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Excess winter deaths

Excess Winter Deaths

Introduction

Excess deaths in winter (EWD) are an important public health issue in the United Kingdom linked to cold weather, which can be reduced through implementing preventative approaches with vulnerable groups, for example, older people and those with long term conditions. It has been observed that other countries in Europe especially the colder Scandinavian countries have relatively fewer excess winter deaths in winter compared to the United Kingdom (Public Health England).

Excess winter deaths are calculated from the excess of deaths in winter (December to March) compared with non-winter months (August to November) and are expressed as a percentage.

Excess Winter Deaths Index (EWD Index) is the excess winter deaths measured as the ratio of extra deaths from all causes that occur in the winter months compared with the expected number of deaths, based on the average of the number of non-winter deaths.

         
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. Research carried out by the Eurowinter Group and Curwen found that mortality during winter increases more in England and Wales compared to other European countries with colder climates, suggesting that many more deaths could be preventable in England and Wales.

     

Some ways to reduce excess winter deaths are:

  • supporting energy efficient interventions in housing
  • encouraging fuel poverty referrals
  • increasing uptake of flu and pneumococcal vaccinations among priority groups

         

 -An estimated 43,900 excess winter deaths occurred in England and Wales in 2014/15 -the highest number since 1999/2000.

-27% more people died in the winter months compared with the non-winter months in 2014/15.

-There were more excess winter deaths in females than in males in 2014/15 as in previous years.

-Male excess winter deaths increased from 7,210 to 18,400, and female deaths from 10,250 to 25,500 between 2013/14 and 2014/15.

-The majority of deaths occurred among those aged 75 and over; there were an estimated 36,300 excess winter deaths in this age group in 2014/15 compared with 7,700 in people aged under 75

   

Source : Excess Winter Mortality in England and Wales , 2014/2015 ( provisional) and 2013/2014 final       

Excess winter deaths are calculated from the excess of deaths in winter (December to March) compared with non-winter months (August to November) and are expressed as a percentage.

 

Deaths in the Wokingham Borough increased from 17.6 in 2013 to 19.4 in 2014 during the winter months compared to other seasons of the year. Excess winter deaths in Wokingham have always been lower than the England value until this year where it is higher that rate of 15.6

  

The rate in Wokingham for excess winter deaths for 85 years plus residents was 28.8 in 2014.  This is significantly above the national value of 22.3 Both males and females are above the national value with both genders actually increasing from 2013 to 2014

Source : Public Health Outcomes Framework

 

Figure 1: Excess winter deaths all ages (2006-2013)     

Excess winter deaths

Figure 2: Excess winter deaths ages 85+ (2006-2013)

Excess winter deaths 85+

Fuel Poverty

 

Figure 3 shows the percentage of households in different parts of the Wokingham Borough that are estimated to be living in ‘fuel poverty’. A household is considered to be in fuel poverty if their income does not cover the cost of keeping their home heated.

 

Figure 3: Fuel poverty in the Wokingham Borough by Lower Super Output Area (2010)     

Fuel poverty

Seasonal flu

 

Public Health England’s report Excess winter mortality 2012-13 concluded that excess deaths were found predominantly in the elderly and in deaths coded as resulting from respiratory causes. Their analysis showed influenza to be a major explanatory factor. 

Seasonal flu vaccination is an evidence based public health measure to prevent this and coverage is measured as part of the Public Health Outcomes Framework. The Department of Health has set a target of 75% uptake in all groups for 2013/14, which includes those aged 65 and over. The seasonal flu immunisation uptake for 2012/13 is shown in Figure 4 below to demonstrate the level of challenge to achieve the target this year.

 

Figure 4: Seasonal flu immunization uptake in Wokingham Borough compares to the national uptake target (2012/13)

Seasonal flu

Source: IMMFORM, Jan 2013. All figures are derived from data as extracted from records on GP systems or as submitted by GP practices or Primary Care Trusts

    Those unable to get to their GP surgery or Pharmacist are unable to receive Flu Vaccinations out in the community              
  • There is a huge need to addressing reasons causing the increase in Excess Winter deaths figures for people over 85 and working in partnership with Adult and Social care services , Fire and Rescue team in the Borough  
  •  To work with Housing to ensure that support is available to vulnerable people to keep themselves warm in winter
  •  To explore the links and cross over with the Royal Berkshire Fire and rescue Service to increase the ability to reach more vulnerable individual s within the Borough
  • To work with NHS England and Public Health England to maximise on the communications regarding the Stay Warm Stay Well Campaign, and ensure that this works well for all parties involved

        

Last updated on the 26th of October 2016