Explaining the long term decrease in the death rate

Table of Contents

Last Updated on August 29, 2023 by Karl Thompson

The death rate is the number of deaths in relation to the number of people in a population. It is normally measured per hundred thousand or per thousand people.

The death rate is also known as the mortality rate.

The crude mortality (or death) rate in England and Wales was approximately 10/1000 in 2021. This has decreased significantly since 1840 when the death rate was approximately 23/1000.

What is the long term trend in the death rate?

*The long term decrease in the death rate, England and Wales, 1840 to 2020.*

The death rate has halved in the last century, declining from 23/1000 in 1840 to 10/1000 today.
The death rate decreased most rapidly between 1840 and 1830.

Since 1930 the death rate has declined overall, but at a slower rate.
There were spikes in the death rate during WW1 and WW2 (not shown on the graph below). See the data source (1) for details.
The death rate has increased since 2010, when the Tory government came to power.

NB the Census cites the death rate per 100 000 of the population. To get the death rate per 1000 you simply divide the above figures by 100!

How did Coronavirus affect the death rate?

There were more deaths in England and Wales due to the Coronavirus Pandemic especially in 2020 and 2021 (2)

graph showing increase in death rates for males and females, England and Wales.

The age standardised death rate for males increased from 1079 per thousand in 2019 to 1236 per thousand in 2020

The age standardised death rate for females increased from 798 per thousand in 2019 to 894 per thousand in 2020.

The death rates now seem to be coming back down to what they were before the Pandemic. The overall long term trend is towards a declining death rate, and this is what this post will focus on.

Why has the death rate declined?

There are three major reasons for the long term decline in the death rate:

Economic growth and improved living standards resulting in declining infant mortality and increased life expectancy.
Medical advances such as improved immunisation and better survival rates from ‘diseases of affluence’ such as heart disease.

Social policies and improved public health. Such as the establishment of the NHS and pollution laws.

In the first part of the century, most of this decrease was due to fewer children dying of infectious diseases, later on in the century, the continued decline is due to people living longer into old age.

The major causes of death have changed: from mainly being due to preventable, infectious diseases in the early part of the century to ‘diseases of affluence’ such as heart disease and cancers today.

There are considerable variations in life expectancy by gender and social class – people in the poorest parts of Glasgow die before 60, in the wealthiest parts of the UK (e.g. Kensington) life expectancy is nearer 90.

Economic growth and improving living standards

There are number of ways in which this had led to a decline in the death rate:

better food and nutrition (which in turn is related to better transport networks and refrigeration) which has meant that children are better able to resist infectious diseases, reducing the infant and child mortality rates. This is estimated to account for 50% of the decline in the death rate.

Better quality housing – Better heating and less damp, means less illness.
Smaller family sizes – as people get richer they have fewer children, which reduces the chances of disease transmission.
More income = more taxation which = more money for public health services.
Evaluation – It’s worth noting that not all people have benefited equally from the above advances. The wealthy today have longer life expectancy than the poor, who still suffer health problems related to poverty.

Evaluation – In terms of food and nutrition, obesity is now becoming a serious problem – more food doesn’t necessarily mean better nutrition.

Medical Advances

Mass immunisation programmes limited the spread of infectious diseases such as measles.
Important in improving survival rates from ‘diseases of affluence’ such as heart disease and cancers.

Only really significant since the 1950s.
Evaluation – It’s easy to fall into the trap into thinking that modern medicine is the most important factor in improving life expectancy, it isn’t – economic growth, rising living standards and improvements in public health are more important.

Social Policies

The setting up of the NHS.

Health and safety laws – which legislate so that we have clean drinking water, food hygiene standards and safe sewage and waste disposal.
The clean air act and other policies designed to reduce pollution.
Health and Safety laws at work.

Evaluation – These are largely taken for granted, but they are important!

Other factors

There is greater knowledge and concern about health today
The decline of manual work means work is less physical and exhausting and less dangerous.

Analysis points

Two important related trends are the declining in infant mortality and the increase in life expectancy.

Declining Infant Mortality

The decline in infant mortality has broadly mirrored the declining death rate:

Increasing life Expectancy

Much of the decrease in the death rate has been due to increasing life expectancy.

Life expectancy isn’t increasing as fast today as it did between 1840 and 1850. This partly explains why the death rate has remained at around 10/1000 for the last several decades. People simply aren’t living that much longer!

Conclusions

3/4s of the decline between the 1850s and 1970 was due to the reduction of infectious (fairly easily preventable) diseases such as Cholera, and improved nutrition accounts for half of this reduction. In these early years
More recently, the decrease in the death rate has been due to improving survival rates from heart disease and cancers.

The declining death rate is not necessarily all good – in the last decades we have witnessed a declining death rate and a declining birth rate – and so we now have an ageing population, which requires society to adapt in order to meet the different demands of differently structured population.