
5,736
5,608
5,996
6,863
7,056
6,924
6,887
6,925
7,003
7,146
7,325
317
286
316
397
482
497
522
556
601
657
725
2,513
2,442
2,519
2,743
2,658
2,561
2,500
2,463
2,446
2,449
2,458
48
104
178
293
388
403
423
444
464
483
503
13
12
12
12
12
11
12
12
12
13
13
2,891
2,843
3,024
3,444
3,539
3,472
3,456
3,475
3,523
3,602
3,700
201
167
170
213
280
295
316
343
374
414
459
2,529
2,427
2,540
2,816
2,760
2,669
2,612
2,587
2,568
2,575
2,593
66
129
222
350
444
456
473
491
509
527
545
48
42
41
39
34
32
31
29
29
28
28
2,845
2,765
2,972
3,419
3,517
3,452
3,431
3,449
3,480
3,544
3,625
Note: Population estimates by marital status for 1971 and 1976 are based on the 1971 Census and those for 1981 and 1986 are based on the 1981 Census and have not been rebased using
the 1991 Census.
Office for National Statistics
48
Health Statistics Quarterly 03
Table 1.6
continued
Population: age, sex and legal marital status
Numbers (thousands)
Total
population
Mid-year
45–64
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
65 and over
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
Autumn 1999
England
England and
andWales
Males
Single
Married
Divorced
Females
Widowed
Total
Single
Married
Divorced
Widowed
Total
11,887
11,484
11,040
10,860
10,960
11,228
11,436
11,596
11,730
11,844
11,959
502
496
480
461
456
468
479
489
500
512
524
4,995
4,787
4,560
4,423
4,394
4,479
4,532
4,564
4,581
4,587
4,590
81
141
218
332
456
499
544
587
630
673
715
173
160
147
141
127
125
122
120
119
118
117
5,751
5,583
5,405
5,356
5,433
5,571
5,677
5,759
5,830
5,890
5,946
569
462
386
326
292
295
297
300
305
310
318
4,709
4,568
4,358
4,221
4,211
4,308
4,376
4,422
4,452
4,473
4,494
125
188
271
388
521
568
615
659
703
746
789
733
683
620
569
503
487
471
456
440
425
412
6,136
5,901
5,635
5,504
5,527
5,658
5,759
5,837
5,900
5,954
6,013
6,592
7,119
7,548
7,752
8,127
8,162
8,191
8,203
8,237
8,259
8,272
179
197
216
223
231
235
237
239
241
242
242
1,840
2,033
2,167
2,233
2,337
2,349
2,360
2,368
2,385
2,401
2,417
17
33
54
76
99
106
113
121
128
137
147
492
510
534
539
589
593
596
595
595
594
593
2,527
2,773
2,971
3,070
3,257
3,283
3,306
3,323
3,349
3,375
3,399
580
569
533
475
427
416
405
393
382
370
358
1,437
1,579
1,692
1,754
1,858
1,866
1,873
1,879
1,893
1,904
1,912
32
60
90
127
153
161
170
179
190
201
213
2,016
2,138
2,263
2,325
2,433
2,436
2,436
2,429
2,422
2,410
2,390
4,065
4,347
4,578
4,681
4,870
4,879
4,885
4,880
4,887
4,884
4,873
See note opposite.
49
Office f or National Statistics
Health Statistics Quar terly 03
Table 2.1
Year and
quarter
Autumn 1999
Vital statistics summary
Numbers (thousands) and rates
All live
births
Number
Rate*
Live births
outside marriage
Constituent countries of the United Kingdom
Marriages
Number
Rate†
Number
Rate**
Divorces
Deaths
Number
Rate††
Number
Rate*
Infant
mortality***
Number
Neonatal
mortality†††
Rate†
Number
Rate†
17.9
14.5
11.2
9.5
7.4
6.6
10.8
6.68
4.93
4.00
3.46
3.37
12.0
9.9
6.7
5.3
4.4
4.3
Perinatal
mortality****
Number
Rate††††
United Kingdom
1971
1976
1981
1986
1991
1992
901.6
675.5
730.8
755.0
792.5
781.0
16.1
12.0
13.0
13.3
13.7
13.5
73.9
61.1
91.3
158.5
236.1
240.8
82
90
125
210
298
308
459.4
406.0
397.8
393.9
349.7
356.0
..
..
49.4
43.5
36.0
..
79.6
135.4
156.4
168.2
173.5
175.1
..
..
11.3
12.5
13.0
..
645.1
680.8
658.0
660.7
646.2
634.2
11.5
12.1
11.7
11.6
11.3
10.9
1993
1994
1995
1996
1997
1998
761.7
750.7
732.0
733.4
726.8
717.2‡
13.1
12.9
12.5
12.5
12.3
12.1‡
241.8
240.1
245.7
260.4
267.0
269.7‡
318
320
336
355
367
376‡
341.6
331.2
322.3
317.5
310.2‡
..
..
..
..
..
180.0
173.6
170.0
171.7
161.1‡
..
..
..
..
..
658.5
627.6
645.5
636.0
629.7
627.6‡
11.3
10.7
11.0
10.8
10.7
10.6‡
4.83
4.63
4.52
4.50
4.25
4.06‡
6.3
6.2
6.2
6.1
5.9
5.7‡
3.18
3.09
3.05
3.00
2.81
2.70‡
4.2
4.1
4.2
4.1
3.9
3.8‡
6.73
6.74
6.52
6.41
6.06
5.92‡
8.8
9.0
8.9
8.7
8.3
8.2‡
1997 Sept
1997 Dec
186.3
177.0
12.5
11.9
68.9
66.4
370
375
128.9‡
54.9‡
..
..
141.2
159.3
9.5
10.7
1.01
1.08
5.4
6.1
0.69
0.71
3.7
4.0
1.49
1.53
8.0
8.6
1998 March
1998 June
1998 Sept
1998 Dec
176.0‡
178.9‡
187.1‡
175.0‡
12.1‡
12.1‡
12.5‡
11.7‡
65.7‡
65.5‡
70.7‡
67.7‡
373‡
366‡
378‡
387‡
37.7‡
85.4‡
..
..
166.7‡
152.3‡
143.1‡
165.4‡
11.5‡
10.4‡
9.6‡
11.1‡
1.02‡
0.97‡
0.98‡
1.10‡
5.8‡
5.4‡
5.2‡
6.3‡
0.67‡
0.65‡
0.68‡
0.70‡
3.8‡
3.7‡
3.6‡
4.0‡
1.51‡
1.45‡
1.44‡
1.53‡
8.5‡
8.1‡
7.7‡
8.7‡
1999 March
171.8‡
11.8‡
66.4‡
387‡
184.0‡
12.6‡
16.2
9.79
8.16
7.18
5.82
5.14
20.7
12.3
8.79
7.31
6.45
6.01
22.6
18.0
12.0
9.6
8.1
7.7
England and Wales
1971
783.2
1976
584.3
1981
634.5
1986
661.0
1991
699.2
1992
689.7
15.9
11.8
12.8
13.2
13.7
13.4
65.7
53.8
81.0
141.3
211.3
215.2
84
92
128
214
302
312
404.7
358.6
352.0
347.9
306.8
311.6
69.0
57.7
49.6
43.5
35.6
35.8
74.4
126.7
145.7
153.9
158.7
160.4
5.9
10.1
11.9
12.9
13.5
13.7
567.3
598.5
577.9
581.2
570.0
558.3
11.5
12.1
11.6
11.6
11.2
10.9
1993
1994
1995
1996
1997
1998
673.5
664.7
648.1
649.5
643.1
635.9‡
13.1
12.9
12.5
12.5
12.3
12.1‡
216.5
215.5
219.9
232.7
238.2
240.6‡
322
324
339
358
370
388‡
299.2
291.1
283.0
279.0
272.5‡
33.9
32.6
31.0
30.0
28.7‡
165.0
158.2
155.5
157.1
146.7‡
14.2
13.7
13.6
13.8
13.0‡
578.8
553.2
569.7
560.1
555.3
553.4
11.3
10.7
11.0
10.8
10.6
10.6‡
4.24
4.10
3.98
3.99
3.80
3.61‡
6.3
6.2
6.1
6.1
5.9
5.7‡
2.80
2.74
2.70
2.68
2.52
2.41‡
4.2
4.1
4.2
4.1
3.9
3.8‡
6.03
5.95
5.70
5.62
5.38
5.25‡
8.9
8.9
8.8
8.6
8.3
8.2‡
1997 Sept
1997 Dec
164.9
156.8
12.5
11.9
61.4
59.3
373
378
113.2‡
47.7‡
47.4‡
19.9‡
37.2‡
35.0‡
13.1‡
12.3‡
124.3
140.4
9.4
10.7
0.91
0.96
5.5
6.1
0.62
0.64
3.8
4.1
1.32
1.36
8.0
8.6
1998 March
1998 June
1998 Sept
1998 Dec
155.8‡
158.6‡
166.1‡
155.4‡
12.1‡
12.1‡
12.6‡
11.8‡
58.5‡
58.4‡
63.2‡
60.5‡
375‡
368‡
381‡
389‡
33.4‡
74.9‡
14.3‡
31.7‡
37.0‡
36.6‡
37.1‡
13.3‡
13.0‡
13.0‡
146.9
134.0
125.8
146.6
11.4‡
10.3‡
9.6‡
11.1‡
0.93‡
0.83‡
0.86‡
0.99‡
6.0‡
5.3‡
5.2‡
6.4‡
0.60‡
0.57‡
0.60‡
0.64‡
3.9‡
3.6‡
3.6‡
4.1‡
1.34‡
1.28‡
1.26‡
1.37‡
8.6‡
8.1‡
7.5‡
8.8‡
1999 March
151.9‡
11.8‡
58.9‡
388‡
161.6‡
12.6‡
England
1971
1976
1981
1986
1991
1992
740.1
550.4
598.2
623.6
660.8
651.8
15.9
11.8
12.8
13.2
13.7
13.5
62.6
50.8
76.9
133.5
198.9
202.4
85
92
129
214
301
311
382.3
339.0
332.2
328.4
290.1
295.0
..
..
..
..
..
..
..
..
..
146.0
150.1
151.5
..
..
..
..
..
..
532.4
560.3
541.0
544.5
534.0
522.7
11.5
12.0
11.6
11.5
11.2
10.8
1993
1994
1995
1996
1997
1998
636.5
629.0
613.2
614.2
608.6
602.5‡
13.1
13.0
12.5
12.5
12.3
12.2‡
203.6
202.7
206.8
218.2
223.4
225.8‡
320
322
337
355
367
375‡
283.3
275.5
268.3
264.2
258.0‡
..
..
..
..
..
156.1
149.6
147.5
148.7
138.7‡
..
..
..
..
..
541.1
517.6
532.6
524.0
519.1
518.1
11.1
10.6
10.9
10.7
10.5
10.5‡
4.00
3.83
3.74
3.74
3.60
3.37‡
6.3
6.1
6.1
6.1
5.9
5.6‡
2.65
2.57
2.55
2.53
2.37
2.28‡
4.2
4.1
4.2
4.1
3.9
3.8‡
5.70
5.58
5.41
5.36
5.09
4.96‡
8.9
8.8
8.8
8.7
8.3
8.2‡
1997 Sept
1997 Dec
156.1
148.4
12.6
11.9
57.7
55.6
370
374
107.0‡
45.1‡
..
..
35.1‡
33.1‡
..
..
116.1
131.4
9.3
10.6
0.86
0.91
5.5
6.1
0.60
0.61
3.8
4.1
1.26
1.28
8.0
8.6
1998 March
1998 June
1998 Sept
1998 Dec
147.6‡
150.2‡
157.4‡
147.3‡
12.1‡
12.2‡
12.6‡
11.8‡
54.9‡
54.8‡
59.3‡
56.7‡
372‡
365‡
377‡
385‡
31.6‡
70.9‡
..
..
35.0‡
34.6‡
35.1‡
..
137.6
125.4
117.6
137.5
11.3‡
9.6‡
8.9‡
10.4‡
0.87‡
0.77‡
0.79‡
0.94‡
5.9‡
5.2‡
5.1‡
6.4‡
0.57‡
0.54‡
0.56‡
0.61‡
3.9‡
3.6‡
3.5‡
4.2‡
1.26‡
1.21‡
1.18‡
1.31‡
8.5‡
8.0‡
7.5‡
8.8‡
1999 March
144.0‡
11.8‡
55.3‡
384‡
151.0‡
12.4‡
13.7
8.34
7.02
6.31
5.16
4.54
12.9
7.83
6.50
5.92
4.86
4.26
17.5
14.3
11.1
9.6
7.4
6.6
17.5
14.2
10.9
9.5
7.3
6.5
9.11
5.66
4.23
3.49
3.05
2.96
8.58
5.32
3.93
3.27
2.87
2.79
11.6
9.7
6.7
5.3
4.4
4.3
11.6
9.7
6.6
5.2
4.3
4.3
17.6
10.5
7.56
6.37
5.65
5.24
16.6
9.81
7.04
5.98
5.33
4.95
22.3
17.7
11.8
9.6
8.0
7.6
22.1
17.6
11.7
9.5
8.0
7.6
* Per 1,000 population of all ages. † Per 1,000 live births. ** Persons marrying per 1,000 unmarried population 16 and over. †† Per 1,000 married population. *** Deaths under 1 year.
††† 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 and stillbirths. ‡ Provisional.
Office for National Statistics
50
Health Statistics Quarterly 03
Table 2.1
continued
Year and
quarter
Vital statistics summary
Numbers (thousands) and rates
All live
births
Number
Wales
1 971
Rate*
Live births
outside marriage
Autumn 1999
Constituent countries of the United Kingdom
Marriages
Number
Rate†
Number
Rate**
Divorces
Number
Deaths
Rate††
Number
Rate*
Infant
mortality***
Number
Neonatal
mortality†††
Rate†
18.4
13.7
12.6
9.5
6.6
6.0
Number
0.53
0.32
0.29
0.21
0.16
0.14
Rate†
12.3
9.6
8.1
5.6
4.1
3.8
Perinatal
mortality****
Number
1.07
0.64
0.51
0.38
0.30
0.26
Rate††††
1976
1981
1986
1991
1992
43.1
33.4
35.8
37.0
38.1
37.5
15.7
11.9
12.7
13.1
13.2
12.9
3.1
2.9
4.0
7.8
12.3
12.8
71
86
112
211
323
340
22.4
19.5
19.8
19.5
16.6
16.6
..
..
..
..
..
..
..
..
..
7.9
8.6
8.9
..
..
..
..
..
..
34.8
36.3
35.0
34.7
34.1
33.8
12.7
13.0
12.4
12.3
11.8
11.7
0.79
0.46
0.45
0.35
0.25
0.23
24.4
19.0
14.1
10.3
7.9
7.0
1993
1994
1995
1996
1997
1998
36.6
35.4
34.5
34.9
34.5
33.4‡
12.6
12.2
11.8
11.9
11.8
11.4‡
12.9
12.7
13.1
14.4
14.8
14.8‡
352
360
381
412
428
443‡
15.9
15.5
14.7
14.8
14.6‡
..
..
..
..
..
8.9
8.6
8.0
8.4
8.0‡
..
..
..
..
..
35.9
33.9
35.6
34.6
34.6
33.9
12.4
11.6
12.2
11.8
11.8
11.6‡
0.20
0.22
0.20
0.20
0.20
0.19‡
5.5
6.1
5.9
5.6
5.9
5.7‡
0.12
0.14
0.13
0.13
0.13
0.12‡
3.3
4.1
3.9
3.6
3.9
3.7‡
0.30
0.33
0.27
0.26
0.27
0.27‡
8.2
9.3
7.9
7.5
7.9
8.0‡
1997 Sept
1997 Dec
8.8
8.4
12.0
11.4
3.7
3.7
420
446
6.2‡
2.5‡
..
..
2.0‡
1.9‡
..
..
7.7
8.7
10.5
11.8
0.04
0.04
4.9
4.5
0.02
0.03
2.5
3.3
0.06
0.07
7.2
7.7
1998 March
1998 June
1998 Sept
1998 Dec
8.3‡
8.4‡
8.8‡
8.0‡
11.4‡
11.4‡
11.8‡
10.9‡
3.6‡
3.6‡
3.9‡
3.8‡
435‡
428‡
444‡
468‡
1.8‡
4.0‡
..
..
2.0‡
2.0‡
2.0‡
..
..
9.0
8.3
7.8
8.8
12.5‡
11.3‡
10.6‡
12.0‡
0.04‡
0.04‡
0.05‡
0.05‡
5.3‡
5.3‡
5.9‡
6.1‡
0.03‡
0.03‡
0.04‡
0.03‡
3.4‡
3.7‡
4.3‡
3.1‡
0.07‡
0.07‡
0.08‡
0.06‡
7.9‡
8.5‡
8.5‡
7.1‡
1999 March
7.9‡
11.0‡
3.6‡
454‡
10.3‡
14.2‡
Scotland
1971
1976
1981
1986
1991
1992
86.7
64.9
69.1
65.8
67.0
65.8
16.6
12.5
13.4
12.9
13.1
12.9
7.0
6.0
8.5
13.6
19.5
20.0
81
93
122
206
291
303
42.5
37.5
36.2
35.8
33.8
35.1
64.1
53.8
47.5
42.8
38.7
39.9
4.8
8.1
9.9
12.8
12.4
12.5
3.9
6.5
8.0
10.7
10.6
10.7
61.6
65.3
63.8
63.5
61.0
60.9
11.8
12.5
12.3
12.4
12.0
11.9
1.72
0.96
0.78
0.58
0.47
0.45
1993
1994
1995
1996
1997
1998
63.3
61.7
60.1
59.3
59.4
57.4‡
12.4
12.0
11.7
11.6
11.6
11.2‡
19.9
19.2
20.3
21.4
22.4
22.3‡
313
312
337
360
377
389‡
33.4
31.5
30.7
30.2
29.6
29.6‡
37.6
35.1
33.7
32.8
31.7
31.1‡
12.8
13.1
12.2
12.3
12.2
12.4‡
11.0
11.4
10.7
10.9
11.0
11.2‡
64.0
59.3
60.5
60.7
59.5
59.2‡
12.5
11.6
11.8
11.8
11.6
11.5‡
0.41
0.38
0.38
0.37
0.32
0.32‡
6.5
6.2
6.2
6.2
5.3
5.5‡
0.25
0.25
0.24
0.23
0.19
0.20‡
4.0
4.0
4.0
3.9
3.2
3.5‡
0.61
0.56
0.58
0.55
0.47
0.49‡
9.6
9.0
9.6
9.2
7.8
8.5‡
1997 Sept
1997 Dec
15.2
14.6
11.7
11.3
5.7
5.6
379
382
12.1
5.8
51.4
24.6
3.1
3.0
11.1
10.8
13.4
15.1
10.4
11.7
0.06
0.07
4.0
4.9
0.04
0.04
2.8
2.6
0.11
0.12
7.4
8.1
1998 March
1998 June
1998 Sept
1998 Dec
14.2‡
14.2‡
14.8‡
14.1‡
11.2‡
11.2‡
11.5‡
10.9‡
5.5‡
5.5‡
5.7‡
5.6‡
389‡
384‡
385‡
402‡
3.5‡
8.4‡
11.9‡
5.8‡
14.7‡
35.4‡
49.8‡
24.2‡
3.1‡
3.2‡
3.1‡
3.0‡
11.5‡
11.5‡
11.1‡
10.8‡
15.7‡
14.4‡
13.8‡
15.2‡
12.5‡
11.3‡
10.7‡
11.8‡
0.06‡
0.09‡
0.09‡
0.08‡
4.2‡
6.4‡
5.7‡
5.9‡
0.04‡
0.06‡
0.06‡
0.05‡
2.8‡
4.0‡
4.1‡
3.2‡
0.12‡
0.12‡
0.13‡
0.12‡
8.1‡
8.5‡
9.0‡
8.3‡
1999 March
13.9‡
11.0‡
5.7‡
411‡
3.6‡
15.3‡
17.7‡
14.0‡
Northern Ireland
1971
1976
1981
1986
1991
1992
31.8
26.4
27.3
28.2
26.3
25.6
20.7
17.3
17.8
18.0
16.5
15.9
1.2
1.3
1.9
3.6
5.3
5.6
38
50
70
127
202
219
12.8
11.2
10.6
10.3
9.4
9.3
1993
1994
1995
1996
1997
1998
24.9
24.3
23.9
24.6
24.3
23.9‡
15.3
14.9
14.5
14.8
14.5
14.2‡
5.5
5.4
5.5
6.4
6.4
6.8‡
219
220
231
259
266
283‡
1997 Sept
1997 Dec
6.3
5.6
14.8
13.3
1.7
1.5
1998 March
1998 June
1998 Sept
1998 Dec
6.1‡
6.1‡
6.2‡
5.5‡
14.6‡
14.5‡
14.7‡
13.0‡
1999 March
6.0‡
14.4‡
12.2
9.9
9.6
10.2
9.2
9.4
19.9
14.8
11.3
8.8
7.1
6.8
0.72
0.48
0.36
0.36
0.19
0.15
22.7
18.3
13.2
13.2
7.4
6.0
1.17
0.67
0.47
0.34
0.29
0.30
..
..
45.4
..
37.7
..
0.3
0.6
1.4
1.5
2.3
2.3
..
..
4.2
..
6.8
..
17.6
17.0
16.3
16.1
15.1
15.0
0.51
0.35
0.23
0.23
0.12
0.10
9.0
8.7
8.6
8.3
8.1
7.8‡
..
..
..
..
..
..
2.2
2.3
2.3
2.3
2.2
..
..
..
..
..
15.6
15.1
15.3
15.2
15.0
15.0‡
9.6
9.2
9.3
9.1
9.0
8.9‡
0.18
0.15
0.17
0.14
0.14
0.13‡
7.1
6.1
7.1
5.8
5.6
5.6‡
0.12
0.10
0.13
0.09
0.10
0.09‡
269
264
3.6
1.4
..
..
3.4
3.7
8.2
8.9
0.04
0.05
5.7
8.6
1.7‡
1.7‡
1.8‡
1.6‡
281‡
273‡
285‡
294‡
0.8‡
2.2‡
3.4‡
1.4‡
..
..
..
..
4.1‡
3.8‡
3.5‡
3.6‡
9.9‡
9.2‡
8.2‡
8.5‡
0.04‡
0.04‡
0.03‡
0.02‡
5.8‡
7.1‡
5.5‡
4.0‡
1.8‡
302‡
4.7‡
11.4‡
13.5
10.3
6.9
5.2
4.4
4.6
15.9
13.3
8.3
8.3
4.6
4.1
2.15
1.20
0.81
0.67
0.58
0.60
24.5
18.3
11.6
10.2
8.6
9.0
0.88
0.59
0.42
0.42
0.22
0.21
27.2
22.3
15.3
15.3
8.4
8.2
4.9
4.2
5.5
3.7
4.2
3.9‡
0.22
0.24
0.25
0.23
0.21
0.20‡
8.8
9.7
10.4
9.4
8.6
8.1‡
0.03
0.03
4.2
6.1
0.05
0.06
8.1
10.3
0.03‡
0.03‡
0.02‡
0.02‡
4.3‡
4.4‡
3.5‡
3.3‡
0.05‡
0.05‡
0.05‡
0.05‡
8.8‡
7.7‡
8.0‡
8.2‡
Notes: 1. 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. 2. Figures for England and Wales represent the numbers of deaths registered in each year up to 1992, and the number of deaths occurring in each
year from 1993. Provisional figures are registrations. 3.The marriage and divorce rates for 1991 onwards differ in part from those previously published because of a revision of the
denominators. 4. From 1972 births for England and Wales are excluded if the mother was usually resident outside England and Wales, but included in the total for the United Kingdom.
5. From 1972 deaths for England and for Wales separately exclude deaths to persons usually resident outside England and Wales, but these deaths are included in the totals for England
and Wales combined, and the United Kingdom.
51
Office f or National Statistics
Health Statistics Quar terly 03
Table 2.2
Autumn 1999
Key demographic and health indicators
Numbers (thousands), rates, percentages, mean age
Constituent countries of the United Kingdom
Dependency ratio
Population
Live births
Deaths
Children*
Elderly†
United Kingdom
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998
55,928.0
56,216.1
56,352.2
56,851.9
57,807.9
58,006.5
58,191.2
58,394.6
58,605.8
58,801.5
59,008.6
901.6
675.5
730.8
755.0
792.5
781.0
761.7
750.7
732.0
733.4
726.8
717.2‡
645.1
680.8
658.0
660.7
646.2
634.2
658.5
627.6
645.5
636.0
629.7
627.6‡
43.8
42.1
37.1
33.5
33.1
33.3
33.6
33.8
33.8
33.6
33.4
28.0
29.5
29.7
29.6
29.9
29.9
29.9
29.8
29.7
29.6
29.5
England
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998
46,411.7
46,659.9
46,820.8
47,342.4
48,208.1
48,378.3
48,532.7
48,707.5
48,903.4
49,089.1
49,284.2
740.1
550.4
598.2
623.6
660.8
651.8
636.5
629.0
613.2
614.2
608.6
602.5‡
532.4
560.3
541.0
544.5
534.0
522.7
541.1
517.6
532.6
524.0
519.1
518.1
42.9
41.4
36.4
33.1
32.8
33.1
33.4
33.6
33.6
33.4
33.3
Wales
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998
2,740.3
2,799.3
2,813.5
2,819.6
2,891.5
2,898.5
2,906.5
2,913.0
2,916.8
2,921.1
2,926.9
43.1
33.4
35.8
37.0
38.1
37.5
36.6
35.4
34.5
34.9
34.5
33.4‡
34.8
36.3
35.0
34.7
34.1
33.8
35.9
33.9
35.6
34.6
34.6
33.9
Scotland
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998
5,235.6
5,233.4
5,180.2
5,123.0
5,107.0
5,111.2
5,120.2
5,132.4
5,136.6
5,128.0
5,122.5
86.7
64.9
69.1
65.8
67.0
65.8
63.3
61.7
60.1
59.3
59.4
57.4‡
Northern Ireland
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998
1,540.4
1,523.5
1,537.7
1,566.8
1,601.4
1,618.4
1,631.8
1,641.7
1,649.0
1,663.3
1,675.0
31.8
26.4
27.3
28.2
26.3
25.6
24.9
24.3
23.9
24.6
24.3
23.9‡
Live births
TPFR**
Expectation of
life (in years)
at birth
Outside
marriage as
percentage
of total
live births
Mean age
of mother
at birth
(years)
Agestandardised
mortality
rate††
Males
Females
Infant
mortality
rate***
2.41
1.74
1.82
1.78
1.82
1.79
1.76
1.74
1.71
1.72
1.72
1.72‡
8.2
9.0
12.5
21.0
29.8
30.8
31.8
32.0
33.6
35.5
36.7
37.6‡
26.2
26.4
26.8
27.0
27.6
27.9
28.1
28.4
28.5
28.6
28.8
28.9‡
10,448
10,486
9,506
8,897
8,107
7,860
8,037
7,622
7,706
7,522
7,370
7,344 ‡
68.8
69.6
70.8
71.9
73.2
73.4
73.7
73.9
74.1
74.3‡
75.0
75.2
76.8
77.7
78.8
78.9
79.1
79.2
79.4
79.5‡
17.9
14.5
11.2
9.5
7.4
6.6
8.3
6.2
6.2
6.1
5.9‡
28.1
29.7
29.9
29.8
29.9
30.0
29.9
29.8
29.8
29.6
29.5
2.37
1.70
1.79
1.87
1.81
1.79
1.76
1.74
1.71
1.73
1.72
1.72‡
8.5
9.2
12.9
21.4
30.1
31.1
32.0
32.2
33.7
35.5
36.7
37.5‡
26.4
26.8
27.0
27.7
27.9
28.1
28.4
28.6
28.7
28.8
29.0‡
10,278
10,271
9,298
8,694
7,941
7,678
7,825
7,440
7,526
7,333
7,190
7,175 ‡
71.1
72.0
73.4
73.7
74.0
74.1
74.4
74.6‡
77.0
77.9
79.0
79.1
79.3
79.4
79.6
79.7‡
43.4
42.0
37.6
34.4
34.4
34.6
34.9
35.1
35.0
34.7
34.5
29.8
30.9
31.6
32.5
33.4
33.6
33.6
33.6
33.6
33.5
33.5
2.44
1.79
1.87
1.86
1.88
1.87
1.84
1.79
1.78
1.82
1.82
1.77‡
7.2
8.7
11.2
21.1
32.3
34.0
35.2
36.0
38.1
41.2
42.8
44.4‡
26.0
26.6
26.5
27.0
27.3
27.4
27.7
27.8
27.8
28.0
28.0
11,175
10,858
9,846
9,012
8,074
7,886
8,227
7,753
7,953
7,664
7,578
7,419 ‡
61.6
65.3
63.8
63.5
61.0
60.9
64.0
59.3
60.5
60.7
59.5
59.2‡
48.2
44.7
38.2
33.5
32.2
32.3
32.5
32.6
32.5
32.3
32.0
27.1
28.4
28.4
28.0
28.7
28.7
28.7
28.6
28.7
28.7
28.8
2.53
1.80
1.84
1.67
1.70
1.67
1.62
1.58
1.55
1.55
1.57
1.54‡
8.1
9.3
12.2
20.6
29.1
30.3
31.3
31.2
33.7
36.0
37.7
39.0‡
26.0
26.3
26.6
27.4
27.7
27.9
28.2
28.4
28.5
28.6
28.8‡
17.6
17.0
16.3
16.1
15.1
15.0
15.6
15.1
15.3
15.2
15.0
15.0‡
56.6
56.1
50.6
46.5
44.0
43.6
43.3
42.9
42.3
41.6
40.8
24.0
25.3
25.3
24.7
25.6
25.4
25.4
25.2
25.1
24.9
25.0
3.13
2.70
2.60
2.46
2.18
2.09
2.01
1.95
1.91
1.95
1.93
1.91‡
3.8
5.0
7.0
12.7
20.2
21.9
21.9
22.0
23.1
25.9
26.6
28.3‡
27.4
27.6
27.6
28.0
28.1
28.4
28.6
28.8
28.8
29.0
29.1‡
52
18.4
13.7
12.6
9.5
6.6
6.0
5.5
6.1
5.8
5.6
5.9‡
70.4
71.6
73.2
73.3
73.5
73.5
73.8
74.0‡
76.4
77.6
78.9
78.9
79.0
79.0
79.2
79.2‡
11,444
11,675
10,849
10,135
9,254
9,146
9,529
8,840
8,887
8,868
8,623
8,593 ‡
67.3
68.2
69.1
70.2
71.4
71.5
71.7
71.9
72.1
72.2
73.7
74.4
75.3
76.2
77.1
77.1
77.3
77.4
77.6
77.8
19.9
14.8
11.3
8.8
7.1
6.8
6.5
6.2
6.2
6.2
5.3‡
11,607
11,746
10,567
10,071
8,564
8,347
8,600
8,256
8,255
8,057
7,810
7,818 ‡
67.6
67.5
69.1
70.6
72.3
72.5
72.8
72.9
73.3
73.6
73.7
73.8
75.4
76.7
78.1
78.3
78.4
78.4
78.7
78.9
22.7
18.3
13.2
10.2
7.4
6.0
7.1
6.1
7.1
5.8
5.6‡
‡ Provisional.
* Percentage of children under 16 to working population (males 16–64 and females 16–59).
† Percentage of males 65 and over and females 60 and over to working population (males 16–64 and females 16–59).
** TPFR (the total period fertility rate) is the number of children that would be born to a woman if current patterns of fertility persisted throughout her childbearing life.
†† Per million population. The age-standardised mortality rate makes allowances for changes in the age structure of the population. See Notes to tables.
***Deaths under one year per 1,000 live births.
Notes: 1. Some of these indicators are also in other tables. They are brought together to make comparison easier.
2. 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.
Office for National Statistics
17.5
14.2
10.9
9.5
7.3
6.5
6.3
6.1
6.1
6.1
5.9‡
Health Statistics Quarterly 03
Table 3.1
Live births: age of mother
Numbers (thousands), rates, mean age and TPFRs
England and Wales
Age of mother at birth
Year and
quarter
Autumn 1999
All
ages
Under
20
20–24
25–29
30–34
Age of mother at birth
35–39
40 and
over
All
ages
Under
20
Total live births (numbers)
20–24
25–29
30–34
35–39
40 and
over
Mean
age
(years)
TPFR†
Age-specific fertility rates*
1961
1964(max)†
1966
1971
1976
1977(min)†
1981
1986
1991
811.3
876.0
849.8
783.2
584.3
569.3
634.5
661.0
699.2
59.8
76.7
86.7
82.6
57.9
54.5
56.6
57.4
52.4
249.8
276.1
285.8
285.7
182.2
174.5
194.5
192.1
173.4
248.5
270.7
253.7
247.2
220.7
207.9
215.8
229.0
248.7
152.3
153.5
136.4
109.6
90.8
100.8
126.6
129.5
161.3
77.5
75.4
67.0
45.2
26.1
25.5
34.2
45.5
53.6
23.3
23.6
20.1
12.7
6.5
6.0
6.9
7.6
9.8
89.2
92.9
90.5
83.5
60.4
58.1
61.3
60.6
63.6
37.3
42.5
47.7
50.6
32.2
29.4
28.1
30.1
33.0
172.6
181.6
176.0
152.9
109.3
103.7
105.3
92.7
89.3
176.9
187.3
174.0
153.2
118.7
117.5
129.1
124.0
119.4
103.1
107.7
97.3
77.1
57.2
58.6
68.6
78.1
86.7
48.1
49.8
45.3
32.8
18.6
18.2
21.7
24.6
32.1
15.0
13.7
12.5
8.7
4.8
4.4
4.9
4.8
5.3
27.6
27.2
26.8
26.2
26.4
26.5
26.8
27.0
27.7
2.77
2.93
2.75
2.37
1.71
1.66
1.80
1.77
1.82
1992
1993
1994
1995
1996
1997
1998‡
689.7
673.5
664.7
648.1
649.5
643.1
635.9
47.9
45.1
42.0
41.9
44.7
46.4
48.3
163.3
152.0
140.2
130.7
125.7
118.6
113.5
244.8
236.0
229.1
217.4
211.1
202.8
193.1
166.8
171.1
179.6
181.2
186.4
187.5
188.5
56.7
58.8
63.1
65.5
69.5
74.9
78.9
10.2
10.5
10.7
11.3
12.1
12.9
13.6
63.5
62.6
61.9
60.4
60.5
59.8
59.1
31.7
31.0
29.0
28.5
29.8
30.2
30.7
86.2
82.7
79.4
76.8
77.5
76.6
75.4
117.3
114.1
112.1
108.6
106.9
104.8
102.6
87.2
87.0
88.7
87.3
88.6
88.8
89.9
33.4
34.1
35.8
36.2
37.2
38.9
39.9
5.8
6.2
6.4
6.8
7.2
7.6
7.8
27.9
28.1
28.4
28.5
28.6
28.8
28.9
1.80
1.76
1.75
1.72
1.73
1.73
1.73
1996
Dec
164.2
12.0
32.1
52.6
46.6
17.7
3.2
61.9
32
82
109
90
38
8
28.6
1.79
1997
March
June
Sept
Dec
158.1
163.3
164.9
156.8
11.5
11.3
11.8
11.8
29.8
29.5
30.3
29.0
50.4
51.6
52.1
48.7
45.7
48.4
48.1
45.4
17.7
19.2
19.3
18.7
3.1
3.3
3.3
3.2
60.8
60.4
59.0
59.0
31
29
30
31
78
75
76
76
107
106
104
103
90
91
88
87
38
40
38
39
8
8
7
8
28.7
28.9
28.8
28.8
1.75
1.74
1.71
1.72
1998
March‡
June‡
Sept‡
Dec‡
155.8
158.6
166.1
155.4
11.7
11.4
12.7
12.4
27.8
27.5
29.8
28.5
47.9
48.6
50.6
46.1
46.2
48.1
48.9
45.4
18.8
19.7
20.7
19.6
3.3
3.3
3.6
3.4
59.5
58.8
59.6
58.6
31
29
31
32
75
73
76
77
103
103
104
101
90
91
90
88
39
40
40
40
8
8
8
8
28.9
29.0
28.9
28.9
1.73
1.71
1.74
1.72
1999
March‡ 151.9
12.0
27.0
44.9
45.0
19.6
3.4
58.1
31
74
101
89
40
8
29.9
1.71
* Births per 1,000 women in the age-group; all quarterly rates and total period fertility rates (TPFRs) are seasonally adjusted.
† TPFR (the total period fertility rate) is the number of children that would be born to a woman if current patterns of fertility persisted throughout her childbearing life. During the post
Second World War period the TPFR reached a maximum in 1964 and a minimum in 1997.
‡ Provisional.
Note: 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.
53
Office f or National Statistics
Health Statistics Quar terly 03
Table 3.2
Autumn 1999
Live births outside marriage: age of mother and type of registration
Numbers (thousands), mean age and percentages
Age of mother at birth
Year and
quarter
All
ages
Under
20
20–24
25–29
30–34
England and Wales
Age of mother at birth
35–39
40 and
over
Mean
age
(years)
All
ages
Under
20
20–24
25–29
30–34
Registration*
35–39
40 and
over
Joint
Sole
Same Different
address† address†
Percentage of total births
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
1992
141.3
211.3
215.2
39.6
43.4
40.1
54.1
77.8
77.1
27.7
52.4
55.9
13.1
25.7
28.9
5.7
9.8
10.9
1.1
2.1
2.3
23.8
24.8
25.2
21.4
30.2
31.2
69.0
82.9
83.7
28.2
44.9
47.2
12.1
21.1
22.8
10.1
16.0
17.3
12.6
18.3
19.3
14.7
21.3
22.9
46.6
54.6
55.4
19.6
19.8
20.7
33.8
25.6
23.9
1993
1994
1995
1996
1997
1998‡
216.5
215.5
219.9
232.7
238.2
240.6
38.2
35.9
36.3
39.3
41.1
43.0
75.0
71.0
69.7
71.1
69.5
67.8
57.5
58.5
59.6
62.3
63.4
62.4
31.4
34.0
37.0
40.5
42.2
43.9
11.9
13.4
14.4
16.2
18.2
19.6
2.5
2.7
3.0
3.2
3.7
3.9
25.4
25.8
25.9
26.0
26.2
26.3
32.2
32.4
33.9
35.8
37.0
37.8
84.8
85.5
86.6
88.0
88.7
89.1
49.4
50.6
53.3
56.5
58.6
59.7
24.4
25.5
27.4
29.5
31.3
32.3
18.4
18.9
20.4
21.7
22.5
23.3
20.2
21.2
22.0
23.4
25.0
24.8
23.5
25.2
26.2
26.7
28.6
29.0
54.8
57.5
58.1
58.1
59.5
60.9
22.0
19.8
20.1
19.9
19.3
18.3
23.2
22.7
21.8
21.9
21.2
20.8
1996 Dec
61.3
10.6
18.7
16.4
10.5
4.2
0.8
26.0
37.3
87.9
58.2
31.2
22.6
23.9
26.7
58.2
19.9
21.8
1997 March
1997 June
1997 Sept
1997 Dec
58.5
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
31.0
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
22.1
21.0
21.2
20.7
1998 March‡
1998 June‡
1998 Sept‡
1998 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
26.4
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
25.6
29.6
28.3
28.5
29.6
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‡
58.9
10.7
16.3
15.0
10.9
5.0
1.0
26.3
38.8
89.7
60.4
33.4
24.1
25.4
29.4
61.5
18.1
20.4
{
1971
1976
1981
* Births outside marriage can be registered by both the mother and father (joint) or by the mother alone (sole).
† Usual address of parents.
‡ Provisional.
Office for National Statistics
54
Health Statistics Quarterly 03
Table 4.1
Autumn 1999
Conceptions: age of woman at conception
Numbers (thousands) and rates; and percentage terminated by abortion
England and Wales (residents)
Age of woman at conception
Year and quarter
All ages
Under 16
Under 20
20–24
25–29
30–34
35–39
40 and over
(a) numbers (thousands)
1990
1991
1992
1993
1994
1995
1996
1997‡
871.5
853.6
828.0
819.0
801.6
790.3
816.1
799.2
8.6
7.8
7.3
7.2
7.8
8.0
8.8
8.3
115.1
103.3
93.0
86.7
85.0
86.2
94.4
95.5
245.2
234.1
215.0
202.9
189.6
180.4
179.1
166.5
283.8
281.1
274.8
271.4
261.5
249.9
251.9
241.8
160.2
166.3
172.9
181.9
185.9
191.2
200.5
201.2
55.4
56.9
60.1
63.5
66.7
69.2
76.0
79.4
11.8
11.9
12.2
12.6
12.9
13.3
14.2
14.8
1995 March
1995 June
1995 Sept
1995 Dec
193.2
194.1
195.2
207.8
1.9
2.0
2.1
2.0
20.9
21.3
21.0
23.0
45.2
44.7
43.3
47.2
61.4
61.1
62.0
65.4
45.8
46.4
48.4
50.6
16.6
17.2
17.2
18.2
3.3
3.4
3.3
3.4
1996 March
1996 June
1996 Sept
1996 Dec
206.3
200.7
202.3
206.7
2.3
2.3
2.1
2.1
24.1
23.7
22.5
24.1
47.2
44.4
42.9
44.7
63.8
61.9
63.0
63.2
49.4
48.9
51.0
51.3
18.4
18.4
19.3
19.8
3.4
3.6
3.6
3.6
1997 March‡
1997 June ‡
1997 Sept ‡
1997 Dec ‡
193.9
198.1
199.0
208.2
2.0
2.2
2.0
2.1
23.1
23.8
23.2
25.5
41.4
41.5
40.2
43.3
59.3
59.6
60.5
62.3
47.7
49.9
51.3
52.3
18.7
19.6
20.1
20.9
3.6
3.8
3.6
3.9
(b) rates (conceptions per thousand women in age group)
1990
79.2
10.1
1991
77.7
9.3
1992
76.3
8.5
1993
76.1
8.1
1994
74.7
8.3
1995
73.7
8.5
1996
76.0
9.4
1997‡
74.3
8.9
69.1
65.1
61.7
59.6
58.6
58.7
63.0
62.3
124.4
120.6
113.5
110.4
107.3
105.9
110.4
107.5
137.8
135.0
131.7
131.2
128.0
124.8
127.6
124.9
89.1
89.4
90.4
92.5
91.8
92.1
95.3
95.3
33.2
34.0
35.4
36.8
37.8
38.2
40.7
41.2
6.4
6.4
7.0
7.4
7.7
8.0
8.5
8.7
1995 March
1995 June
1995 Sept
1995 Dec
73.0
72.6
72.2
76.8
8.2
8.7
8.7
8.6
58.0
58.2
56.5
61.7
106.0
104.9
101.5
112.0
123.5
122.1
123.1
130.2
90.3
89.9
92.5
96.2
37.6
38.2
37.5
39.5
8.0
8.1
7.8
8.0
1996 March
1996 June
1996 Sept
1996 Dec
77.3
75.2
74.9
76.5
9.9
9.8
9.1
9.0
65.2
63.7
59.6
63.4
114.9
109.3
105.8
111.5
129.4
125.8
127.2
128.3
94.9
93.6
96.4
96.8
40.1
39.7
41.0
41.8
8.1
8.6
8.6
8.6
1997 March‡
1997 June ‡
1997 Sept ‡
1997 Dec ‡
73.1
73.9
73.4
76.8
8.7
9.4
8.6
8.9
61.6
62.3
60.3
65.8
106.5
106.9
104.2
113.1
123.4
123.2
125.6
130.1
91.8
94.8
97.3
99.3
39.9
41.0
41.6
43.0
8.6
8.9
8.5
9.1
(c) percentage terminated by abortion
1990
19.9
1991
19.3
1992
19.3
1993
19.2
1994
19.5
1995
19.7
1996
20.8
1997‡
21.3
50.6
51.0
51.0
52.1
52.8
49.8
51.5
51.8
35.6
34.4
34.5
34.9
35.3
35.2
36.8
37.3
22.2
22.1
22.4
22.9
23.5
24.3
25.9
26.8
13.5
13.4
13.9
13.8
14.3
14.8
15.6
16.4
13.8
13.7
13.7
13.4
13.4
13.4
14.0
14.1
23.3
22.0
21.8
21.2
20.8
20.3
20.9
20.8
43.3
41.8
40.6
39.4
40.0
37.2
36.7
37.2
1995 March
1995 June
1995 Sept
1995 Dec
19.8
20.2
19.3
19.6
48.7
48.8
52.1
49.3
35.3
35.4
35.1
34.8
23.8
24.7
24.1
24.5
14.9
15.4
14.4
14.5
13.8
13.8
12.9
13.4
20.6
20.8
19.6
20.3
38.0
37.4
38.1
35.3
1996 March
1996 June
1996 Sept
1996 Dec
21.0
21.3
19.8
21.1
49.4
51.6
52.9
52.5
36.7
37.2
35.7
37.7
25.6
26.6
24.8
26.4
15.8
16.0
14.9
15.9
14.3
14.3
13.2
14.2
21.5
21.6
20.0
20.8
36.1
37.2
36.4
37.1
1997 March‡
1997 June ‡
1997 Sept ‡
1997 Dec ‡
21.4
21.8
20.6
21.6
50.8
52.0
50.2
54.1
36.6
37.3
37.2
38.2
26.7
27.3
25.9
27.2
16.6
16.8
15.8
16.5
14.4
14.5
13.5
14.2
20.7
21.7
20.4
20.3
37.7
38.2
35.5
37.2
‡ Provisional
Notes: 1. Conceptions are estimates derived from birth registrations and abortion notifications.
2. Rates for women of all ages, under 16, under 20 and 40 and over are based on the population of women aged 15–44, 13–15, 15–19 and 40–44 respectively. Some figures for
September 1996 onwards have been amended.
These rates use mid-1997 population estimates.
55
Office f or National Statistics
Health Statistics Quarterly 03
Table 4.2
Autumn 1999
Abortions: residents and non-residents; age and gestation (residents only)
Numbers (thousands) and rates; and percentages for gestation weeks
Englandand
andWales
Wales
England
All women (residents)
All ages
Year and quarter
All
women
Residents**
Numbers (thousands)
126.8
94.6
129.7
101.9
162.5
128.6
172.3
147.6
179.5
167.4
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998++
Age group
Gestation weeks (percentages)
Nonresidents
Under
16
16–19
20–24
25–29
30–34
35–44
45 and
over
32.2
27.8
33.9
24.7
12.1
2.3
3.4
3.5
3.9
3.2
18.2
24.0
31.4
33.8
31.1
24.5
23.6
34.3
45.3
52.7
17.3
19.3
21.9
28.7
38.6
14.2
14.6
18.7
18.0
23.4
15.9
14.7
17.6
17.5
17.9
0.5
0.5
0.6
0.4
0.4
Under
9
9–12
Percentages
16.6
57.9
24.8
55.8
31.0
53.4
33.4
53.8
35.2
52.9
13–19
20 and
over
21.8
15.0
13.5
11.5
10.6
1.0
1.1
1.3
1.4
1.2
172.1
168.7
166.9
163.6
177.5
179.7
186.9
160.5
157.8
156.5
154.3
167.9
170.1
177.3
11.6
10.9
10.3
9.3
9.6
9.6
9.5
3.0
3.1
3.2
3.2
3.6
3.4
3.7
27.6
25.8
25.1
24.9
28.8
29.9
33.2
49.0
46.8
44.9
43.4
46.4
45.0
45.6
38.4
38.1
38.1
37.3
39.3
40.2
40.3
23.9
24.7
25.5
25.8
28.2
28.9
30.4
18.1
18.8
19.1
19.2
21.1
22.3
23.7
0.5
0.5
0.4
0.5
0.4
0.5
0.5
36.8
39.2
40.5
41.9
40.0
41.2
41.4
51.8
49.7
48.4
47.3
48.7
47.9
47.6
10.3
9.9
9.9
9.6
10.1
9.6
9.7
1.2
1.2
1.2
1.2
1.3
1.2
1.3
1995
March
June
Sept
Dec
42.9
40.0
41.3
39.5
40.4
37.7
38.9
37.3
2.4
2.3
2.4
2.2
0.9
0.8
0.8
0.8
6.5
6.0
6.4
6.1
11.6
10.6
10.8
10.4
9.6
9.2
9.5
9.0
6.7
6.3
6.4
6.3
5.0
4.7
4.9
4.6
0.1
0.1
0.1
0.1
39.1
41.9
42.2
44.6
49.4
47.5
46.7
45.4
10.4
9.4
9.7
8.7
1.1
1.2
1.3
1.2
1996
March
June
Sept
Dec
45.7
45.5
44.0
42.4
43.2
42.9
41.6
40.1
2.4
2.5
2.4
2.2
0.9
0.9
0.9
0.9
7.4
7.3
7.1
7.0
12.4
11.9
11.2
10.8
10.2
10.1
9.8
9.3
7.2
7.2
7.0
6.8
5.2
5.4
5.4
5.2
0.1
0.1
0.1
0.1
38.0
38.9
40.0
43.1
50.5
49.3
48.3
46.3
10.2
10.5
10.3
9.3
1.2
1.4
1.4
1.3
1997
March
June
Sept
Dec
46.2
45.2
45.1
43.3
43.6
42.8
42.7
41.0
2.5
2.4
2.4
2.3
0.9
0.8
0.9
0.8
7.7
7.4
7.5
7.4
11.8
11.4
11.1
10.7
10.3
10.2
10.0
9.6
7.3
7.2
7.3
7.0
5.5
5.6
5.8
5.4
0.1
0.1
0.1
0.1
37.4
41.3
42.0
44.5
50.2
48.0
47.2
46.0
11.1
9.4
9.6
8.3
1.3
1.2
1.2
1.2
1998++ March
June
Sept
Dec
47.9
46.1
46.6
45.2
45.4
43.7
44.2
43.0
2.5
2.4
2.4
2.2
1.0
0.9
1.0
0.9
8.6
8.1
8.2
8.0
11.9
11.3
11.2
10.9
10.3
10.0
10.0
9.7
7.7
7.5
7.6
7.5
5.8
5.8
6.1
5.9
0.1
0.1
0.1
0.1
37.6
40.9
42.6
45.0
50.3
48.1
46.6
45.0
10.8
9.5
9.5
8.9
1.3
1.4
1.2
1.2
1999++ March
47.0
44.7
2.4
0.9
8.6
11.7
9.8
7.5
6.0
0.1
40.2
48.1
10.3
1.4
Rates (per thousand women 14–49)
1971
:
8.4
1976
:
8.9
1981
:
10.6
1986
:
11.7
1991
:
13.1
:
:
:
:
:
3.5
4.4
4.5
5.4
5.6
13.9
16.9
19.4
22.0
24.0
13.1
14.2
19.1
21.9
27.2
10.7
10.4
13.3
15.5
18.6
10.0
9.2
10.3
10.9
12.7
5.6
5.3
5.9
5.1
5.1
0.3
0.3
0.4
0.3
0.3
1992
1993
1994
1995
1996
1997
1998++
:
:
:
:
:
:
:
12.5
12.3
12.2
12.0
13.0
13.3
13.8
:
:
:
:
:
:
:
5.4
5.3
5.2
5.2
5.8
5.5
6.0
22.4
22.0
22.0
21.7
24.3
24.5
27.1
25.9
25.5
25.4
25.5
28.6
29.0
29.5
18.4
18.4
18.6
18.6
19.9
20.8
20.8
12.5
12.6
12.6
12.4
13.4
13.7
14.4
5.2
5.5
5.6
5.5
6.0
6.1
6.5
0.3
0.3
0.2
0.2
0.2
0.3
0.3
1995
March
June
Sept
Dec
:
:
:
:
12.8
11.8
12.0
11.5
:
:
:
:
5.6
4.9
5.1
5.2
22.9
21.0
21.9
21.0
27.7
24.9
25.2
24.1
19.5
18.4
18.7
17.8
13.1
12.2
12.3
12.1
5.8
5.4
5.6
5.2
0.3
0.2
0.3
0.2
1996
March
June
Sept
Dec
:
:
:
:
13.5
13.4
12.8
12.4
:
:
:
:
5.7
5.9
5.9
5.8
25.0
24.9
24.0
23.5
30.7
29.6
27.5
26.5
20.7
20.6
19.7
18.7
13.8
13.7
13.3
12.9
5.9
6.1
6.1
5.8
0.2
0.2
0.2
0.3
1997
March
June
Sept
Dec
:
:
:
:
13.8
13.4
13.2
12.7
:
:
:
:
5.7
5.4
5.7
5.3
25.5
24.1
24.3
24.0
30.8
29.6
28.3
27.4
21.7
21.1
20.6
19.7
14.1
13.8
13.8
13.1
6.2
6.2
6.3
5.9
0.2
0.3
0.3
0.3
1998++ March
June
Sept
Dec
:
:
:
:
14.4
13.7
13.7
13.3
:
:
:
:
6.3
5.7
6.1
5.9
28.5
26.4
26.7
26.0
31.2
29.3
28.8
28.0
21.7
20.8
20.4
19.8
14.7
14.3
14.2
14.0
6.5
6.4
6.7
6.4
0.3
0.3
0.3
0.3
1999++* March
:
14.0
:
5.8
27.2
31.1
21.7
14.4
6.3
0.3
++
*
**
Provisional
The denominators used to calculate rates are the 1999 population projections
Includes cases with not stated age and/or gestation weeks.
Office for National Statistics
56
Health Statistics Quarterly 03
Table 5.1
Expectation of life (in years) at birth and selected age
Autumn 1999
Constituent countries of the United Kingdom
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
1971
1976
68.8
69.6
65.3
66.0
50.9
51.4
41.3
41.9
23.0
23.4
15.3
15.7
9.5
9.6
5.5
5.6
1971
1976
75.0
75.2
71.4
72.0
56.7
57.3
47.0
47.5
28.3
28.7
19.8
20.3
12.5
12.9
6.9
7.2
1981
1986
70.8
71.9
66.9
67.8
52.3
53.2
42.7
43.6
24.1
24.9
16.3
16.8
10.1
10.5
5.7
6.0
1981
1986
76.8
77.7
72.7
73.5
57.9
58.7
48.1
48.9
29.2
29.8
20.8
21.2
13.3
13.8
7.5
7.9
1991
1992
1993
1994
1995
1996‡
73.2
73.4
73.7
73.9
74.1
74.3
68.9
69.1
69.3
69.5
69.7
69.9
54.2
54.4
54.6
54.8
55.0
55.2
44.7
44.8
45.1
45.2
45.5
45.7
26.0
26.1
26.4
26.5
26.8
26.9
17.7
17.8
18.0
18.1
18.4
18.5
11.1
11.1
11.3
11.3
11.5
11.6
6.4
6.4
6.5
6.5
6.6
6.6
1991
1992
1993
1994
1995
1996‡
78.8
78.9
79.1
79.2
79.4
79.5
74.4
74.4
74.6
74.7
74.9
75.0
59.6
59.6
59.8
59.9
60.1
60.1
49.7
49.8
50.0
50.0
50.2
50.3
30.7
30.7
30.9
31.0
31.2
31.2
21.9
21.9
22.1
22.2
22.4
22.4
14.4
14.4
14.5
14.5
14.6
14.6
8.3
8.3
8.4
8.4
8.5
8.5
England and Wales
1971
69.0
1976
69.9
65.6
66.2
51.1
51.6
41.5
42.1
23.1
23.5
15.4
15.8
9.5
9.7
5.5
5.7
1971
1976
75.2
76.0
71.6
72.2
56.9
57.4
47.1
47.7
28.4
28.8
20.0
20.4
12.6
13.0
7.0
7.2
1981
1986
71.0
72.1
67.1
68.0
52.5
53.4
42.9
43.8
24.3
25.0
16.4
16.9
10.1
10.6
5.8
6.1
1981
1986
77.0
77.9
72.9
73.6
58.1
58.9
48.3
49.0
29.4
30.0
20.9
21.4
13.4
13.9
7.5
7.9
1991
1992
1993
1994
1995
1996‡
73.4
73.6
74.0
74.1
74.4
74.6
69.1
69.3
69.6
69.7
70.0
70.2
54.5
54.6
54.9
55.0
55.2
55.4
44.9
45.0
45.3
45.4
45.7
45.9
26.2
26.3
26.5
26.7
26.9
27.1
17.9
17.9
18.2
18.3
18.5
18.7
11.2
11.2
11.4
11.4
11.6
11.7
6.4
6.4
6.5
6.5
6.6
6.7
1991
1992
1993
1994
1995
1996‡
79.0
79.1
79.3
79.4
79.6
79.7
74.6
74.6
74.8
74.9
75.1
75.2
59.8
59.8
60.0
60.1
60.3
60.3
49.9
50.0
50.2
50.3
50.4
50.6
30.8
30.9
31.1
31.2
31.3
31.4
22.1
22.1
22.3
22.3
22.5
22.6
14.5
14.5
14.6
14.6
14.7
14.7
8.4
8.4
8.5
8.5
8.6
8.6
England
1981
1986
71.1
72.2
67.1
68.1
52.5
53.4
42.9
43.8
24.3
25.1
16.4
17.0
10.1
10.6
5.8
6.1
1981
1986
77.0
77.9
72.9
73.7
58.2
58.9
48.4
49.1
29.4
30.0
20.9
21.4
13.4
13.9
7.5
7.9
1991
1992
1993
1994
1995
1996‡
73.4
73.7
74.0
74.1
74.4
74.6
69.1
69.3
69.6
69.7
70.0
70.2
54.5
54.6
54.9
55.0
55.3
55.5
44.9
45.0
45.3
45.5
45.7
45.9
26.2
26.3
26.6
26.7
27.0
27.2
17.9
18.0
18.2
18.3
18.5
18.7
11.2
11.2
11.4
11.4
11.6
11.7
6.4
6.4
6.5
6.6
6.6
6.7
1991
1992
1993
1994
1995
1996‡
79.0
79.1
79.3
79.4
79.6
79.7
74.6
74.6
74.9
74.9
75.1
75.2
59.8
59.8
60.0
60.1
60.3
60.4
49.9
50.0
50.2
50.3
50.5
50.6
30.9
30.9
31.1
31.2
31.4
31.4
22.1
22.1
22.3
22.4
22.5
22.6
14.5
14.5
14.6
14.6
14.7
14.8
8.4
8.4
8.5
8.5
8.6
8.6
Wales
1981
1986
70.4
71.6
66.5
67.5
51.9
52.9
42.2
43.3
23.6
24.6
15.8
16.6
9.7
10.4
5.5
6.0
1981
1986
76.4
77.6
72.3
73.3
57.5
58.5
47.7
48.7
28.9
29.7
20.4
21.1
13.1
13.8
7.4
7.8
1991
1992
1993
1994
1995
1996‡
73.2
73.3
73.5
73.5
73.8
74.0
68.9
68.9
69.1
69.1
69.4
69.5
54.2
54.2
54.4
54.4
54.7
54.8
44.6
44.7
44.9
44.9
45.2
45.4
25.9
25.9
26.1
26.2
26.5
26.6
17.6
17.7
17.8
17.9
18.1
18.3
11.0
11.0
11.2
11.1
11.3
11.4
6.4
6.4
6.6
6.5
6.6
6.5
1991
1992
1993
1994
1995
1996‡
78.9
78.9
79.0
79.0
79.2
79.2
74.4
74.4
74.5
74.5
74.7
74.7
59.6
59.6
59.7
59.7
59.8
59.8
49.8
49.8
49.9
49.8
50.0
50.0
30.7
30.7
30.8
30.8
30.9
31.0
21.9
21.9
22.0
22.0
22.2
22.2
14.4
14.3
14.4
14.4
14.5
14.5
8.4
8.3
8.4
8.4
8.5
8.5
Scotland
1971
1976
67.3
68.2
64.0
64.4
49.5
49.9
40.1
40.4
22.0
22.3
14.6
14.9
9.1
9.2
5.4
5.3
1971
1976
73.7
74.4
70.1
70.6
55.4
55.9
45.6
46.1
27.2
27.6
19.0
19.4
11.9
12.4
6.7
6.9
1981
1986
69.1
70.2
65.2
66.0
50.6
51.4
41.1
41.9
22.9
23.5
15.4
15.8
9.5
9.9
5.5
5.7
1981
1986
75.3
76.2
71.2
71.9
56.4
57.1
46.7
47.3
27.9
28.4
19.7
20.1
12.7
13.0
7.2
7.5
1991
1992
1993
1994
1995
1996
71.4
71.5
71.7
71.9
72.1
72.2
67.1
67.2
67.3
67.5
67.7
67.8
52.5
52.5
52.7
52.8
53.1
53.1
43.0
43.1
43.2
43.4
43.6
43.7
24.6
24.6
24.8
24.9
25.2
25.3
16.6
16.6
16.8
16.9
17.2
17.3
10.4
10.4
10.5
10.6
10.8
10.9
6.1
6.0
6.0
6.1
6.2
6.2
1991
1992
1993
1994
1995
1996
77.1
77.1
77.3
77.4
77.6
77.8
72.6
72.6
72.8
72.9
73.2
73.2
57.8
57.8
58.0
58.1
58.3
58.4
48.1
48.1
48.2
48.3
48.6
48.7
29.1
29.1
29.3
29.4
29.6
29.7
20.6
20.6
20.7
20.8
21.0
21.1
13.4
13.4
13.4
13.5
13.7
13.7
7.8
7.7
7.8
7.8
7.9
7.9
Northern Ireland
1971
1976
67.6
67.5
64.6
64.1
50.1
49.7
40.7
40.5
22.6
22.5
15.0
14.9
9.4
9.2
5.3
4.8
1971
1976
73.7
73.8
70.4
70.4
55.6
55.7
45.9
46.0
27.3
27.3
18.9
19.0
11.7
11.8
6.5
6.1
1981
1986
69.1
70.6
65.3
66.4
50.8
51.8
41.4
42.4
23.1
23.9
15.5
16.0
9.6
10.0
5.5
5.7
1981
1986
75.4
76.7
71.4
72.5
56.7
57.7
47.0
47.9
28.1
28.9
19.9
20.4
12.6
13.0
7.1
7.2
1991
1992
1993
1994
1995
1996
72.3
72.5
72.8
72.9
73.3
73.6
67.9
68.2
68.4
68.6
68.9
69.2
53.3
53.6
53.8
54.0
54.3
54.5
43.8
44.1
44.4
44.5
44.8
45.0
25.2
25.5
25.6
25.8
26.1
26.3
17.0
17.2
17.4
17.5
17.7
17.9
10.6
10.7
10.8
10.9
11.0
11.0
6.0
6.0
6.1
6.1
6.0
6.0
1991
1992
1993
1994
1995
1996
78.1
78.3
78.4
78.4
78.7
78.9
73.7
73.9
74.0
74.0
74.2
74.5
58.9
59.1
59.2
59.2
59.4
59.7
49.1
49.3
49.4
49.4
49.6
49.8
30.0
30.2
30.3
30.3
30.5
30.7
21.3
21.5
21.6
21.6
21.7
21.9
13.8
13.9
14.0
14.0
14.0
14.1
7.8
8.0
7.9
7.9
7.9
8.0
Note: Figures from 1981 are calculated from the population estimates revised in the light of the 1991 Census. All figures are based on a three-year period; see Notes to tables for further
information.
‡
Provisional.
57
Office f or National Statistics
Health Statistics Quarterly 03
Table 6.1
Autumn 1999
Deaths: age and sex
Numbers (thousands) and rates
England and Wales
Age group
Year and quarter
All ages
Under 1*
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
1971
1976
1981
1986
1991
1992
288.4
300.1
289.0
287.9
277.6
271.7
7.97
4.88
4.12
3.72
2.97
2.61
1.23
0.88
0.65
0.57
0.55
0.49
0.92
0.68
0.45
0.32
0.34
0.30
0.69
0.64
0.57
0.38
0.35
0.32
1.54
1.66
1.73
1.43
1.21
0.97
1.77
1.66
1.58
1.75
1.76
1.62
3.05
3.24
3.18
3.10
3.69
3.75
6.68
5.93
5.54
5.77
6.16
5.95
21.0
20.4
16.9
14.4
13.3
13.1
55.7
52.0
46.9
43.6
34.9
33.7
89.8
98.7
92.2
84.4
77.2
76.4
71.9
80.3
86.8
96.2
95.8
92.7
26.1
29.0
28.5
32.2
39.3
39.9
1993
1994
1995
1996
1997
1998
279.6
267.6
274.4
268.7
264.9
264.2
2.41
2.37
2.31
2.27
2.14
2.06
0.51
0.43
0.39
0.44
0.41
0.42
0.28
0.28
0.27
0.24
0.27
0.25
0.34
0.33
0.34
0.29
0.33
0.31
0.91
0.84
0.91
0.93
0.95
0.96
1.60
1.55
1.53
1.41
1.44
1.40
3.81
4.07
4.04
4.06
3.94
4.11
5.78
5.77
5.88
5.84
5.71
5.89
13.4
12.9
13.5
13.6
13.5
13.6
33.3
31.3
31.0
30.1
28.9
28.9
78.9
76.3
75.0
71.0
68.0
66.0
93.8
88.2
92.3
90.7
90.2
90.0
44.5
43.2
47.1
47.8
49.1
50.2
Females
1971
1976
1981
1986
1991
1992
278.9
298.5
288.9
293.3
292.5
286.6
5.75
3.46
2.90
2.59
2.19
1.93
0.98
0.59
0.53
0.49
0.44
0.39
0.57
0.45
0.30
0.25
0.25
0.21
0.42
0.42
0.37
0.27
0.22
0.20
0.63
0.62
0.65
0.56
0.46
0.43
0.79
0.67
0.64
0.67
0.64
0.62
1.84
1.94
1.82
1.65
1.73
1.72
4.53
4.04
3.74
3.83
3.70
3.72
13.3
12.8
10.5
8.8
8.4
8.3
30.8
29.6
27.2
25.8
21.3
20.6
64.0
67.1
62.8
58.4
54.2
53.4
95.0
104.7
103.6
106.5
103.3
99.5
60.4
72.1
73.9
83.6
95.7
95.5
1993
1994
1995
1996
1997
1998
299.2
285.6
295.2
291.5
290.4
289.2
1.84
1.75
1.68
1.69
1.66
1.55
0.37
0.36
0.33
0.32
0.30
0.30
0.19
0.19
0.20
0.18
0.18
0.19
0.25
0.20
0.21
0.20
0.21
0.21
0.39
0.36
0.38
0.43
0.43
0.43
0.58
0.54
0.50
0.51
0.49
0.47
1.80
1.77
1.86
1.85
1.72
1.77
3.63
3.67
3.64
3.66
3.74
3.71
8.6
8.7
9.0
8.9
9.0
9.1
20.4
19.0
18.9
18.2
18.0
17.9
55.2
53.9
53.0
50.2
48.3
46.7
100.9
94.2
97.2
96.7
95.5
94.3
105.0
101.0
108.4
108.7
110.9
112.7
Rates (deaths per 1,000 population in each age group)
Males
1971
1976
1981
1986
1991
1992
12.1
12.5
12.0
11.8
11.2
10.8
19.8
16.2
12.6
11.0
8.3
7.3
0.76
0.65
0.53
0.44
0.40
0.34
0.44
0.34
0.27
0.21
0.21
0.18
0.37
0.31
0.29
0.23
0.23
0.20
0.90
0.88
0.82
0.71
0.69
0.61
0.93
0.96
0.83
0.82
0.86
0.82
0.97
0.92
0.89
0.87
0.94
0.91
2.31
2.09
1.83
1.67
1.76
1.71
7.07
6.97
6.11
5.27
4.62
4.29
20.1
19.6
17.7
16.6
13.8
13.4
50.5
50.3
45.6
42.9
38.5
37.3
113.0
116.4
105.2
101.1
93.6
90.1
231.8
243.2
226.5
214.8
197.1
193.9
1993
1994
1995
1996
1997
1998‡
11.1
10.6
10.8
10.5
10.3
10.3
7.0
6.9
6.9
7.0
6.5
6.3
0.36
0.31
0.28
0.32
0.31
0.31
0.16
0.16
0.15
0.13
0.15
0.14
0.21
0.20
0.21
0.18
0.19
0.18
0.59
0.55
0.58
0.58
0.58
0.59
0.83
0.83
0.86
0.83
0.89
0.86
0.91
0.96
0.95
095
0.93
0.97
1.67
1.66
1.67
1.62
1.54
1.59
4.24
3.99
4.08
4.02
3.94
3.98
13.3
12.4
12.3
12.0
11.5
11.5
37.9
36.2
36.1
34.5
33.2
32.2
93.3
89.5
89.4
85.1
82.5
82.3
202.3
188.6
196.0
192.1
190.3
194.8
1997 Sept
1997 Dec
9.3
10.4
5.9
6.6
0.24
0.34
0.16
0.12
0.20
0.19
0.57
0.62
0.89
0.86
0.93
0.94
1.48
1.61
3.76
4.04
10.9
11.7
30.5
33.2
72.4
83.1
161.8
194.4
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
11.0
10.1
9.4
10.7
6.5
6.0
5.7
7.1
0.38
0.28
0.27
0.30
0.17
0.14
0.13
0.14
0.19
0.21
0.15
0.19
0.60
0.65
0.50
0.62
0.93
0.87
0.84
0.81
1.02
0.93
0.88
1.04
1.64
1.57
1.52
1.64
4.13
3.90
3.88
4.00
12.1
11.3
10.7
11.7
34.7
31.6
29.5
33.2
88.0
80.8
74.7
85.9
210.9
186.5
169.9
212.1
1999 March‡
11.9
7.1
0.36
0.11
0.20
0.60
0.77
0.93
1.70
4.26
12.2
35.7
96.8
249.7
Females
1971
1976
1981
1986
1991
1992
11.0
11.8
11.3
11.4
11.3
10.9
15.1
12.2
9.4
8.0
6.4
5.7
0.63
0.46
0.46
0.40
0.33
0.29
0.29
0.24
0.19
0.17
0.16
0.14
0.24
0.21
0.19
0.17
0.15
0.13
0.39
0.35
0.32
0.29
0.28
0.29
0.42
0.40
0.35
0.33
0.33
0.32
0.60
0.56
0.52
0.47
0.45
0.43
1.59
1.46
1.26
1.12
1.06
1.08
4.32
4.30
3.80
3.23
2.91
2.73
10.0
10.1
9.5
9.2
8.1
7.9
26.1
26.0
24.1
23.4
22.0
21.5
73.6
74.6
66.2
62.5
58.6
56.9
185.7
196.6
178.2
171.0
163.8
148.8
1993
1994
1995
1996
1997
1998‡
11.4
10.9
11.2
11.0
10.9
10.9
5.6
5.4
5.3
5.4
5.3
5.0
0.28
0.27
0.25
0.24
0.23
0.23
0.12
0.11
0.12
0.10
0.10
0.11
0.16
0.13
0.13
0.12
0.13
0.13
0.27
0.25
0.26
0.29
0.28
0.28
0.31
0.30
0.29
0.31
0.32
0.30
0.45
0.44
0.46
0.45
0.42
0.44
1.06
1.06
1.05
1.03
1.03
1.02
2.73
2.68
2.72
2.62
2.63
2.65
7.9
7.3
7.3
7.1
6.9
6.9
22.0
21.3
21.4
20.7
20.2
19.5
59.4
56.9
57.1
55.8
54.6
53.9
156.5
146.6
153.1
150.8
151.8
154.1
1997 Sept
1997 Dec
9.6
10.9
4.8
5.6
0.18
0.22
0.08
0.12
0.15
0.15
0.26
0.31
0.33
0.30
0.43
0.44
1.01
1.00
2.57
2.63
6.6
6.9
18.3
20.3
48.0
54.1
127.2
151.3
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
11.8
10.5
9.8
11.5
5.4
4.4
4.6
5.6
0.25
0.21
0.19
0.30
0.12
0.11
0.08
0.13
0.18
0.09
0.10
0.14
0.30
0.29
0.28
0.25
0.31
0.29
0.29
0.30
0.41
0.45
0.45
0.43
1.03
1.00
0.98
1.07
2.64
2.68
2.51
2.77
7.1
6.8
6.4
7.3
21.3
18.9
17.8
20.2
58.5
52.4
48.1
56.6
169.3
146.6
134.9
165.8
1999 March‡
13.2
5.5
0.29
0.11
0.17
0.31
0.34
0.46
1.09
2.81
7.4
21.8
64.3
202.5
* Rates per 1,000 live births.
‡ Provisional registrations.
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.
Office for National Statistics
58
Health Statistics Quarterly 03
Table 6.2
Year and
quarter
Deaths: subnational
Rates
Northern and
Yorkshire
Autumn 1999
Health Regional Office areas of England*
Trent
Anglia and
Oxford
North
Thames
South
Thames
South and
West
West
Midlands
North
West
Total deaths (deaths per 1,000 population of all ages)
1991
11.8
11.2
1992
11.4
11.0
9.7
9.5
10.0
9.6
11.3
11.1
11.5
11.3
10.8
10.6
12.0
11.7
1993
1994
1995
1996
1997
1998‡
11.8
11.2
11.3
11.2
11.0
11.3
11.4
10.8
11.0
10.9
10.8
10.9
9.8
9.4
9.6
9.6
9.4
9.5
9.9
9.5
9.7
9.4
9.2
9.1
11.5
10.9
11.1
10.9
10.7
10.4
11.6
11.1
11.5
11.2
11.2
11.0
11.0
10.5
10.9
10.6
10.5
10.5
12.1
11.5
11.6
11.5
11.4
11.4
1997 Sept
1997 Dec
9.8
11.1
9.6
11.1
8.3
9.4
8.3
9.1
9.4
10.6
9.8
11.2
9.4
10.6
10.2
11.6
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
12.4
10.9
10.0
11.8
11.7
10.7
9.5
11.8
10.0
9.2
8.7
10.1
9.8
8.6
8.3
9.6
11.3
10.1
9.4
10.8
11.9
11.0
10.0
11.3
11.2
10.1
9.5
11.1
12.1
11.1
10.4
12.1
1999 March‡
12.9
13.0
11.5
10.6
12.3
13.2
12.6
13.6
Infant mortality (deaths under 1 year per 1,000 live births)
1991
8.5
8.0
1992
6.9
6.8
6.8
5.4
6.5
6.4
6.5
6.0
6.4
5.6
8.7
8.2
7.5
7.3
1993
1994
1995
1996
1997
1998‡
6.9
6.8
6.6
6.4
6.3
6.1
7.0
7.2
6.4
6.3
5.9
6.0
5.3
5.6
5.2
5.8
5.1
5.1
6.2
6.1
5.7
5.6
5.3
5.5
6.4
5.2
5.8
6.1
5.3
5.1
5.6
5.0
5.6
5.5
5.8
4.7
7.0
7.2
7.1
6.8
7.0
6.5
6.5
6.2
6.6
6.4
6.7
6.2
1997 Sept
1997 Dec
6.5
6.0
5.8
5.2
4.4
6.0
5.0
5.9
5.8
4.5
5.1
6.0
5.8
8.0
5.9
7.8
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
6.5
6.4
5.1
6.6
6.0
5.6
5.5
6.8
5.1
4.4
5.2
6.0
5.2
5.4
4.8
6.7
5.8
4.4
4.2
6.0
5.1
3.8
4.5
5.5
7.2
6.3
5.7
6.6
6.8
5.2
5.9
6.9
Neonatal mortality (deaths under 4 weeks per 1,000 live births)
1991
4.9
4.7
3.8
1992
4.5
4.5
3.5
4.2
4.2
3.8
3.9
3.6
3.4
5.9
5.9
4.0
4.4
1993
1994
1995
1996
1997
1998‡
4.3
4.4
4.5
4.1
4.1
3.8
4.7
5.1
4.5
4.2
4.0
4.1
3.6
3.8
3.4
3.7
3.3
3.4
4.4
3.9
3.9
3.9
3.4
3.7
4.2
3.7
3.9
4.1
3.6
3.6
3.6
3.1
3.9
3.9
3.9
3.0
4.8
5.4
5.3
5.0
5.0
4.7
4.0
3.9
4.2
4.1
4.3
4.1
1997 Sept
1997 Dec
4.5
3.8
4.2
3.5
2.6
3.8
3.5
3.4
4.1
3.2
3.6
4.3
4.3
5.6
3.9
5.5
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
3.8
4.0
3.1
4.3
4.2
4.2
3.9
4.3
2.9
3.6
3.6
3.3
3.2
3.6
3.7
4.6
3.9
3.1
3.1
4.5
3.3
2.5
3.2
3.2
5.2
4.9
3.9
4.9
4.8
3.2
4.1
4.3
Perinatal mortality (stillbirths and deaths under 1 week per 1,000 total births)†
1991
8.7
8.6
7.2
1992
7.3
8.5
6.2
8.0
7.5
7.4
7.2
7.0
6.7
9.9
9.2
7.8
8.1
1993
1994
1995
1996
1997
1998‡
9.4
9.1
9.4
8.6
8.2
8.6
8.6
9.1
9.5
8.7
7.9
8.7
8.5
7.9
7.2
7.7
7.5
7.2
9.2
9.1
9.0
9.0
8.4
8.3
8.9
8.1
8.6
8.6
7.8
8.0
7.8
7.8
7.7
7.5
8.4
6.8
9.9
10.6
10.2
10.2
9.6
9.3
8.9
9.2
8.6
8.7
8.8
8.7
1997 Sept
1997 Dec
8.6
8.4
8.4
7.5
6.5
7.6
8.0
8.8
7.9
7.3
7.3
9.4
8.5
11.1
9.1
9.1
1998 March‡
1998 June‡
1998 Sept‡
1998 Dec‡
9.5
9.0
7.0
8.8
8.9
8.8
8.8
8.4
6.5
7.4
6.3
8.7
8.5
8.2
7.7
9.0
7.8
7.5
7.7
9.2
6.5
5.9
7.6
7.4
10.6
9.5
7.8
9.3
10.3
8.3
7.0
9.6
* As constituted on 1 April 1996. The Regional Office boundaries were revised from 1 April 1999.The new Regions will be shown in this table in Health Statistics Quarterly 04, when data for
the June quarter 1999 are included.
† 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.
‡ Provisional registrations.
Note: Figures represent the numbers of deaths registered in each year up to 1992 and the number of deaths occurring in each year from 1993.
59
Office f or National Statistics
Health Statistics Quarterly 03
Table 6.3
Autumn 1999
Deaths: selected causes (International Classification)* and sex
Number (thousands) and rate for all deaths and age-standardised rates† per million population for selected causes
England and Wales
Malignant neoplasms
Year and
quarter
All deaths
Number
(thousands)
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998‡
All causes Oesophagus
Stomach
Colon,
rectum,
rectosigmoid
junction and
anus
Trachea,
bronchus
and lung
Melanoma
of skin
Other
neoplasm
of skin
Breast
Cervix
uteri
Ovary and
other
uterine
Prostate
(150)
(151)
(153,154)
(162)
(172)
(173)
(174)
(180)
(183)
(185)
Rate**
288.4
300.1
289.0
287.9
277.6
271.7
279.6
267.6
274.4
268.7
264.9
264.2
1,207
1,246
1,196
1,177
1,121
1,083
1,109
1,057
1,079
1,051
1,031
1,029
13,464
13,613
12,200
11,349
10,234
9,870
10,010
9,502
9,582
9,271
9,019
9,011
76
84
90
101
117
120
123
128
126
126
125
130
317
292
251
224
185
179
162
162
148
145
136
133
331
339
316
313
310
316
294
283
281
272
267
266
1,066
1,091
1,028
949
841
810
766
743
712
681
649
650
10
14
17
18
23
22
25
24
26
25
25
26
12
12
9
9
10
10
8
9
9
8
7
8
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
:
198
211
214
263
302
303
296
295
296
287
277
278
1996 Dec
69.3
1,078
9,634
132
146
282
684
25
8
:
:
:
306
1997 Sep
1997 Dec
60.1
67.5
928
1,042
8,142
9,126
132
125
138
141
267
267
630
663
27
23
8
7
:
:
:
:
:
:
277
285
1998 Mar‡
1998 Jun‡
1998 Sep‡
1998 Dec‡
69.7
64.4
60.6
69.5
1,100
1,006
936
1,074
9,626
8,712
8,209
9,414
130
126
134
130
133
127
135
136
276
257
263
265
667
622
640
663
26
26
26
26
8
8
6
9
:
:
:
:
:
:
:
:
:
:
:
:
277
275
275
284
1999 Mar‡
75.1
1,186
10,385
127
138
258
626
24
7
:
:
:
278
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998‡
278.9
298.5
288.9
293.3
292.5
286.6
299.2
285.6
295.2
291.5
290.4
289.2
1,104
1,176
1,134
1,141
1,127
1,095
1,140
1,085
1,119
1,102
1,095
1,090
8,186
8,303
7,433
6,947
6,399
6,197
6,347
6,039
6,128
5,995
5,925
5,891
40
43
42
47
49
49
51
50
52
51
51
49
149
136
111
89
74
73
66
66
61
55
57
54
255
262
231
220
207
206
190
187
179
174
169
163
183
219
252
285
300
297
294
298
294
292
285
293
14
16
16
19
18
17
22
22
20
20
20
21
6
6
5
4
4
5
3
4
4
3
3
3
379
393
405
420
401
395
376
370
359
343
336
330
83
78
69
69
54
52
47
42
42
41
37
35
127
125
122
121
118
118
116
114
116
122
115
118
:
:
:
:
:
:
:
:
:
:
:
:
1996 Dec
75.5
1,136
6,259
55
56
172
300
20
4
350
38
130
:
1997 Sep
1997 Dec
64.3
73.0
961
1,091
5,309
5,921
54
51
58
58
169
170
293
286
20
20
3
3
340
338
38
37
116
118
:
:
1998 Mar‡
1998 Jun‡
1998 Sep‡
1998 Dec‡
77.3
69.6
65.2
77.1
1,181
1,053
976
1,153
6,321
5,650
5,332
6,027
45
48
49
52
50
57
58
51
158
160
166
168
295
274
288
310
21
18
23
23
4
3
3
3
331
312
330
343
37
35
35
34
120
113
120
117
:
:
:
:
1999 Mar‡
86.5
1,323
6,947
53
51
164
288
20
3
329
33
116
:
* The Ninth Revision of the International Classification of Diseases, 1975, came into operation in England and Wales on 1 January 1979. ONS has produced a publication containing details of
the effect of this Revision (Mortality statistics: comparison of the 8th and 9th revision of the International Classification of Diseases, 1978 (sample), (Series DH1 no.10).
‡ Provisional registrations.
† Directly age-standardised to the European Standard population. See Notes to Tables.
** Per 100,000 population.
Notes 1. Between 1 January 1984 and 31 December 1992, ONS applied the International Classification of Diseases Selection Rule 3 in the coding of deaths where terminal events and other
‘modes of dying’ such as cardiac arrest, cardiac failure, certain thromboembolic 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 Rule 3 allows 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 from 1993 onwards, such certificates are coded to the terminal event. ONS
also introduced automated coding of cause of death in 1993, which may also affect comparisons of deaths by cause from 1993. Further details may 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.
2. On 1 January 1986 a new certificate for deaths within the first 28 days of life was introduced. It is not possible to assign one underlying cause of death from this certificate. The
‘cause’ figures for 1986 onwards therefore exclude deaths at ages under 28 days.
3. Figures represent the numbers of deaths registered in each year up to 1992, and the number of deaths occurring in each year from 1993. Provisional figures are registrations.
Office for National Statistics
60
Health Statistics Quarterly 03
Table 6.3
continued
Autumn 1999
Deaths: selected causes (International Classification)* and sex
Number (thousands) and rate for all deaths and age-standardised rates† per million population for selected causes
England and Wales
Malignant neoplasms
Bladder
Leukaemia
Diabetes
mellitus
Ischaemic
heart
disease
Cerebrovascular
disease
Pneumonia
Bronchitis,
emphysema
and allied
conditions
Asthma
Gastric,
duodenal
and peptic
ulcers
Chronic
liver
disease
and
cirrhosis
Chronic
renal
failure
Motor
vehicle
traffic
accidents
Suicides and
undetermined
deaths
Year and
quarter
(188)
(204-208)
(250)
(410-414)
(430-438)
(480-486)
(490-492,
496)
(493)
(531-533)
(571)
(585)
124
128
121
120
121
123
114
109
111
104
100
99
74
76
74
75
76
72
69
68
70
65
66
67
82
91
82
134
130
127
100
97
100
96
94
94
3,801
3,930
3,664
3,463
2,981
2,854
2,829
2,595
2,535
2,410
2,261
2,223
1,541
1,357
1,141
1,071
939
886
794
755
754
743
714
708
920
1,237
1,054
460
390
361
759
679
753
725
741
717
944
852
683
725
605
573
566
494
524
480
475
462
21
17
28
33
31
27
24
23
20
19
19
18
107
108
90
85
73
69
67
67
63
63
61
60
35
45
49
56
70
70
67
67
75
88
95
107
48
61
44
38
24
14
21
20
21
19
17
18
198
170
113
130
117
109
90
86
83
87
86
86
124
135
151
154
158
157
149
148
146
137
140
153
Males
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998‡
104
66
99
2,513
759
800
502
21
69
97
18
90
131
1996 Dec
101
100
68
65
87
93
1,976
2,296
637
726
531
717
347
458
20
19
53
65
89
108
17
19
90
84
145
145
1997 Sep
1997 Dec
94
101
100
101
64
65
67
70
99
87
86
105
2,419
2,168
1,980
2,304
758
685
637
746
843
689
551
781
560
424
363
497
17
18
17
18
64
57
55
63
107
104
109
106
18
18
16
19
93
86
76
89
158
153
144
154
1998 Mar‡
1998 Jun‡
1998 Sep‡
1998 Dec‡
96
68
107
2,454
803
1,146
697
20
81
109
23
86
145
1999 Mar‡
32
35
35
36
34
35
34
34
32
31
31
31
47
48
46
46
43
42
43
42
41
40
43
41
89
81
66
100
95
94
73
69
72
67
65
64
1,668
1,774
1,601
1,554
1,404
1,347
1,330
1,222
1,179
1,126
1,060
1,042
1,352
1,212
1,012
930
809
773
711
677
677
667
639
637
623
824
741
349
324
284
569
499
553
534
559
531
193
183
155
194
211
216
223
202
227
220
225
224
25
22
30
35
30
29
27
24
24
21
23
22
44
49
57
52
46
46
45
43
42
43
41
40
26
29
36
38
45
43
43
46
49
52
55
58
30
35
28
21
13
8
12
12
11
10
9
11
80
65
39
49
44
40
34
33
29
29
28
30
84
83
81
67
51
51
48
44
46
44
45
46
Females
1971
1976
1981
1986
1991
1992
1993
1994
1995
1996
1997
1998‡
31
42
68
1,181
686
587
243
22
45
49
11
31
43
1996 Dec
30
32
43
47
64
66
934
1,061
559
640
378
530
160
227
19
23
36
38
55
55
10
9
28
30
43
46
1997 Sep
1997 Dec
32
32
32
29
41
35
40
46
66
61
60
69
1,140
1,020
931
1,068
691
614
576
661
651
493
380
598
288
198
157
250
24
19
19
24
45
41
35
41
57
54
55
65
13
11
9
11
29
34
27
30
46
43
45
50
1998 Mar‡
1998 Jun‡
1998 Sep‡
1998 Dec‡
30
46
74
1,140
723
916
354
26
45
64
12
28
42
1999 Mar‡
(E810-E819) (E950-E959,
E980-E989
exc. E9888)
61
Office f or National Statistics
Health Statistics Quar terly 03
Autumn 1999
Report:
Infant and perinatal
mortality 1998: health
areas, England and Wales
This report gives provisional statistics of live births, stillbirths and
infant deaths registered in 1998 in England and Wales, for each health
authority and regional office.
In addition, 1.2 per cent of live births with a stated birthweight were
under 1,500 grams (very low birthweight), the same as 1997.
LIVE BIRTHS AND BIRTHWEIGHT
There were 635,901 live births in England and Wales in 1998 (Table 1),
compared to 643,095 in 1997, a decrease of 1.1 per cent.
Table 1
Of live births in 1998 with a stated birthweight, 7.5 per cent weighed
less than 2,500 grams (low birthweight), compared with 7.4 in 1997.
Table 2 gives proportions of low and very low birthweight babies for
each health area in 1998.
Live births, stillbirths and infant deaths †, 1973–98
England and Wales
Deaths
Live births
Year
1973
1978
1983
1988
1992
1993
1994
1995
1996
1997
1998
Stillbirths+
Numbers
675,953
596,418
629,134
693,577
689,656
671,224
664,256
648,001
649,489
643,095††
635,901
7,936
5,108
3,631
3,382
2,944
3,866
3,816
3,597
3,539
3,439††
3,417
Under 1
week
6,438
4,242
2,951
2,701
2,294
2,178
2,142
2,104
2,066
1,941
1,835
Under
4 weeks
4 weeks –
1 year
Under
1 year
3,879
2,694
2,699
2,849
1,584
1,446
1,371
1,284
1,314
1,282
1,195
11,407
7,881
6,381
6,270
4,539
4,242
4,120
3,982
3,959
3,799
3,605
Neonatal*
Postneonatal*
Infant*
11.1
8.7
5.9
4.9
4.3
4.2
4.1
4.2
4.1
3.9
3.8
5.7
4.5
4.3
4.1
2.3
2.2
2.1
2.0
2.0
2.0
1.9
7,528
5,187
3,682
3,421
2,955
2,796
2,749
2,698
2,645
2,517
2,410
Mortality
Stillbirths**
Rates
Perinatal **
1973
1978
1983
1988
1992
1993
1994
1995
1996
1997
1998
**
*
+
†
††
11.6
8.5
5.7
4.9
4.3
5.7
5.7
5.5
5.4
5.3
5.3
21.0
15.5
10.4
8.7
7.6
9.0
8.9
8.7
8.6
8.3
8.2
Per 1,000 live births and stillbirths.
Per 1,000 live births.
Excluding the 216 stillbirths of 24–27 weeks’ gestation which occurred between 1.10.92 and 31.12.92.
Numbers of deaths shown are based on annual occurrences for years 1993 to 1997, and on annual registrations for all other years.
Revised numbers – see ‘In brief’ on page 2.
Office for National Statistics
62
16.9
13.2
10.1
9.0
6.6
6.3
6.2
6.1
6.1
5.9
5.7
Health Statistics Quarterly 03
Between 1988 and 1998 this pattern reversed. Over these years the
neonatal rate fell by only 22 per cent, but the postneonatal rate
decreased by 54 per cent. A major reason for the large fall in
postneonatal mortality since 1988 has been the reduction in the number
of sudden infant deaths. Provisional statistics on the latter are shown in
the Report on page 66.
Infant mortality rates, 1973–98,
England and Wales
Figure 1
Infant deaths per 1,000 live births
40
Infant
Autumn 1999
Neonatal
35
Postneonatal
NOTES
30
Statistics in this Report
25
Numbers of live births in this Report correspond to those in the Report
on 1998 births in the recent issue of Population Trends 96. These
numbers are based on births registered in 1998, while the mortality data
are based on deaths registered in 1998. However, in line with ONS
practice in publishing mortality data, final mortality statistics will be
based on deaths occurring in the year, and will not be available until
later in 1999.
20
15
10
Note also that in Table 1 numbers of deaths for 1993 to 1997 are based
on occurrences in these years, while numbers for years up to 1992 are
based on death registrations.
5
0
1971
74
77
80
83
86
Year
89
92
95
98
PERINATAL AND INFANT MORTALITY
In 1998 there were 3,417 stillbirths in England and Wales, and 1,835
deaths at ages under seven days (Table 1). The perinatal mortality rate
was 8.2 per thousand live births and stillbirths, a decrease from 8.3 in
1997.
In 1998 there were also 3,605 infant deaths in England and Wales, with
an infant mortality rate of 5.7 per thousand live births – the lowest yet
recorded.
Neonatal deaths (at ages under 28 days) numbered 2,410 in 1998. The
neonatal mortality rate was 3.8 per thousand live births, down from 3.9
in 1997.
Postneonatal deaths (at ages between 28 days and one year) numbered
1,195 in 1998. The postneonatal mortality rate was 1.9 deaths per
thousand live births, compared to 2.0 in 1997.
NEONATAL AND POSTNEONATAL MORTALITY 1973–98
The separate contributions of neonatal and postneonatal deaths to the
fall in infant mortality rates over 1973–98 are illustrated in Figure 1.
Over the 25 year period the infant mortality rate fell by 66 per cent, while
the neonatal and postneonatal rates fell by 66 per cent and 67 per cent,
respectively. However, these declines were not uniform over the period.
Between 1973 and 1988 the decline was more marked for neonatal
deaths, falling by 56 per cent. Over the same period the decline in the
postneonatal rate was only 28 per cent.
Areal statistics in this Report are derived from the usual residence at the
time of birth or death. If the usual residence was outside England and
Wales, these events were included in the aggregate for England and
Wales and elsewhere, but excluded from the figures for individual
health authorities and regional offices.
Health authority boundary changes
In Table 2 the figures shown are for health authorities and regional
offices as on 1 April 1998. Because of differences between these areas
and the previous regional and district health authorities, it is not
possible to compare the statistics directly with earlier Monitors in the
DH3 series.
Recording of birthweight
Since 1975 ONS (formerly OPCS) has obtained the birthweight of a
baby from information provided to the registrar of births and deaths by
the local health services. By 1986, birthweight was recorded for 99.9
per cent of all live births, with the same proportion in 1998.
Legal definition of stillbirths
On 1 October 1992 the legal definition of a stillbirth was altered, from a
baby born dead after 28 or more weeks’ completed gestation to one
born after 24 or more weeks’ completed gestation. This means that
perinatal and stillbirth data for 1998 can be compared with data only
from 1993 onwards.
General
More details on the above, and on other aspects of stillbirth and infant
mortality data, may be found in the ONS annual volume Mortality
statistics: childhood, infant and perinatal 1997, series DH3 no 30,
published in March 1999.
63
Office for National Statistics
Health Statistics Quar terly 03
Table 2
Autumn 1999
Births, perinatal and infant mortality statistics 1998, health regional office and health authority of usual residence
England and Wales
Numbers
Births
Mortality rates
Percentage of
live births with
a stated
birthweight
Deaths
Live
births
Still
births
Under
1 wk
Under
4 wks
Under
1 yr
Perinatal**
Neonatal*
Postneonatal*
Infant*
Under
1,500g
Under
2,500g
England, Wales and elsewhere***
635,901
3,417
1,835
2,410
3,605
8.2
3.8
1.9
5.7
1.2
7.5
England
602,111
3,219
1,743
2,277
3,371
8.2
3.8
1.8
5.6
1.2
7.5
72,941
416
212
276
446
8.6
3.8
2.3
6.1
1.2
7.6
7,098
7,622
6,724
6,303
3,815
8,358
5,205
3,295
3,199
7,928
3,223
6,554
3,617
34
43
35
36
19
47
39
18
20
43
21
36
25
24
29
16
23
9
32
12
9
6
18
7
18
9
31
37
21
28
10
40
17
11
7
23
11
25
15
64
51
35
44
16
64
26
17
13
39
18
37
22
8.1
9.4
7.5
9.3
7.3
9.4
9.7
8.1
8.1
7.7
8.6
8.2
9.3
4.4
4.9
3.1
4.4
2.6
4.8
3.3
3.3
2.2
2.9
3.4
3.8
4.1
4.6
1.8
2.1
2.5
1.6
2.9
1.7
1.8
1.9
2.0
2.2
1.8
1.9
9.0
6.7
5.2
7.0
4.2
7.7
5.0
5.2
4.1
4.9
5.6
5.6
6.1
1.4
1.3
1.0
1.2
0.9
1.4
1.1
0.8
0.9
1.1
1.0
1.3
1.0
9.8
8.2
7.0
7.4
6.8
8.4
7.5
6.6
6.7
6.0
8.4
7.8
7.7
Trent
59,186
323
194
243
352
8.7
4.1
1.8
5.9
1.3
7.8
Barnsley
Doncaster
Leicestershire
Lincolnshire
North Derbyshire
North Nottinghamshire
Nottingham
Rotherham
Sheffield
South Derbyshire
South Humber
2,569
3,538
11,133
6,665
3,973
4,493
7,334
3,009
6,088
6,831
3,553
11
22
69
32
16
20
36
18
40
40
19
13
16
33
23
12
7
13
14
21
29
13
17
16
40
27
16
10
24
17
26
35
15
22
26
64
40
21
20
39
24
33
42
21
9.3
10.7
9.1
8.2
7.0
6.0
6.6
10.6
10.0
10.0
9.0
6.6
4.5
3.6
4.1
4.0
2.2
3.3
5.6
4.3
5.1
4.2
1.9
2.8
2.2
2.0
1.3
2.2
2.0
2.3
1.1
1.0
1.7
8.6
7.3
5.7
6.0
5.3
4.5
5.3
8.0
5.4
6.1
5.9
1.5
1.4
1.2
1.4
1.1
1.3
1.0
1.5
1.3
1.4
1.4
7.8
7.7
8.0
7.3
6.4
7.7
7.8
7.8
8.4
7.9
8.2
Anglia and Oxford
66,265
315
164
222
341
7.2
3.4
1.8
5.1
1.1
7.0
Bedfordshire
Berkshire
Buckinghamshire
Cambridge and Huntingdon
East Norfolk
Northamptonshire
North West Anglia
Oxfordshire
Suffolk
7,527
10,645
8,638
5,256
6,575
7,519
4,994
7,449
7,662
35
54
41
16
30
32
25
37
45
18
31
15
11
21
21
15
12
20
27
39
23
14
29
26
19
19
26
38
52
46
23
45
39
29
31
38
7.0
7.9
6.5
5.1
7.7
7.0
8.0
6.5
8.4
3.6
3.7
2.7
2.7
4.4
3.5
3.8
2.6
3.4
1.5
1.2
2.7
1.7
2.4
1.7
2.0
1.6
1.6
5.0
4.9
5.3
4.4
6.8
5.2
5.8
4.2
5.0
1.0
1.2
1.0
1.0
1.2
1.2
1.5
0.8
1.1
7.6
7.6
6.6
5.8
6.9
7.5
8.1
5.9
7.0
North Thames
97,777
550
269
366
536
8.3
3.7
1.7
5.5
1.3
7.6
Barking and Havering
Barnet
Brent and Harrow
Camden and Islington
Ealing, Hammersmith and Hounslow
East and North Hertfordshire
East London and The City
Enfield and Haringey
Hillingdon
Kensington & Chelsea and Westminster
North Essex
Redbridge and Waltham Forest
South Essex
West Hertfordshire
5,000
4,227
6,626
5,219
10,135
6,435
12,026
7,581
3,534
4,298
10,267
6,759
8,830
6,840
24
19
39
32
44
29
99
55
17
23
49
36
43
41
18
13
24
9
17
6
44
13
15
20
34
18
21
17
22
15
34
14
26
12
56
23
18
25
43
26
27
25
30
23
46
23
42
24
86
38
26
35
49
35
42
37
8.4
7.5
9.5
7.8
6.0
5.4
11.8
8.9
9.0
10.0
8.0
7.9
7.2
8.4
4.4
3.5
5.1
2.7
2.6
1.9
4.7
3.0
5.1
5.8
4.2
3.8
3.1
3.7
1.6
1.9
1.8
1.7
1.6
1.9
2.5
2.0
2.3
2.3
0.6
1.3
1.7
1.8
6.0
5.4
6.9
4.4
4.1
3.7
7.2
5.0
7.4
8.1
4.8
5.2
4.8
5.4
1.4
1.2
1.8
1.0
1.4
0.9
1.5
1.4
1.3
1.6
1.0
1.2
1.2
1.1
6.8
7.2
8.4
7.2
8.2
6.1
9.7
8.3
8.2
7.5
6.4
7.7
6.3
6.8
South Thames
88,304
472
242
318
445
8.0
3.6
1.4
5.0
1.2
7.0
6,025
3,644
28
14
16
7
26
11
36
16
7.3
5.7
4.3
3.0
1.7
1.4
6.0
4.4
1.3
0.9
7.6
6.3
Area
Northern and Yorkshire
Bradford
Calderdale and Kirklees
County Durham
East Riding
Gateshead and South Tyneside
Leeds
Newcastle and North Tyneside
North Cumbria
Northumberland
North Yorkshire
Sunderland
Tees
Wakefield
Bexley and Greenwich
Bromley
* Per 1,000 live births.
** Per 1,000 live and stillbirths.
*** Including births and deaths to persons normally resident outside England and Wales.
Office for National Statistics
64
Health Statistics Quarterly 03
Table 2
continued
Autumn 1999
Births, perinatal and infant mortality statistics 1998, health regional office and health authority of usual residence
England and Wales
Numbers
Births
Mortality rates
Percentage of
live births with
a stated
birthweight
Deaths
Live
births
Still
births
Under
1 wk
Under
4 wks
Under
1 yr
Croydon
East Kent
East Surrey
East Sussex, Brighton and Hove
Kingston and Richmond
Lambeth, Southwark and Lewisham
Merton, Sutton and Wandsworth
West Kent
West Surrey
West Sussex
4,651
6,721
5,110
7,964
4,417
12,250
8,912
12,297
7,867
8,446
21
21
21
47
16
101
65
61
31
46
20
16
10
19
8
56
21
28
22
19
25
21
13
25
11
74
27
36
26
23
32
29
19
37
16
101
39
49
37
34
8.8
5.5
6.0
8.2
5.4
12.7
9.6
7.2
6.7
7.7
5.4
3.1
2.5
3.1
2.5
6.0
3.0
2.9
3.3
2.7
1.5
1.2
1.2
1.5
1.1
2.2
1.3
1.1
1.4
1.3
6.9
4.3
3.7
4.6
3.6
8.2
4.4
4.0
4.7
4.0
1.6
1.1
0.9
0.9
0.8
1.9
1.1
1.1
1.0
1.0
8.7
6.3
5.9
6.3
5.4
8.8
6.9
6.9
6.5
6.60
South and West
74,328
340
172
228
350
6.9
3.1
1.6
4.7
1.0
6.60
Avon
Cornwall and Isles of Scilly
Dorset
Gloucestershire
Isle of Wight
North and East Devon
North and Mid Hampshire
Portsmouth and South East Hampshire
Somerset
Southampton and South West Hampshire
South and West Devon
11,666
5,039
6,831
6,439
1,221
4,866
7,075
6,229
5,313
5,980
6,112
45
31
28
24
6
21
30
29
26
17
33
29
9
18
15
2
14
9
14
16
12
15
37
10
25
21
3
18
13
21
18
14
18
58
14
31
37
4
27
26
33
25
26
29
6.3
7.9
6.7
6.0
6.5
7.2
5.5
6.9
7.9
4.8
7.8
3.2
2.0
3.7
3.3
2.5
3.7
1.8
3.4
3.4
2.3
2.9
1.8
0.8
0.9
2.5
0.8
1.8
1.8
1.9
1.3
2.0
1.8
5.0
2.8
4.5
5.7
3.3
5.5
3.7
5.3
4.7
4.3
4.7
0.9
1.0
1.2
0.9
1.1
1.0
0.9
1.2
0.9
1.2
1.0
6.3
6.2
7.0
6.5
7.3
6.7
6.4
6.6
6.3
7.0
6.7
Wiltshire
7,557
50
19
30
40
9.1
4.0
1.3
5.3
1.0
6.50
West Midlands
Birmingham
Coventry
Dudley
Herefordshire
North Staffordshire
Sandwell
Shropshire
Solihull
South Staffordshire
Walsall
Warwickshire
Wolverhampton
Worcestershire
65,035
14,762
3,724
3,569
1,811
5,164
3,870
4,945
2,182
6,676
3,476
5,659
3,117
6,080
365
92
20
19
8
30
17
25
14
43
21
37
14
25
241
64
24
12
6
17
17
15
3
16
15
22
10
20
305
81
26
15
7
24
23
25
3
17
20
28
12
24
418
118
35
20
10
31
34
32
6
24
26
35
16
31
9.3
10.5
11.8
8.6
7.7
9.0
8.7
8.0
7.7
8.8
10.3
10.4
7.7
7.4
4.7
5.5
7.0
4.2
3.9
4.6
5.9
5.1
1.4
2.5
5.8
4.9
3.8
3.9
1.7
2.5
2.4
1.4
1.7
1.4
2.8
1.4
1.4
1.0
1.7
1.2
1.3
1.2
6.4
8.0
9.4
5.6
5.5
6.0
8.8
6.5
2.7
3.6
7.5
6.2
5.1
5.1
1.4
1.7
1.7
1.3
1.1
1.3
1.9
1.3
0.7
1.1
1.8
1.2
2.1
1.0
8.40
10.0
8.7
8.8
6.7
8.2
10.4
7.0
6.6
7.4
10.3
6.7
10.0
6.60
North West
78,275
438
249
319
483
8.7
4.1
2.1
6.2
1.3
8.10
5,038
6,888
5,545
5,842
3,160
4,008
4,972
4,006
5,428
2,879
7,358
3,449
3,234
6,013
6,879
3,576
31
39
33
37
22
12
27
23
32
16
40
11
15
34
48
18
12
21
19
17
8
10
19
16
19
14
13
15
10
22
17
17
14
27
26
25
12
14
20
22
25
16
17
18
13
25
24
21
25
44
38
41
19
22
30
30
35
21
32
25
16
39
37
29
8.5
8.7
9.3
9.2
9.4
5.5
9.2
9.7
9.3
10.4
7.2
7.5
7.7
9.3
9.4
9.7
2.8
3.9
4.7
4.3
3.8
3.5
4.0
5.5
4.6
5.6
2.3
5.2
4.0
4.2
3.5
5.9
2.2
2.5
2.2
2.7
2.2
2.0
2.0
2.0
1.8
1.7
2.0
2.0
0.9
2.3
1.9
2.2
5.0
6.4
6.9
7.0
6.0
5.5
6.0
7.5
6.4
7.3
4.3
7.2
4.9
6.5
5.4
8.1
1.5
1.5
1.6
1.6
1.1
1.4
1.5
1.2
1.3
1.4
0.8
1.2
1.5
1.3
0.9
1.4
9.2
9.5
8.2
9.3
6.9
6.5
8.3
8.5
8.3
7.9
6.1
6.3
7.2
8.4
8.9
8.0
33,438
182
87
122
189
8.0
3.6
2.0
5.7
1.1
7.20
45
25
34
59
26
8.6
8.3
8.9
8.3
6.0
4.0
2.2
5.0
4.0
2.7
2.0
2.9
1.3
2.6
1.2
6.0
5.1
6.3
6.6
3.9
1.2
1.1
1.2
1.2
1.0
6.6
6.4
7.4
8.0
7.0
Area
Bury and Rochdale
East Lancashire
Liverpool
Manchester
Morecambe Bay
North Cheshire
North West Lancashire
St Helens and Knowsley
Salford and Trafford
Sefton
South Cheshire
South Lancashire
Stockport
West Pennine
Wigan and Bolton
Wirral
Wales
North Wales
7,499
43
22
Dyfed Powys
4,909
31
10
Morgannwg
5,370
29
19
Bro Taf
8,981
51
24
Gwent
6,679
28
12
* Per 1,000 live births.
** Per 1,000 live and stillbirths.
*** Including births and deaths to persons normally resident outside England and Wales.
30
11
27
36
18
Perinatal**
Neonatal*
65
Postneonatal*
Infant*
Under
1,500g
Under
2,500g
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
Report:
Sudden infant deaths
1998
This report presents provisional statistics on sudden infant deaths in
England and Wales which occurred in 1998. It also compares the
number of sudden infant deaths by sex, age at death and month of
occurrence with data from 1994 to 1998.
●
●
There were 284 sudden infant deaths which occurred in England and
Wales in 1998, compared with 393 in 1997, a decrease of 28 per cent.
The sudden infant mortality rate decreased from 0.61 to 0.45 per
thousand live births, a decrease of 26 per cent.
Key findings for the period 1994–98:
●
●
●
Sudden infant deaths are more common amongst boys than girls. In
the period 1994–98, 60 per cent of all sudden infant deaths
occurred amongst boys, whilst boys comprised 51 per cent of all
live births.
In the period 1994–98, 87 per cent of sudden infant deaths occurred
at ages less than six months and 55 per cent occurred at ages less
than three months.
There is a clear seasonal pattern in sudden infant deaths with most
cases occurring during the winter months. In the period 1994 to
1998 there were 36 per cent more sudden infant deaths in the three
month period January to March compared with the three month
period July to September.
●
The sudden infant death rate for babies born outside marriage
where only one parent registered the birth was over three times
higher than the overall sudden infant death rate.
The rate for babies born inside marriage to mothers who had no
previous births was 66 per cent lower than the overall sudden infant
death rate.
For births inside marriage, the babies of fathers in Social Classes
IV and V had higher sudden infant death rates than babies of fathers
in the other social classes. In all social classes babies born outside
marriage had higher sudden infant death rates than babies born
inside marriage.
EXPLANATORY NOTES:
Definition
The statistics given in this report are based on any mention of ‘sudden
infant death’, ‘cot death’, ‘SIDS’, ‘crib death’, or some similar term
mentioned on the death certificate.
Future changes to the data
The figures presented in this report relate to our database as at 9 June
1999. Therefore these figures may differ slightly from those published
elsewhere.
Key findings for 1998:
Differences in tables
●
●
●
The sudden infant death rate was highest for very low birthweight
babies (under 1,500 grams) and it decreased with increasing
birthweight. The rate for babies weighing less than 1,500 grams
was ten times higher than that for babies weighing 3,500 grams and
over.
The sudden infant death rate was highest for children of mothers
aged under 20 compared to all other age groups at the time of the
child’s birth.
There were only 23 babies (8 per cent) whose mothers were born
outside the United Kingdom.
Office for National Statistics
66
Tables 1 to 4 include data for years 1994 to 1998 and relate to number
of occurrences in each year.
Tables 5 to 9 present statistics on sudden infant deaths which occurred
in 1998 and which have been linked to their corresponding birth
records. Information about parents which was collected at birth
registration can then be used to enable analysis of the data according to
certain risk factors. The risk factors presented here include birthweight
(Table 5), mother’s age at birth of child (Table 6), mother’s country of
birth (Table 7), marital status and parity (Table 8), and father’s social
class based on his occupation (Table 9).
Health Statistics Quarterly 03
Table 1
Autumn 1999
Sudden infant deaths by sex, 1994–98
Numbers and rates
Year
England and Wales
Boys
Girls
All babies
Neonatal
deaths
Postneonatal
deaths
Infant
deaths
Neonatal
deaths
Postneonatal
deaths
Infant
deaths
Neonatal
deaths
Postneonatal
deaths
Infant
deaths
1994
1995
1996
1997
1998
Numbers
15
24
24
23
19
269
217
227
221
142
284
241
251
244
161
24
24
29
22
15
146
133
144
127
108
170
157
173
149
123
39
48
53
45
34
415
350
371
348
250
454
398
424
393
284
1994
1995
1996
1997
1998
Rates per 1,000 live births
0.04
0.79
0.07
0.65
0.07
0.68
0.07
0.67
0.06
0.44
0.83
0.73
0.75
0.74
0.49
0.07
0.08
0.09
0.07
0.05
0.45
0.42
0.46
0.41
0.35
0.53
0.50
0.55
0.48
0.40
0.06
0.07
0.08
0.07
0.05
0.62
0.54
0.57
0.54
0.39
0.68
0.61
0.65
0.61
0.45
Table 2
Sudden infant deaths by age at death, 1994–98
Numbers and percentage distribution
England and Wales
Year
Age at death
Under
28 days
28 days and over
but less than
2 months
2 completed
months
1994
1995
1996
1997
1998
Numbers
39
48
53
45
34
1994
1995
1996
1997
1998
Percentages of all sudden infant deaths under 1 year
8.6
20.7
19.6
12.1
22.6
19.8
12.5
23.1
22.4
11.5
24.2
19.3
12.0
30.3
18.7
Table 3
94
90
98
95
86
3 completed
months
4 completed
months
5 completed
months
between 6 and
11 completed
months
All babies
64
65
66
49
38
50
31
39
50
30
35
35
30
31
21
83
50
43
47
22
454
398
424
393
284
14.1
16.3
15.6
12.5
13.4
11.0
7.8
9.2
12.7
10.6
7.7
8.8
7.1
7.9
7.4
18.3
12.6
10.1
12.0
7.7
100.0
100.0
100.0
100.0
100.0
89
79
95
76
53
Sudden infant deaths by month of occurrence, 1994–98
Numbers
Year
1994
1995
1996
1997
1998
England and Wales
Month
January
February
March
April
May
June
July
August
September
October
November
60
32
43
39
28
49
35
43
28
24
31
50
54
37
20
34
28
26
37
17
36
32
31
31
23
48
34
26
29
21
23
34
41
32
19
30
25
24
26
15
39
30
29
34
21
41
31
28
29
30
22
27
35
32
24
December
Total
41
40
44
39
42
454
398
424
393
284
Table 4
Sudden infant deaths by quarter of occurence and Health Regional Office, 1998
Numbers and rates
Year
Quarter
ending
England
and Wales
Northern
and Yorkshire
Number
March
June
September
December
72
61
55
96
12
8
8
10
2
7
6
9
9
5
5
8
12
10
2
12
10
4
5
8
13
10
9
15
2
4
6
10
7
10
10
15
5
3
3
5
0.7
0.4
0.4
0.6
0.1
0.5
0.4
0.6
0.5
0.3
0.3
0.5
0.5
0.4
0.1
0.5
0.5
0.2
0.2
0.4
0.7
0.5
0.5
0.8
0.1
0.2
0.4
0.6
0.4
0.5
0.5
0.8
0.6
0.4
0.3
0.6
1998
1998
Rates per 1,000 live births
March
0.5
June
0.4
September
0.3
December
0.6
Trent
Anglia and
Oxford
North
Thames
South
Thames
South and
West
67
West
Midlands
North
West
Wales
Office for National Statistics
Health Statistics Quar terly 03
Table 5
Autumn 1999
Live births, and infant deaths by birthweight, 1998
Numbers and rates
Birthweight (grams)
England and Wales
Numbers
Births
Rates*
Deaths
Live births
Neonatal
Postneonatal
Infants
Neonatal
All
635,921
34
246
280
0.05
0.39
0.44
< 1500
1500–1999
2000–2499
2500–2999
3000–3499
3500 and over
Not Stated
7,746
9,502
30,274
106,865
228,007
252,726
801
0
2
7
9
9
7
0
14
13
39
62
78
40
0
14
15
46
71
87
47
0
0.00
0.21
0.23
0.08
0.04
0.03
0.00
1.81
1.37
1.29
0.58
0.34
0.16
0.00
1.81
1.58
1.52
0.66
0.38
0.19
0.00
*
Postneonatal
Infant
Neonatal, postneonatal, and infant deaths per 1,000 live births.
Table 6
Live births, and infant deaths by mother’s age, 1998
Numbers and rates
Mother‘s age
England and Wales
Numbers
Births
Rates*
Deaths
Live births
Neonatal
Postneonatal
Infants
Neonatal
All
635,921
34
246
280
0.05
0.39
0.44
Under 20
20–24
25–29
30–34
35–39
40 and over
48,287
113,518
193,130
188,510
78,909
13,567
6
11
9
6
1
1
57
73
53
38
21
4
63
84
62
44
22
5
0.12
0.10
0.05
0.03
0.01
0.07
1.18
0.64
0.27
0.20
0.27
0.29
1.30
0.74
0.32
0.23
0.28
0.37
*
Postneonatal
Infant
Neonatal, postneonatal, and infant deaths per 1,000 live births.
Table 7
Live births and infant deaths by mother’s country of birth, 1998
Numbers and rates
Country of birth
England and Wales
Numbers
Births
Rates*
Deaths
Live births
Neonatal
Postneonatal
Infants
Neonatal
Postneonatal
Infant
All
635,921
34
246
280
0.05
0.39
0.44
United Kingdom
Scotland
Northern Ireland
Irish Republic
549,464
9,059
2,649
4,665
33
1
0
0
224
4
1
2
257
5
1
2
0.06
0.41
0.47
Rest of European Union
Australia, Canada, New Zealand
10,417
3,392
0
0
4
1
4
1
New Commonwealth
Bangladesh
Pakistan
East Africa
Rest of Africa
Caribbean
46,011
7,429
13,052
4,496
7,582
2,563
1
0
1
0
0
0
11
2
3
1
3
1
12
2
4
1
3
1
Other††
19,130
0
5
5
*
Neonatal, postneonatal and infant deaths per 1,000 live births.
††
Includes cases where no country of birth was stated.
Note: Where no data is shown indicates that the number of deaths in each category is too small to make the publication of rates meaningful.
Office for National Statistics
68
Health Statistics Quarterly 03
Table 8
Autumn 1999
Live births and infant deaths by marital status, parity (within marriage) and type of registration (outside marriage), 1998
Numbers and rates
England and Wales
Marital status
Numbers
Births
Parity/type of registration
Live births
Rates*
Deaths
Neonatal
Postneonatal
Infants
Neonatal
Postneonatal
Infant
All
635,921
34
246
280
0.05
0.39
0.44
Inside marriage
All
0
1
2
3 and over
395,274
154,680
146,348
60,974
33,272
13
4
6
2
1
74
19
29
15
11
87
23
35
17
12
0.03
0.03
0.04
0.03
0.03
0.19
0.12
0.20
0.25
0.33
0.22
0.15
0.24
0.28
0.36
Outside marriage
All
Joint registration/same address
Joint registration/different address
Sole registration
240,647
146,545
44,119
49,983
21
12
3
6
172
64
37
71
193
76
40
77
0.09
0.08
0.07
0.12
0.71
0.44
0.84
1.42
0.80
0.52
0.91
1.54
*
Neonatal, postneonatal, and infant deaths per 1,000 live births.
Table 9
Live births* and infant deaths by social class (based on father’s occupation at death registration)†, 1998
Numbers and rates
England and Wales
Social class
Numbers
Births
Live births*
Rates**
Deaths
Neonatal
Postneonatal
Infants
Neonatal
Postneonatal
Infant
All††
58,638
28
175
203
0.05
0.30
0.35
Inside marriage
All***
I
II
IIIN
IIIM
IV
V
Other
39,497
3,876
12,407
4,247
10,527
5,172
1,388
1,880
13
2
4
0
3
4
0
0
74
6
16
4
22
12
4
7
87
8
20
4
25
16
4
7
0.03
0.05
0.03
0.00
0.03
0.08
0.00
0.00
0.19
0.15
0.13
0.09
0.21
0.23
0.29
0.37
0.22
0.21
0.16
0.09
0.24
0.31
0.29
0.37
Outside marriage joint registration
All***
I
II
IIIN
IIIM
IV
V
Other
19,141
620
3,422
1,470
7,043
3,868
1,666
1,052
15
0
1
1
7
4
0
2
101
3
11
10
19
18
15
21
116
3
12
11
26
22
15
23
0.08
0.00
0.03
0.07
0.10
0.10
0.00
0.19
0.53
0.48
0.32
0.68
0.27
0.47
0.90
2.00
0.61
0.48
0.35
0.75
0.37
0.57
0.90
2.19
*
**
***
†
††
Figures for live births are a 10 per cent sample coded for father’s occupation.
Neonatal, postneonatal, and infant deaths per 1,000 live births.
Includes cases where father’s occupation was not stated.
Information on the father’s occupation is not collected for births outside marriage if the father does not attend the registration of the baby’s birth.
Excludes births outside marriage, sole registration.
69
Office for National Statistics
Health Statistics Quar terly 03
Autumn 1999
Report:
Death registrations in
England and Wales,1998:
area of residence
This report gives (in Table 1) the numbers of deaths registered in
England and Wales in 1998 by area of usual residence of deceased.
The table also shows standardised mortality ratios (SMRs) by area.
The areas include both local and health authorities, as well as health
regions and Government Office regions. The numbers of deaths are
from all causes.
Mortality levels in 1998 were highest in the North East (SMR of 116)
and North West (110) regions, and lowest in the South West (91).
Among local authorities, mortality was highest in Halton UA (129) and
Merthyr Tydfil UA (127), with lowest levels in Rutland UA (77),
Dorset (83) and Bath and NE Somerset UA (83). For health areas the
heaviest mortality was in Manchester (127), Liverpool (123) and St
Helens and Knowsley (123); the lightest was found in Kensington,
Chelsea and Westminster (81) and Solihull (85).
Figures for 1998 deaths registrations by age and sex, and for selected
causes of deaths, were published in a Report in Health Statistics
Quarterly 02 on 27 May 1999.
EXPLANATORY NOTES:
Occurrences and registrations
Up to 1992 ONS (formerly OPCS) publications gave numbers of deaths
registered in the data year. Since 1993 most of our published figures
represent the number of deaths which occurred in the data year. This
change has had little effect on annual totals but makes it easier to
analyse seasonal variations in mortality. We also reviewed our
production of deaths data by period of occurrence or registration, and
decided to take two annual extracts. The main reason for this is the
considerable number of late registrations, particularly for deaths from
external causes.1
Office for National Statistics
70
The first annual extract from our deaths database, produced in April
following the data year, comprises registrations in that year. Outputs
produced using this extract include this Report and a cause based
Report in Health Statistics Quarterly, VS tables, and the Public Health
Common Dataset. The second extract is produced in the following
September, and comprises occurrences in the data year. This extract
forms the basis for annual mortality publications, with the exception of
the two reports mentioned above. These new arrangements began in
1996, for annual extracts of 1995 data.
Standardised mortality ratios
Comparison of the level of mortality between different areas is difficult
if no account is taken of differences in their population structure. In
Table 1 this is done by using standardised mortality ratios (SMRs). For
each area, the ratio is derived by comparing the number of deaths
actually occurring in it with the number which would have been
expected if the sex and age specific mortality rates for England and
Wales applied to the area’s population distribution. If local mortality
rates are high compared to national rates, the number of deaths
observed will be greater than the expected number, and the SMR
greater than 100; and vice versa for areas with low mortality rates.
More details may be found in ONS annual reference volumes.2 Note
that in Table 1 SMRs for males and females are not directly comparable
with each other.
REFERENCES
1
Office for National Statistics. Mortality statistics: cause 1997,
series DH2 no 24, section 2.2. The Stationery Office (London:
1998).
2
Office for National Statistics (1998). Mortality statistics: general
1996, series DH1 no 29, section 2.6.
Health Statistics Quarterly 03
Table 1
Deaths by area of usual residence, numbers and standardised
mortality ratios (SMRs), by sex, 1998 registrations
England, Wales and elsewhere, government office regions,
unitary authorities, counties, former counties,
regional offices and health authorities
Number of deaths
Area of usual residence
Autumn 1999
Standardised mortality ratios
Persons
Males
Females
Persons
England, Wales and elsewhere
553,435
264,202
289,233
100
100
100
England
518,089
247,202
270,887
100
99
100
33,905
16,112
17,793
102
102
103
1,441
888
553
:
:
:
30,550
14,662
15,888
116
117
115
Darlington UA
Hartlepool UA
Middlesbrough UA
Redcar and Cleveland UA
Stockton-on-Tees UA
1,252
1,017
1,505
1,540
1,817
569
520
743
773
852
683
497
762
767
965
112
115
113
112
117
109
121
118
119
110
115
109
109
107
123
Durham County
Northumberland
Tyne and Wear
5,958
3,815
13,646
2,834
1,853
6,518
3,124
1,962
7,128
116
114
117
115
114
120
117
114
116
5,879
7,210
2,888
3,403
2,991
3,807
114
115
116
114
112
117
78,849
36,917
41,932
110
110
110
Blackburn with Darwen UA
Blackpool UA
Halton UA
Warrington UA
1,558
2,147
1,266
1,971
728
1,011
596
911
830
1,136
670
1,060
122
110
129
112
123
113
124
107
122
108
135
117
Cheshire County
Cumbria County
Greater Manchester
Lancashire County
Merseyside
7,093
6,003
28,923
13,072
16,816
3,327
2,803
13,714
5,977
7,850
3,766
3,200
15,209
7,095
8,966
100
105
114
104
113
97
102
117
102
116
102
108
113
107
112
Former County of Cheshire
Former County of Lancashire
10,330
16,777
4,834
7,716
5,496
9,061
105
106
101
105
108
108
YORKSHIRE AND THE HUMBER
55,469
26,426
29,043
104
105
104
East Riding of Yorkshire UA
Kingston upon Hull, City of UA
North East Lincolnshire UA
North Lincolnshire UA
York UA
3,708
2,953
1,762
1,763
1,915
1,739
1,413
869
900
928
1,969
1,540
893
863
987
104
113
104
109
95
101
113
108
112
98
106
112
101
105
92
North Yorkshire County
South Yorkshire
West Yorkshire
6,555
14,768
22,045
3,005
7,105
10,467
3,550
7,663
11,578
95
109
105
92
110
106
98
108
104
Former County of Humberside
Former County of North Yorkshire
10,186
8,470
4,921
3,933
5,265
4,537
107
95
107
93
107
97
EAST MIDLANDS
44,140
21,534
22,606
102
101
102
Derby UA
Leicester UA
Nottingham UA
Rutland UA
2,447
2,928
2,999
269
1,212
1,388
1,494
120
1,235
1,540
1,505
149
102
106
108
77
104
104
112
67
99
107
104
87
Derbyshire County
Leicestershire County
Lincolnshire
Northamptonshire
Nottinghamshire County
8,204
5,662
7,501
6,027
8,103
3,938
2,770
3,679
2,945
3,988
4,266
2,892
3,822
3,082
4,115
105
93
101
102
103
103
90
99
101
103
106
94
101
102
102
10,651
8,859
11,102
5,150
4,278
5,482
5,501
4,581
5,620
104
96
104
103
93
105
104
98
102
Wales
Elsewhere
NORTH EAST
Former County of Cleveland
Former County of Durham
NORTH WEST
Former County of Derbyshire
Former County of Leicestershire
Former County of Nottinghamshire
Males
Females
Note: SMRs are based on mid-1997 population estimates
71
Office for National Statistics
Health Statistics Quar terly 03
Table 1
Continued
Autumn 1999
Deaths by area of usual residence, numbers and standardised
mortality ratios (SMRs), by sex, 1998 registrations
England,Wales and elsewhere, government office regions,
unitary authorities, counties, former counties,
regional offices and health authorities
Number of deaths
Area of usual residence
Males
Females
Persons
55,648
27,104
28,544
103
103
102
Herefordshire, County of UA
Stoke-on-Trent UA
Telford and Wrekin UA
1,937
2,813
1,303
919
1,376
673
1,018
1,437
630
94
110
109
90
116
114
97
106
105
Shropshire County
Staffordshire County
Warwickshire
West Midlands
Worcestershire County
3,132
8,221
5,193
27,419
5,630
1,481
3,911
2,490
13,586
2,668
1,651
4,310
2,703
13,833
2,962
96
104
100
104
99
93
101
95
108
96
97
107
103
101
101
Former County of Hereford and Worcester
Former County of Shropshire
Former County of Staffordshire
7,567
4,435
11,034
3,587
2,154
5,287
3,980
2,281
5,747
97
99
106
94
98
105
100
99
107
EAST
53,997
25,917
28,080
95
92
96
Luton UA
Peterborough UA
Southend on Sea UA
Thurrock UA
1,426
1,479
2,196
1,139
733
738
1,003
585
693
741
1,193
554
102
108
98
105
104
106
99
111
99
110
98
100
Bedfordshire County
Cambridgeshire County
Essex County
Hertfordshire
Norfolk
Suffolk
3,256
5,051
13,233
9,529
9,422
7,266
1,564
2,452
6,296
4,440
4,640
3,466
1,692
2,599
6,937
5,089
4,782
3,800
96
92
95
94
94
93
94
90
92
89
92
90
98
94
96
98
94
95
Former County of Bedfordshire
Former County of Cambridgeshire
Former County of Essex
4,682
6,530
16,568
2,297
3,190
7,884
2,385
3,340
8,684
98
96
96
97
93
94
98
97
97
LONDON
Inner London
Outer London
62,302
21,874
40,428
30,278
11,113
19,165
32,024
10,761
21,263
95
98
94
97
104
95
93
93
94
SOUTH EAST
81,800
38,147
43,653
93
91
94
Bracknell Forest UA
Brighton and Hove UA
Isle of Wight UA
Medway UA
Milton Keynes UA
832
3,113
1,804
2,137
1,436
389
1,394
868
1,060
708
443
1,719
936
1,077
728
101
98
92
106
105
96
99
94
108
105
105
98
90
105
106
Portsmouth UA
Reading UA
Slough UA
Southampton UA
West Berkshire UA
2,100
1,202
920
2,167
1,155
990
578
487
1,083
564
1,110
624
433
1,084
591
102
90
109
98
90
103
93
115
102
88
102
88
103
94
92
Windsor & Maidenhead UA
Wokingham UA
1,296
1,099
591
492
705
607
95
97
87
85
103
110
Buckinghamshire County
East Sussex County
Hampshire County
Kent County
Oxfordshire
4,136
6,862
11,950
14,700
5,376
1,963
3,017
5,664
6,884
2,551
2,173
3,845
6,286
7,816
2,825
92
86
93
95
93
88
86
91
95
89
96
87
95
96
95
Surrey
West Sussex
10,389
9,126
4,780
4,084
5,609
5,042
88
88
85
86
90
89
Former County of Berkshire
Former County of Buckinghamshire
Former County of East Sussex
Former County of Hampshire
Former County of Kent
6,504
5,572
9,975
16,217
16,837
3,101
2,671
4,411
7,737
7,944
3,403
2,901
5,564
8,480
8,893
96
95
90
95
96
92
92
89
94
96
99
98
90
96
97
WEST MIDLANDS
Persons
Standardised mortality ratios
Office for National Statistics
72
Males
Females
Health Statistics Quarterly 03
Table 1
Continued
Deaths by area of usual residence, numbers and standardised
mortality ratios (SMRs), by sex, 1998 registrations
England, Wales and elsewhere, government office regions,
unitary authorities, counties, former counties,
regional offices and health authorities
Number of deaths
Area of usual residence
Standardised mortality ratios
Males
Females
55,334
26,217
29,117
91
90
91
Bath and North East Somerset UA
Bournemouth UA
Bristol, City of UA
North Somerset UA
1,736
2,387
3,963
2,221
801
1,037
1,940
985
935
1,350
2,023
1,236
83
91
94
91
82
92
98
89
84
92
91
93
Plymouth UA
Poole UA
South Gloucestershire UA
Swindon UA
Torbay UA
2,646
1,645
1,902
1,587
1,935
1,289
762
883
763
868
1,357
883
1,019
824
1,067
99
88
87
102
92
102
87
79
101
95
97
88
94
103
91
Cornwall and the Isles of Scilly
Devon County
Dorset County
Gloucestershire
Somerset
Wiltshire
5,808
8,744
4,837
5,920
5,785
4,218
2,800
4,123
2,329
2,837
2,800
2,000
3,008
4,621
2,508
3,083
2,985
2,218
90
89
83
93
93
92
90
88
82
93
93
89
90
90
82
92
91
94
Former County of Avon
Former County of Devon
Former County of Dorset
Former County of Wiltshire
9,822
13,325
8,869
5,805
4,609
6,280
4,128
2,763
5,213
7,045
4,741
3,042
90
92
86
94
89
92
85
92
91
91
86
96
WALES
33,905
16,112
17,793
102
102
103
Isle of Anglesey
Gwynedd
Conwy
Denbighshire
Flintshire
809
1,461
1,679
1,294
1,378
379
693
793
606
654
430
768
886
688
724
99
97
92
100
97
98
102
97
101
93
100
94
88
99
100
Wrexham
Powys
Ceredigion
Pembrokeshire
Carmarthenshire
1,434
1,588
755
1,404
2,243
676
788
356
656
1,022
758
800
399
748
1,221
106
101
84
108
102
106
99
82
102
98
107
101
85
113
106
Swansea
Neath Port Talbot
Bridgend
The Vale of Glamorgan
Cardiff
2,669
1,734
1,515
1,298
2,950
1,273
832
728
604
1,402
1,396
902
787
694
1,548
100
106
106
102
93
100
112
107
96
94
99
103
106
107
93
Rhondda, Cynon, Taff
Merthyr Tydfil
Caerphilly
Blaenau Gwent
Torfaen
2,768
744
1,917
921
980
1,310
340
921
443
476
1,458
404
996
478
504
115
127
118
115
108
116
126
117
118
108
115
131
120
114
108
Monmouthshire
Newport
953
1,411
476
684
477
727
92
99
95
100
89
99
71,537
34,036
37,501
108
109
108
Bradford
Calderdale and Kirklees
County Durham
East Riding
Gateshead and South Tyneside
5,113
6,301
7,210
6,661
4,521
2,435
2,915
3,403
3,152
2,186
2,678
3,386
3,807
3,509
2,335
108
106
115
107
120
112
106
114
106
122
106
107
117
108
118
Leeds
Newcastle and North Tyneside
North Cumbria
Northumberland
North Yorkshire
7,288
5,757
3,811
3,815
8,470
3,456
2,691
1,822
1,853
3,933
3,832
3,066
1,989
1,962
4,537
98
113
108
114
95
99
116
106
114
93
98
112
109
114
97
Sunderland
Tees
Wakefield
3,368
5,879
3,343
1,641
2,888
1,661
1,727
2,991
1,682
121
114
112
125
116
115
120
112
109
SOUTH WEST
NORTHERN AND YORKSHIRE
Persons
Autumn 1999
Persons
73
Males
Females
Office for National Statistics
Health Statistics Quar terly 03
Table 1
Continued
Autumn 1999
Deaths by area of usual residence, numbers and standardised
mortality ratios (SMRs), by sex, 1998 registrations
England,Wales and elsewhere, government office regions,
unitary authorities, counties, former counties,
regional offices and health authorities
Number of deaths
Area of usual residence
Males
Females
Persons
Males
56,088
27,302
28,786
103
103
103
Barnsley
Doncaster
Leicestershire
Lincolnshire
North Derbyshire
2,715
3,346
8,859
7,501
4,374
1,318
1,633
4,278
3,679
2,072
1,397
1,713
4,581
3,822
2,302
116
118
96
101
107
118
116
93
99
104
115
119
98
101
110
North Nottinghamshire
Nottingham
Rotherham
Sheffield
Southern Derbyshire
South Humber
4,408
6,694
2,670
6,037
5,959
3,525
2,205
3,277
1,280
2,874
2,917
1,769
2,203
3,417
1,390
3,163
3,042
1,756
108
101
106
102
101
106
109
103
106
104
102
110
107
100
107
101
100
103
51,379
24,861
26,518
96
93
97
Bedfordshire
Berkshire
Buckinghamshire
Cambridge and Huntingdon
East Norfolk
4,682
6,504
5,572
3,911
7,426
2,297
3,101
2,671
1,899
3,641
2,385
3,403
2,901
2,012
3,785
98
96
95
89
94
97
92
92
87
92
98
99
98
89
93
Northamptonshire
North West Anglia
Oxfordshire
Suffolk
6,027
4,615
5,376
7,266
2,945
2,290
2,551
3,466
3,082
2,325
2,825
3,800
102
101
93
93
101
98
89
90
102
103
95
95
NORTH THAMES
63,299
30,725
32,574
95
96
94
Barking and Havering
Barnet
Brent and Harrow
Camden and Islington
4,044
3,008
3,773
3,093
1,951
1,351
1,888
1,618
2,093
1,657
1,885
1,475
101
92
93
97
104
87
95
106
99
96
90
89
Ealing, Hammersmith and Hounslow
East and North Hertfordshire
East London and The City
Enfield and Haringey
Hillingdon
5,504
4,655
4,707
3,997
2,178
2,733
2,214
2,539
1,933
1,060
2,771
2,441
2,168
2,064
1,118
98
97
105
91
90
101
93
113
96
91
95
100
96
87
90
Kensington, Chelsea and Westminster
North Essex
Redbridge and Waltham Forest
South Essex
West Hertfordshire
2,694
9,410
4,204
7,158
4,874
1,335
4,497
1,993
3,387
2,226
1,359
4,913
2,211
3,771
2,648
81
95
95
97
91
83
93
97
96
85
79
95
94
99
96
71,427
33,096
38,331
93
93
93
Bexley and Greenwich
Bromley
Croydon
East Kent
East Surrey
4,236
3,033
2,812
7,577
4,365
2,033
1,347
1,319
3,545
2,005
2,203
1,686
1,493
4,032
2,360
101
89
95
95
87
103
88
93
96
85
99
91
97
94
89
East Sussex, Brighton and Hove
Kingston and Richmond
Lambeth, Southwark and Lewisham
Merton, Sutton and Wandsworth
9,975
2,997
6,245
5,777
4,411
1,369
3,163
2,646
5,564
1,628
3,082
3,131
90
88
104
97
89
88
111
99
90
88
99
97
West Kent
West Surrey
West Sussex
9,260
6,024
9,126
4,399
2,775
4,084
4,861
3,249
5,042
98
88
88
96
85
86
99
91
89
73,355
34,822
38,533
92
91
92
9,822
5,808
8,869
5,920
1,804
4,609
2,800
4,128
2,837
868
5,213
3,008
4,741
3,083
936
90
90
86
93
92
89
90
85
93
94
91
90
86
92
90
TRENT
ANGLIA AND OXFORD
SOUTH THAMES
SOUTH AND WEST
Avon
Cornwall and Isles of Scilly
Dorset
Gloucestershire
Isle of Wight
Persons
Standardised mortality ratios
Office for National Statistics
74
Females
Health Statistics Quarterly 03
Table 1
Continued
Deaths by area of usual residence, numbers and standardised
mortality ratios (SMRs), by sex, 1998 registrations
England, Wales and elsewhere, government office regions,
unitary authorities, counties, former counties,
regional offices and health authorities
Number of deaths
Area of usual residence
Persons
Males
Autumn 1999
Standardised mortality ratios
Females
Persons
Males
Females
North and East Devon
North and Mid Hampshire
Portsmouth and South East Hampshire
Somerset
Southampton and South West Hampshire
6,017
4,785
5,734
5,785
5,698
2,836
2,269
2,716
2,800
2,752
3,181
2,516
3,018
2,985
2,946
90
94
97
93
93
88
92
97
93
93
90
97
98
91
93
South and West Devon
Wiltshire
7,308
5,805
3,444
2,763
3,864
3,042
93
94
95
92
92
96
WEST MIDLANDS
55,648
27,104
28,544
103
103
102
Birmingham
Coventry
Dudley
Herefordshire
North Staffordshire
10,277
3,206
3,308
1,937
5,240
5,085
1,562
1,614
919
2,540
5,192
1,644
1,694
1,018
2,700
105
103
103
94
107
110
103
105
90
109
102
102
101
97
106
Sandwell
Shropshire
Solihull
South Staffordshire
3,580
4,435
1,784
5,794
1,809
2,154
929
2,747
1,771
2,281
855
3,047
118
99
85
104
127
98
90
100
111
99
81
107
Walsall
Warwickshire
Wolverhampton
Worcestershire
2,600
5,193
2,664
5,630
1,266
2,490
1,321
2,668
1,334
2,703
1,343
2,962
100
100
107
99
101
95
109
96
99
103
105
101
75,356
35,256
40,100
110
111
111
Bury and Rochdale
East Lancashire
Liverpool
Manchester
Morecambe Bay
4,327
5,841
5,469
4,888
3,870
2,077
2,683
2,572
2,398
1,746
2,250
3,158
2,897
2,490
2,124
115
114
123
127
101
118
110
125
133
97
114
117
122
122
105
North Cheshire
North West Lancashire
St Helens and Knowsley
Salford and Trafford
Sefton
3,237
6,155
3,649
5,157
3,621
1,507
2,876
1,799
2,411
1,610
1,730
3,279
1,850
2,746
2,011
118
104
123
108
100
113
106
126
110
101
124
103
121
108
101
South Cheshire
South Lancashire
Stockport
West Pennine
Wigan and Bolton
Wirral
7,093
3,103
3,104
5,468
6,297
4,077
3,327
1,392
1,421
2,598
2,970
1,869
3,766
1,711
1,683
2,870
3,327
2,208
100
101
97
119
114
105
97
97
97
123
116
109
102
106
98
118
114
104
33,905
16,112
17,793
102
102
103
8,055
5,990
5,918
7,760
6,182
3,801
2,822
2,833
3,656
3,000
4,254
3,168
3,085
4,104
3,182
98
100
103
104
107
99
97
105
104
108
97
103
102
105
107
NORTH WEST
WALES
North Wales
Dyfed Powys
Morgannwg
Bro Taf
Gwent
75
Office for National Statistics
Health Statistics Quar terl y 03
Autumn 1999
Recent ONS publications
The 2001 Census of Population White Paper (The Stationery
Office, March, £7.55, ISBN 0 10 142532 5).
Omnibus Survey: Contraception and Sexual Health, 1997
(Office for National Statistics, March, £10, ISBN 1 85774 312 1).
Population Trends 95 (Spring 1999) (The Stationery Office, March,
£20, ISBN 0 11 621115 6).
Mortality statistics 1997: childhood, infant and perinatal (DH3
no. 30) (The Stationery Office, March, £35, ISBN 0 11 621165 2).
Gazeteer of the old and new geographies of the United Kingdom
(Office for National Statistics, March, £20, ISBN 1 85774 298 2).
Focus on London 99 (The Stationery Office and London Research
Centre, April, £45, ISBN 0 11 621159 8).
Cancer Survival Trends 1991–1995: deprivation and NHS
Regions (The Stationery Office, April, £130, ISBN 0 11 62103 1).
Office for National Statistics
76
Cancer Survival Trends 1971–1995: deprivation and NHS
Regions CD-ROM (The Office for National Statistics, April, £100 +
VAT, ISBN 1 85774324 5).
International migration 1997 (MN no 24) (The Stationery Office,
April, £30, ISBN 0 11 621166 0).
Mid-1996 national population projections (The Stationery Office,
May, £30, ISBN 0 11 621160 1).
Key population and vital statistics 1997 (VS no 24/PP1 no 20)
(The Stationery Office, June, £30, ISBN 0 11 621167 9).
Social Focus on Older People (The Stationery Office, June, £30,
ISBN 0 11 621168 7).
Population Trends 96 (Summer 1999) (The Stationery Office, June,
£20, ISBN 0 11 621116 4).