Recent mortality in Britain: a review of trends and explanations.

The annual percentage improvement in standardised mortality rates in the period 2011-19 was the lowest for 70 years, whereas the 2001-10 value was the highest since records began in 1841. A similar slowdown occurred from around 2011 in most European Union countries, although this was generally less severe than in Britain. Life expectancy at birth actually fell in USA for three successive years in period 2014-17. The downturn in Britain since 2011 was wide-ranging, affecting young and old, women and men and the more and the less advantaged to a broadly similar extent. Year-to-year variation in mortality increased mainly due to increased volatility in winter excess mortality from 2011, but all seasons showed lower rates of improvement in underlying longer-term trends. Mortality had started to improve at the end of the decade and the 2019 value was the lowest-ever value in Britain. Two main explanations for these trends have been advanced: UK Government post-2008 austerity policies, especially in the health and social care sectors, and the role of seasonal influenza. However, the evidence for a dominant role for either of these is weak. Longer-term overall trends have been determined principally by trends in cardiovascular rather than non-cardiovascular causes of death, although recent changes in discovery and coding of dementias makes it difficult to draw firm conclusions. Healthy life expectancy trends are also affected by changes in data and methods, but the proportion of life spent in good health for both women and men over age 65 has increased slightly since 2010.