ONS suggests that one in four deaths are 'avoidable'

Behind the Headlines

Thursday May 8 2014

Deaths can often be prevented using a combination of healthy living and good medical treatment

Cancer and heart disease are the main causes of avoidable death

“1 in 4 deaths could have been prevented,” The Times reports. Figures released by the Office for National Statistics (ONS) found that 23% of deaths could have been prevented through better care, more effective treatment and healthier living.

The news is based on an ONS bulletin titled Avoidable Mortality in England and Wales, 2012 (PDF 186kb).

The bulletin provides mortality figures for causes of death that are considered avoidable if timely and effective healthcare is received or healthier lifestyle choices adopted.

Figures were provided for the period 2001 to 2012 so that trends can be seen.

The bulletin found that deaths from potentially avoidable causes accounted for about 23% of all registered deaths in England and Wales in 2012. While one avoidable death is one too many, there was a downward trend as this rate has fallen from 25% in 2003.

The report also found that:

  • avoidable death rates were higher in Wales than England
  • the leading causes of avoidable deaths were ischaemic heart disease (the most common type of heart disease) in males, and lung cancer in females
  • the neoplasms (cancers and non-cancerous abnormal tissue growths) that are considered to be avoidable have overtaken cardiovascular diseases as the leading cause of avoidable deaths since 2007

According to the report, a degree of caution should be used when interpreting the findings. This is due to factors such as advances in healthcare and policy not being reflected in mortality rates in the short term.


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Where did the story come from?

The report was carried out by the UK Office for National Statistics (ONS). Statistics on avoidable deaths are used by governments, public health experts, academics and charitable organisations to reduce the amount of specific conditions considered avoidable causes of death.

According to the report, it is anticipated that the statistics provided will help in assessing the quality and performance of healthcare as well as wider public health policies. However, several limitations listed in the report are described further below and the report states a degree of caution is required when interpreting the findings.

The ONS is a government body that provides data on the economy and population at a national and local level. Summaries and detailed data are released free of charge.


What did the report base its findings on?

The report provides mortality (death) figures for causes of death that are considered avoidable if timely and effective healthcare or public health interventions are received.

Figures are provided for both England (including the regions of England) and Wales for the period 2001 to 2012 and trends are reported.

The report has presented the statistics using age-standardised rates, which is a standard method for carrying out calculations on mortality rates. This makes allowances for differences in the age structure of the population over time and between genders.

Statistics on mortality are taken from the information provided when deaths are certified or registered (in England and Wales deaths should be registered within five days of the death occurring).


What are the main findings of the report?

The key findings of the report are:

  • deaths from potentially avoidable causes accounted for about 23% (112,493 out of 499,331) of all registered deaths in England and Wales in 2012 (in 2003 this figure was 25%, so deaths from avoidable causes since 2003 have actually decreased)
  • avoidable death rates were significantly higher in Wales than England for the period 2001 to 2012
  • avoidable death rates varied across the regions of England with the highest in the North of England and the lowest in the South and East of England for the period 2001 to 2012
  • for the period 2001 to 2006, cardiovascular diseases were the leading contributors to avoidable deaths. However since 2007, neoplasms (cancers and non-cancerous abnormal tissue growths) that are considered to be avoidable have taken over as the leading cause of avoidable deaths and there has been no significant decrease in the death rate from neoplasms since 2009
  • in males, the leading cause of avoidable death was ischaemic heart disease (representing 22% of all avoidable male deaths)
  • in females, lung cancer was the leading cause of avoidable death (representing 15% of all avoidable deaths in females)


What are the limitations of the report?

According to the report, one of the main difficulties in producing an indicator of avoidable deaths is the selection of the causes of death to be included. While a particular condition can be considered avoidable, the report says this does not mean that every death from that condition could be prevented. This is due to factors such as the age of the patient, the extent of disease progression at diagnosis or the existence of other medical conditions that are not taken into account when compiling a list of causes.

Another limitation the report lists is that improvements in the healthcare system (such as a change in resources or the introduction of a new healthcare innovation or policy) may not equate to immediate changes in death figures in the short term and that this is sometimes mistakenly interpreted as a decrease in healthcare quality.


How can you reduce your risk?

The good news about reducing your risk for one avoidable condition is that it often leads to a reduction in risk for other conditions. For example, if you make an effort to reduce your heart disease risk through exercise and healthy eating, this will also reduce your risk of stroke, diabetes and kidney disease.

Proven methods of reducing your risk of avoidable conditions include:

Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

1 in 4 deaths could have been prevented. The Times, May 8 2014

One in four deaths could be avoided, ONS figures show. The Daily Telegraph, May 8 2014

Avoidable deaths continue to be higher in Wales than in England. BBC News, May 8 2014

How 23% of DEATHS in England and Wales could be avoided with a healthier lifestyle. Daily Express, May 8 2014

Further reading

Office for National Statistics. Avoidable Mortality in England and Wales, 2012. May 2014


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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

David Colquhoun said on 11 May 2014

This account, like the ONS calculations, carry a hidden assumption of causality. Of the "proven methods", causality is well-established only for cigarette smoking, All the rest are guess work.

It is sheer guess work to say that 1 in 4 deaths are preventable, That sort of alarmism can't be justified by the evidence and it brings the idea of evidence into disrepute.

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