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Mortality overview

MortalityAssessing the number and rate of deaths (or mortality) in any population is important in understanding and monitoring the health status of a whole community. Understanding the underlying causes of mortality, the prevalence and trends in premature (deaths before 75 years of age) and preventable mortality (causes of death that can be mainly avoided through effective public health and primary prevention interventions) are particularly important, with preventable mortality being a priority area in the Southampton 2017-25 Health and Wellbeing Strategy.

In the UK, deaths must be reported to the Local Registration Service, in partnership with the General Register Office (GRO). This is a legal requirement as set out in the Births and Deaths Registration Act (1836). The coding used for cause of death is carried out according to the World Health Organization (WHO) International Classification of Diseases (ICD-10) and internationally agreed rules, allowing for international comparisons.

Numbers of deaths represent the number of registered deaths in a population but, because there can be registration delays including those deaths requiring a coroner’s verdict, deaths by date of registration may include deaths that occurred months or even years earlier. Deaths for Southampton include resident deaths that occur outside Southampton.

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Mortality in Southampton

In 2021, there were 2,056 deaths registered in Southampton. Trend and benchmarking data is available for 2018-20 where mortality from all causes in Southampton was 5,713 deaths. This is a directly age standardised rate (DSR) of 1,038 deaths per 100,000 population, which is significantly worse than the national average of 973 per 100,000. Southampton has the 7th highest mortality rate amongst its ONS comparator group.

All cause mortality trend chartLarge differences are seen between males and females. The local DSR of 1,238 per 100,000 population for males, which is significantly worse than the England rate of 1,138 DSR per 100,000 population and 6th highest among our ONS comparator group (12 local authorities). For females, in Southampton, the DSR was 879 per 100,000 population, which is significantly worse than the England average (838 DSR per 100,000) and 8th highest among our ONS comparator group.

Between 2001-2003 and 2009-2011, the mortality rate had been decreasing slightly faster in Southampton than nationally. However, since 2009-2011, the national rate has continued to decrease whilst the Southampton rate has increased. Both nationally and in Southampton, a rise was seen in mortality from 2017-2019 to 2018-2020. This is likely due to the start of the COVID-19 pandemic with the trend expected to continue as further data is released for the COVID-19 pandemic period. More information on the impact of COVID-19 can be found in the COVID-19 impact assessment.

Mortality varies at a local level for 2019-2021 from a DSR of 834.0 per 100,000 population in Shirley ward to 1,529.6 DSR per 100,000 population in Bevois ward, with the city average of 1,061.0 DSR per 100,000 population. North & Central locality has the highest DSR of 1,155.4 per 100,000. The following sections illustrate how mortality varies by age and deprivation.

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Mortality by age

Child mortality DSR chart Southampton England and ONS comparatorsIn Southampton, in 2019-21 (pooled), the number of stillbirths (those infants that died in the womb after having survived through at least the first 24 weeks of pregnancy) was 3.6 per 1,000 births, which is statistically similar to the national average (3.9 per 1,000 births). This period is the first decrease Southampton has seen since 2015-17 and is the 7th lowest among comparators.

The neonatal mortality rate (deaths under 28 days) for Southampton, in the same period, was 4.2 per 1,000 births, which is higher than the England average (2.8 per 1,000 births) and the highest among ONS comparators. The post-neonatal mortality rate (deaths between 28 days and 1 year) for Southampton, for 2019-21, was a crude rate of 0.7 per 1,000 births, which is lower than the England rate (1.1 per 1,000 births), although not statistically significantly so. This is the 4th lowest among the ONS comparator group.

Infant mortality (deaths under 1 year of age) in Southampton has increased from 2.8 per 1,000 births in 2012-14 to 4.9 per 1,000 births in 2019-21. In comparison, the England average has remained consistent between 3.9 and 4.0 per 1,000 births over the same period. Since 2014-16, the infant mortality rate in Southampton is higher than the England average and been one of the top 5 ONS comparators.

The all cause child mortality rate (deaths of a child between the ages of 1 and 17 years) in Southampton in 2018-20 was 10.1 DSR per 100,000 persons, which is lower than the England average (10.3 per DSR per 100,000 persons), although not statistically significantly so. Southampton is mid-rank among its ONS comparator group. The England rate has decreased at a faster rate than in Southampton since 2010-12.

In Southampton, 16.9% of (all cause) mortality occurs in those aged under 65 years, which is higher than the England average of 15.0%. 17.4% of deaths occur in the 65 to 74 age group in the city compared to the England average (16.2%). It is a similar picture for those aged 75 to 84 years, where 27.9% of deaths occur in the city, compared to 28.8% for England. The proportion of deaths occurring in those aged 85 years and over is significantly lower in Southampton (37.9%) compared to the England average (40.0%). This is likely to reflect Southampton’s younger population and lower life expectancy.

Hospitals remain the most common place of death across all age groups (43.0% of all deaths in Southampton and 44.0% in England). In 2020, for those people aged 85 and over, the common place of death were care homes (37.5%), likely due to the pandemic, however this decreased to 31.2% in 2021 reflecting the trends for England.

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Mortality by deprivation

All cause mortality DSR deprivation by England quintiles chartWithin the city, mortality rates are statistically significantly higher and 1.5 times higher in the 20% most deprived areas of Southampton (1,206 DSR per 100,000) compared to the 20% least deprived areas (784 DSR per 100,000). Amongst males in the city, mortality in the 20% most deprived areas is 1.7 times higher than in the 20% least deprived areas (1,478 compared with 871 DSR per 100,000). Amongst females, mortality rates are 1.4 times higher in the 20% most deprived areas (1,000 compared to 725 DSR per 100,000).

Under 75 mortality is 2.0 times higher in the 20% most deprived areas in Southampton compared to the 20% least deprived (538 compared to 266 DSR per 100,000). For males this increases to a difference of 2.4 times higher (644 compared to 269 DSR per 100,000), whilst for females the difference is 1.7 times higher (435 compared to 263 DSR per 100,000).

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Underlying causes of mortality

Total deaths in Southampton in 2021 (all causes) - 2,056 (bubble chart)The underlying cause of death is most often used to understand more about patterns and trends in mortality among a particular population. The underlying cause of death is defined by the World Health Organization as “the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury”.

When looking at deaths grouped by underlying cause in Southampton for 2021, it was found that:

  • The three main causes were:
    • Cancer - 504 deaths (24.5%)
    • Circulatory diseases – 484 deaths (23.5%)
    • Respiratory diseases - 298 deaths (14.5%)
  • Lung cancer accounted for 1 in 18 of all deaths, the most of all cancers (117 deaths)
  • 2% of circulatory disease deaths were caused by ischaemic heart diseases (214 deaths)
  • 6% of all respiratory disease deaths were attributed to other COPD (109 deaths)

COVID-19 was responsible for 11.5% deaths in 2021 (237 deaths), higher than 2020.

The bubble chart for total deaths in Southampton is available in the resources section below.

Breakdown of the life expectancy gap between the most and least deprived quintiles - Southampton 2020 to 2021The Office for Health Improvement and Disparities (OHID) have produced an inequalities segment tool which shows the relative contribution that nine broad causes of death have on the gap between life expectancy for Southampton and that for England for the 2020 to 2021 period. Circulatory disease (20.5%), cancer (19.7%) and respiratory (19.2%) deaths are the largest groups contributing to the gap in male life expectancy compared to England. On closer inspection, the two largest causes are chronic lower respiratory disease followed by heart disease and other circulatory.

For females, circulatory disease (24.6%) is also the largest group contributing to the gap in female life expectancy compared to England, with respiratory diseases (22.5%), other causes (14.9%) and external causes (10.5%) also contributing. Cancer only contributed 3.5% to the gap for females, unlike for males where it was over 5 times higher. More detailed analysis shows the single largest cause of the gap in female life expectancy is chronic lower respiratory diseases followed by other and lung cancer. COVID-19 contributed 4.3% to the gap in male life expectancy and 5.3% to the gap for females.

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Preventable mortality

Mortality from causes considered preventable, DSR Per 100,000 aged under 75 years, Southampton and ONS comparators: 2017-19Preventable mortality is defined as causes of death that can be mainly avoided through effective public health and primary prevention interventions (for example improvement of healthy behaviours to reduce the chance of disease).

In Southampton, under 75 mortality from causes considered preventable, was 189 DSR per 100,000 population in the period 2017-19 (pooled). This is statistically significantly worse than the England average (142 DSR per 100,000 population) and the 4th highest among our Office for National Statistics comparators, behind Liverpool (229), Newcastle upon Tyne (199) and Portsmouth (192). The rate for males and females is also significantly worse than the England average, with both rates the 4th highest amongst the ONS comparator group. For males in Southampton the rate is 241 DSR per 100,000, compared to 189 DSR per 100,000 for England. For females the rate in Southampton is 138 DSR per 100,000 compared to 98 DSR per 100,000 for England.

The England trend has seen a decrease from 192 DSR per 100,000 persons in 2001-03 to 142 DSR per 100,000 persons in 2017-19 (pooled). Although the Southampton trend decreased at a similar rate to the England average, reaching a low of 181 DSR per 100,000 persons in 2014-16, the rate since then has increased once more to 189 DSR per 100,000 in 2017-19.

Within the city, there is substantial variation at a ward level. The preventable mortality rate for Bevois is 300 DSR per 100,000 persons, which is 1.6 times higher than the city average, and significantly higher than Bassett which has the lowest preventable mortality at 105 DSR per 100,000 for the period 2018-20 (pooled). There is also significant variation between those living in the 20% most deprived areas and those living in the 20% least deprived areas, with the former experiencing preventable mortality rates 4.3 times higher compared to the latter (264 compared to 61 DSR per 100,000).

More information is available in the mortality dashboard available below and in the resources section.

Life expectancy and mortality dashboard
Visualisation

Years of life lost

Not only is it important to consider the number of deaths from each underlying cause, but also the impact of each death. One way of measuring this is through calculating the number of life years lost.

Total years of life lost in Southampton in 2019-21 (pooled) - 31,357 totalYears of life lost (YLL) is a measure of the average time a person would have lived had they not died before the age of 75 years. This data helps measure the social and economic loss from dying younger and highlights the specific causes of death affecting younger people such as suicide and accidents.

Between 2019 and 2021, nearly 31,400 years of life were lost for Southampton residents aged under 75 years. During this period:

  • Cancer (26.1% of YLL), circulatory diseases (18.4% of YLL) and respiratory diseases (5.8% of YLL) together accounted for over half of all years of life lost
  • 8,177 years of life were lost due to cancer. The two highest contributing types of cancer were:
    • Lung cancer; 1,679 years of life lost (20.5% of years lost to cancer deaths)
    • Breast cancer; 814 years of life lost (10.0% of years lost to cancer deaths)
  • 5,775 years of life were lost due to circulatory diseases. The highest contributing type was:
    • Coronary heart disease; 2,757 years of life lost (47.7% of years lost to circulatory disease deaths
  • 2,115 years of life were lost due to suicide (and injury undetermined)
  • 1,832 years of life were lost due to respiratory diseases

More information on causes of mortality and years of life lost can be found in the resources section below, whilst analyses of the causes of mortality which contribute most to inequalities in life expectancy in Southampton can be seen in the life expectancy and health inequalities pages.

Life expectancy and mortality dashboard
Visualisation

Excess winter deaths

All ages - excess winter deaths index (persons): Southampton and England (August to July) 2001-02 to 2020-21Excess winter deaths are estimated by comparing the four winter months: December to March with the average of the four-month periods before and after. In England, an estimated 13,400 excess winter deaths occurred in England and Wales in winter 2021 to 2022, this was the second-lowest figure since 1950 to 1951 and was affected by the larger number of deaths in the non-winter months (August 2021 to November 2021 and April 2022 to July 2022).

The number of excess winter deaths depends on the temperature and the level of disease in the population as well as other factors, such as how well equipped people are to cope with the drop in temperature. Most excess winter deaths are due to circulatory and respiratory diseases, and the majority occur amongst the elderly population.

The excess winter mortality index (which is used to compare between sexes, age groups and geographical areas) in England was significantly lower than every winter since the series began in 1991 to 1992, except in 2019 to 2020 (7.3%).

The excess winter mortality index in 2021 to 2022 was higher for some groups when making comparisons between them. It was higher for males than females, for people aged 90 and over compared to those younger, and also for those living in a private home in England compared to those living elsewhere.

COVID-19 is the leading cause of excess winter deaths that occurred in 2021 to 2022 with 25.9% more deaths occurring in the winter than non-winter in England.

In the excess winter death index, Southampton had an estimated 210 (37.0%) excess winter deaths, all ages, occurred in the winter 2020 to 2021. This is higher compared with 36.2% in England and places Southampton the 4th highest among Southampton’s ONS comparators where the highest was 50.8% in Bournemouth, Christchurch and Poole. Pandemic patterns of mortality have affected excess winter mortality. Between August 2019 and July 2020, there were 20 less deaths in the winter months than the summer months.

In Southampton’s wards, between 2018 to 2021 (3 years pooled) Harefield (35.7%) and Peartree (35.6%) have the highest levels of excess winter deaths. This is compared to 12.2% in Southampton over the same period and -11.7% in Freemantle (a negative number means there are fewer winter deaths than summer ones).

Excess winter deaths index (persons) - aged 85 and over: Southampton and England (August to July) - 2001-02 to 2020-21Looking at sub-city deprivation, for England quintiles, between 2018 to 2021 (3 years pooled), excess winter deaths were highest in the 3rd quintile (24.5%) and 15.8% in the 20% least deprived areas. The 20% most deprived areas had a rate of 10.5%.

For those aged over 85 years for the period 2019 to 2020, there were estimated to be -20 (-6.6%) excess winter deaths, this means there were more deaths in the summer months than the winter months, a feature of the pandemic. This compares with 6.8% in England, which had more winter deaths than summer. In 2020 to 2021, there were estimated to be 100 excess deaths (48.3%) in Southampton, higher than England (42.8%) and ranking second lowest compared to its ONS comparators, Bournemouth, Christchurch and Poole was the highest at 70.5% and Leeds has the lowest percentage of 22.7%.

In Southampton’s wards for the period 2018 to 2021, (3 year pooled) for those aged 85 and over, the largest areas are Peartree (45.9%) and Bassett (44.1%). This is compared to 12.4% in Southampton. Freemantle has the lowest ratio of -17.1%, a negative number meaning that there are more deaths during the summer months.

In the 85 and over age group, looking at sub-city deprivation, between 2018 to 2021 (3 years pooled), excess winter deaths were highest in the 4th quintile (27.4%) and the 3rd quintile (17.0%). The 20% most deprived areas in Southampton, excess winter deaths were 6.6%. In the 20% least deprived areas the rate was -1.7%, meaning that there were fewer deaths in the winter than in the summer.

More information is available in the mortality dashboard available in the resources section.

Resources

Life expectancy and mortality dashboard

The life expectancy and mortality dashboard present a range of data regarding life expectancy and mortality, to provide intelligence to help drive strategic decision making. Analysis includes benchmarking against statistical neighbours and trends over time for all indicators included. Some indicators include analysis at sub-city levels, by Southampton wards and deprivation quintiles.

Life expectancy and mortality dashboard
Visualisation

Mortality bubble charts

Below are two bubble charts showing all cause mortality and the number of years of life lost. In these charts the size of the bubble is proportionate to the number of incidences.

Total deaths in Southampton in 2021 (all causes)
Visualisation
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Total years of life lost in Southampton in 2019-21 (pooled)
Visualisation
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OHID Fingertips - Mortality profile

The Mortality Profile brings together a selection of mortality indicators, including from other OHID data tools such as the Public Health Outcomes Framework, making it easier to assess outcomes across a range of causes of death.

OHID fingertips tool - Mortality profile
Dataset

OHID – Segment tool

This tool provides information on the causes of death and age groups that are driving inequalities in life expectancy at local area level. Targeting the causes of death which contribute most to the life expectancy gap should have the biggest impact on reducing inequalities.

OHID - Life expectancy segment tool
Dataset

ONS - Deaths broken down by age, sex, area and cause of death

Data on deaths broken down by age, sex, area and cause of death.

ONS – Deaths, broken down by age, sex, area and cause of death
Report

ONS - Child and infant mortality in England and Wales: 2021

Information on stillbirths, infant and childhood deaths occurring annually in England and Wales, and associated risk factors.

ONS - Child and infant mortality in England and Wales
Report

IHME – Global Burden of Disease (GBD)

The Global Burden of Disease (GBD) study provides a comprehensive picture of mortality and disability across countries, time, age, and sex. It quantifies health loss from hundreds of diseases, injuries, and risk factors, so that health systems can be improved and disparities eliminated.

IHME – Global Burden of Disease (GBD)
Visualisation

Last updated: 02 October 2023