Deaths

Healthy People
Mortality
Life Expectancy
behavioural risk factors
mental health
physical health conditions
cancer
cardiovascular disease
falls
air pollution
avoidable mortality
deaths

introduction Introduction

Mortality refers to deaths in a population. Information gathered about the number and causes of deaths helps to understand the overall health of a population. The Public Health Outcomes Framework1 sets out the aim to increase healthy life expectancy and reduce differences in life expectancy between communities. To achieve this, the underlying causes of deaths, or mortality, must be addressed. Not all deaths can be avoided but those which occur prematurely due to preventable or treatable diseases, illnesses, or injuries, offer the opportunity to reduce mortality by targeting interventions to address the underlying causes. The below table describes the different categories of mortality in more detail.2

Term Description
Mortality rate The number of deaths in a population over a period of time
Premature mortality All deaths in people under the age of 75 years
Preventable mortality Deaths in people under the age of 75 years which could have been prevented by effective public health intervention. For example, a death from lung cancer may be prevented by stopping smoking. This is called primary prevention.
Treatable mortality Deaths caused by diseases which could have been prevented if good quality treatment is given early enough. This is called secondary prevention as the disease has already started. For example, lung cancer detected at an early stage and successfully treated.
Avoidable mortality All the deaths defined as preventable or treatable. There is a defined list of conditions the right time. However, this does not mean that every death caused by these conditions could be avoided because there are lots of other factors such other medical conditions in the same individual.
Excess mortality A certain number of deaths are expected in a population over a period of time as people age, and not all diseases, illnesses and accidents are preventable. ‘Excess mortality’ is the number of deaths which happen above this expected level. Excess mortality can be caused by an outbreak of a disease where more people die than is usually recorded such as during the COVID-19 pandemic.

Other measures of mortality recorded in the Public Health Outcomes Framework3 include mortality related to a range of modifiable risk factors, including smoking, alcohol, drug misuse and air pollution. This domain also includes mortality rates for all causes in all ages, specific causes such as stroke, COVID-19 and coronary heart disease, infectious diseases, infant and child deaths, suicides and people killed and seriously injured casualties on England’s roads.

When comparing mortality between two populations, a higher number of deaths in one population may indicate possible health inequalities. Health inequalities refers to unfair differences in health between groups of people as a result of differences in the environment in which people are born, live and work, social and economic factors, access to healthcare and health behaviours. In order to compare mortality rates fairly, the age standardised mortality rate needs to be calculated. This takes into account the ages of the people who make up the population. In a population with a lot of older people, you would expect a higher number of deaths compared with a population with more younger people. By standardising age in two populations and then comparing the number of deaths you can see if a higher number of deaths is just because the population is older overall or if it due to another reason (such as poorer healthcare services). Age standardised mortality rate is usually stated as number of deaths per 100,000 population.

why is it important to population health Why is it important to Population Health?

Mortality data is an indicator of general health and also gives specific causes of death. This information can be used to guide resource allocation with the aim of improving the life expectancy of the population, both in terms of longevity and the amount of time of a person’s lifespan spent in good health (healthy life expectancy). Avoidable mortality data in particular highlights areas where resources could have maximum impact on improving the health of a population. For example, lung disease and lung cancer are major causes of avoidable mortality and in many of these cases smoking is a significant contributing factor to the development of the disease. The provision of effective and accessible smoking cessation services contributes to preventing the development of these diseases and therefore reducing avoidable mortality. Mortality data over time can also identify trends in the overall health of a population. These trends give an indication of the impact of environmental, social, economical and political factors on people’s health. Trends may also indicate how effective any implemented initiatives or policies have been at improving the health of a population.

the derbyshire population approach The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of mortality within The Derbyshire Population Health Approach:

Strategies for mortality prevention focus on reducing the number of avoidable deaths by improving the overall health of the population. There are different points at which interventions can be effective in preventing either the development or progression of disease:

  • Primary interventions aim to prevent the onset of the diseases which are associated with mortality. This includes public health campaigns to raise awareness about which lifestyle behaviours increase the risk of developing diseases which lead to premature mortality, such as smoking, poor diet, lack of physical activity, and drug use and aim to promote healthier lifestyles.
  • Secondary interventions aim to identify diseases early, give effective treatment and prevent progression which in turn prevents premature mortality. Public health screening campaigns for diseases such as cancer help identify diseases at an early stage when they are often easier to treat.
  • Tertiary interventions aim to make effective treatment for established disease accessible to all who need it.

The provision of mental health services are also an important aspect of prevention of avoidable mortality as good mental health is an important part of overall wellbeing which is protective against the development of conditions associated with premature mortality.

A population-focused approach involves understanding mortality rates and monitoring trends within different geographical areas, communities, and age groups. This includes identifying inequalities.

Identifying areas with higher levels of avoidable mortality allows resources to be allocated, and services to be tailored, to address the specific needs of these populations to help prevent these avoidable deaths and increase healthy life expectancy.

The population health approach to mortality relies on evidence-informed practices to guide interventions and policies to ensure that efforts to reduce mortality are well-informed and effective. Strategies for reducing mortality may include health behaviour and lifestyle interventions, vaccination programmes, injury prevention and improving healthcare access and chronic disease management.

Focusing on the top causes of mortality in Derbyshire (cancer, cardiovascular, respiratory and liver disease), there are several modifiable risk factors with strong evidence-informed interventions. For example, professional support to quit smoking, lifestyle interventions to address excess weight and alcohol consumption and early treatment for conditions such as high blood pressure and cholesterol have been shown to be effective at preventing the development of diseases which lead to premature mortality.

In Derbyshire the main causes of mortality are cancer, cardiovascular, respiratory (lung) and liver disease. Cardiovascular disease (CVD) refers to diseases that affect the heart and blood vessels and can cause heart attacks and strokes. A substantial proportion of these deaths are preventable, and all have contributing factors which could be modified by population health interventions. Smoking is the biggest single cause of preventable mortality, contributing to the development of cancer, cardiovascular disease and respiratory disease4,5. Excess weight is another significant and modifiable factor in the development of these conditions6. Most liver disease is caused by preventable risk factors: alcohol and excess weight.7

Chronic health conditions such as those described above can be worsened by cold living conditions and this can also make people more susceptible to infectious respiratory diseases such as influenza which can lead to mortality.8 The ‘winter mortality index’ compares the number of deaths that occurred in the winter period (December to March) with the average of the non-winter period. This measure reflects pressures on services in addition to diseases and living conditions and shows whether policies are having an impact on mortality risks during the winter period.9

Because there are a wide range of direct and indirect causes of mortality, collaboration among various stakeholders is vital for addressing the factors which can lead to mortality. Collaborative efforts amongst governmental agencies, public health organisations, healthcare providers, emergency services, and community groups can lead to the development of comprehensive healthcare systems and community-based interventions that improve the overall health of the population and prevent mortality.

latest derbyshire data Latest Derbyshire Data

Mortality

Cancer

Circulatory Diseases

Liver disease

Respiratory disease

Trend Data

Mortality

Cancer

Circulatory Diseases

Liver disease

Respiratory disease

Derbyshire Quilt

Prevalence Maps of Derbyshire

The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.

In the top right of the map, you’ll find the ‘Layer Control’ icon. This is an easy way to customise what you see on the map visualisation. Click the ‘Layer Control’ to choose which information is displayed on the map. Pick the indicator that interests you the most, and the map will transform accordingly.

Mortality by deprivation

further analysis and assessments Further Analysis & Assessments

Derbyshire Joint Strategic Needs Assessment (JSNA) involves a thorough examination of a specific health problem, exploring its causes, consequences, and underlying factors. It combines various data sources, collaboration with stakeholders, and rigorous analysis to generate insights for evidence-informed interventions and policy changes.

more information and resources More Information & Resources

Here is a list of useful resources and information to help address mortality. These materials are meant to provide individuals, healthcare professionals, and communities with the knowledge and tools they need to understand and address mortality in Derbyshire.

Contributors

Elizabeth Jane Maughan, Public Health Registrar