The Office for National Statistics (ONS) released a health and social care statistical bulletin last month about the excess mortality figures last winter, and a projection of figures for this year. In 2014-2015, there was a 151% rise in excess winter deaths in England and Wales, which represents the biggest yearly increase since records began.
Excess deaths in winter (EWD) continue to be an important public health issue in the UK, potentially amenable to effective interventions. This excess mortality is highest in both relative and absolute terms in elderly people and for certain disease groups. It also varies from area to area. EWD are also associated with cold weather. However, it has been observed that other countries in Europe, especially the colder Scandinavian countries have relatively fewer excess winter deaths in winter compared to the UK.
Elderly people, individuals with low incomes (up to 9 million people in the UK live in fuel poverty), sick and disable people, those with mental health problems, babies and children under five, and pregnant women are considered vulnerable when the outside temperature drops below 6°C. Not all people living in fuel poverty is on benefits or are pension age. In fact, a study last winter found that half of households living in fuel poverty in the UK had someone in work.
The ineffective influenza vaccine was partly blamed for some of the increase over the 2014-15 period. The flu vaccine was quoted to have quite a low effectiveness, between 3% or 4%. By the end of the period it was quoted at 34%, but that is still below what we would expect, which is at least 50% effectiveness. However, most people offered the ‘flu vaccine are also offered a pneumonia vaccine. Pneumonia, a respiratory disease, is a complication of ‘flu that is the biggest cause of mortality. But pneumonia is a complication of other illnesses, too. People are much more susceptible to pneumonia when they are also malnourished and living in poverty. And the category “respiratory disease” includes asthma, bronchitis and a range of other illnesses. The ‘flu vaccine’s efficacy is really something of a red herring. Respiratory disease is always a major cause of death in the UK and research shows consistently that it is more likely to be correlated with poverty than an ineffective ‘flu vaccine.
Janet Morrison, the chief executive of the charity Independent Age, described the figures as shocking. She said: “Even discounting the impact of the flu, the figures are still far higher than in previous years.”
“Councils, the government and energy companies need to help with things like insulating homes and assistance with energy bills for vulnerable customers. But there are also simple things we can all do like checking on our frail and elderly family and neighbours in cold weather. And making sure they are able to take up their flu vaccination, wrap up warm and eat well.”
There were more excess winter deaths in females than in males, as is the case over previous years. Male excess winter deaths increased from 7,210 to 18,400, and female deaths from 10,250 to 25,500 between 2013-14 and 2014-15.
In 2014/15 excess winter deaths increased significantly in all age groups compared with 2013/14.
Main points of the ONS Bulletin:
- An estimated 43,900 excess winter deaths occurred in England and Wales in 2014/15; the highest number since 1999/00, with 27% more people dying in the winter months compared with the non-winter months.
- The majority of deaths occurred among people aged 75 and over; there were an estimated 36,300 excess winter deaths in this age group in 2014/15, compared with 7,700 in people aged under 75.
- There were more excess winter deaths in females than in males in 2014/15, as in previous years. Male excess winter deaths increased from 7,210 to 18,400, and female deaths from 10,250 to 25,500 between 2013/14 and 2014/15.
- Respiratory diseases were the underlying cause of death in more than a third of all excess winter deaths in 2014/15.
- The excess winter mortality index was highest in the South West in 2014/15 and joint lowest in Yorkshire and The Humber, and Wales.
Last month, David Cameron dismissed questions from Jeremy Corbyn about a looming winter crisis in the NHS (and the impact of the proposed cuts to tax credits) by mocking Labour’s move to the left under the new leader.
The prime minister declined an invitation from Corbyn to guarantee that the NHS will avoid a winter crisis this year and instead joked that he would award the Labour leader “full Marx” for creating his own winter crisis in his party.
Cameron has a very nasty habit of trivialising and diverting attention from what are often serious life and death issues for many of our most vulnerable UK citizens.
Image courtesy of Robert Livingstone
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This post was written for Welfare Weekly, which is a socially responsible and ethical news provider, specialising in social welfare related news and opinion.
Politics and Insights 
The only fly in the ointment about the “flu vaccine” excuse, is that there wasn’t a flu epidemic. The deaths were predominately from respiratory illness, not flu which is a notifiable illness, which is only lethal in a weakened state. It is a pointer at the effect of food and fuel poverty, for years. Poverty is debilitating a huge swathe of our population, by design it seems.
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In fairness, ‘flu causes respiratory illness, and pneumonia is a big killer – one of the most common complications of ‘flu. Especially for older people, and those like me, with chronic illness, autoimmune problems (I have lupus, have had ‘flu-related pneumonia and pleurisy more than twice) and infants.
But as we know, fuel poverty is also a major factor in the increase in winter deaths.
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So sorry to quibble, but I think “in fairness” is actually a direct nudge unit hit, because that was the way we were directed in the commentary to these data. I hesitate to say this because you have been inspirational in unmasking the Nudge Unit and the quasi-fascist politics behind it.
The breakdown by cause was respiratory illness / flu – 36%, Circulatory – 25%, dementia & Alzheimer’s, 24%, the balance 15% was poisonings(?) and injury. The level of flu reported was up a little, but not nearly as high as in 2010/11 or 1999/2000 when the EWD rates did not show any major increase overall or in this category. The finger pointing at the vaccine and flu infections is actually a mis-direction. The most common cause of respiratory illness is not flu but rhinoviruses (common cold) and these have a low level of serious complication, of about 1%, leading to pneumonia, and death and that is shown clearly in these figures. Those with the complications are of course the most vulnerable, young and old. But what is outstanding is the ONS observation that “In 2014/15 EWD increased significantly in all age groups compared with 2013/14” . Across all age groups, and across all categories – worth repeating, because this shows an increased number of vulnerable individuals across society, beyond the very old we have come to expect in these figures.
The category showing the largest uplift was Dementia, and the ONS indicate this may be related to “care problems”. Again, this is something that we can provide a reasonable explanation for – the cuts to care services budgets, and effective rationing of care to those deemed the highest risk group, and denied to many who in previous years would have support. Seasonality for circulatory disease is less generally, but in 2014/15 this also increased over baseline by 23% in the winter, whereas in previous years it was about 11%, and the ONS had no explanation for this.
The ONS commentary stated that the single largest factor was temperature related, even though it wasn’t a cold year. In previous years you have to go back to 1999/ 2000 for a similar rate of EWD, when flu rates were much higher that year. So they are saying that even though it wasn’t very cold, many more dies during the colder periods than would be expected based on temperatures in previous years.
So we have a not very cold year, a few more flu cases but not many, and a 150% increase in EWD, affecting all age groups. Looking for causes, the most likely must be poverty – food and fuel – which has increased across all age groups in the lower income groups. There probably are more causes, but until more work is done, we shouldn’t start casting around for more esoteric reasons (such as vaccination actually causing worse respiratory disease from non-flu infections).
So I’m sorry for the long reply, but the devil is in the detail and the official line is simply wrong, but like all the Nudge Unit disinformation it has worked well to quell any suspicions by pointing at something that was already being worked up in the past few weeks – the heavily trailed story about the “wrong flu” vaccine – set the scene for these EWD figures which were already in the pipeline. Instead, in my opinion, there should be an outcry about the worsening health and nutrition across all age groups, and the link to the “welfare reforms”, and the evidence that serious harm is being caused leading to the avoidable death of tens of thousands.
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I don’t mind quibbling 🙂 I do agree with you, and actually, an increase in respiratory illness – which also covers asthma, COPD, bronchitis and as you say, secondary infections from common cold viruses, may be linked with fuel poverty and deprivation also. I checked that out, and of course there is a body of research confirming that respiratory disease in every form is linked with poverty. Correlated, at least. Malnutrition also causes susceptibility to infections, making it more likely that people get both colds, flu and pneumonia. I have circulatory illness, too. (Severe Raynaud’s). I can say that last winter, though not as cold as 2010, was far more miserable and painful for me, because I couldn’t afford to heat my home adequately.
I absolutely agree that the increase in winter deaths is most likely related to the welfare “reforms”, and we know that other increases in mortality are also because of Tory policies. Many people offered the ‘flu vaccine are also offered a pneumonia vaccine too. That protects people for 10 years I think. The ‘flu vaccine may well have been inadequate, but it doesn’t really explain the increase in deaths very well at all. In fact I’ll add that to the piece, because it’s an important point, along with the links to research into the correlation between respiratory disease and poverty.
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Also, with regard to the comment about “a direct Nudge Unit hit”, well, I’m more concerned with ensuring that my criticism of nudge is accurate and valid. When I don’t know whether something is directly linked with something else, I will say so. I don’t use pseudoscience and ideology to criticise pseudoscience and ideology … if you see what I mean 🙂
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Superb post had to feature rather than reblog on main news here hope you like FEATURED: BRITAIN: Excess Winter Mortality in England and Wales rise by 151% – ONS reported | Ace News Services
https://acenewsservices.wordpress.com/2015/12/12/featured-britain-excess-winter-mortality-in-england-and-wales-rise-by-151-ons-reported/
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