Excess winter mortality and stalling international improvements in life expectancy and mortality rates

Abstract

In the UK, government austerity has been suggested as a major reason for the stalling of life expectancy improvements and age-standardised mortality rates. However, these trends have also been observed in many other countries. Influenza has been suggested as a potential confounding factor, as this condition contributes significantly to excess winter mortality (EWM) rates each year. This study uses calculated EWM rates in 64 countries with more than 12 000 deaths per annum to show that the decade before the financial crash was characterised by lower than average rates of EWM. The observed international stalling in life expectancy may therefore have been happening as early as the year 2000 but may have been partly masked by a decade of lower than usual winter deaths. From a health service perspective, EWM is also a source of winter bed pressures because of the associated medical admissions. The coincidental decade of low EWM rates may have also created a false picture of low winter demand, to which managers will have responded by trimming resources. This will, in part, have contributed to current winter pressures as EWM rates have returned to more ‘normal’ levels.