Avoidable mortality in England and Wales: 2021 and 2022

• In 2020, 2021 and 2022 respectively, 22.3%, 23.8% and 21.8% of total deaths (all ages) in England and Wales were considered avoidable: in 2021 there were 139,495 avoidable deaths out of 585,484 total deaths, and in 2022 there were 125,612 avoidable deaths of 576,027 total.

• The age-standardised avoidable mortality rates (ASMR) for England and Wales in 2022 were 238.1 and 273.8 per 100,000 people, respectively; lower than 2020 (257.7 and 289.6 per 100,000) but still higher than 2019 (221.5 and 262.0 per 100,000 people, respectively).

• Neoplasms (cancers) remained the leading cause of avoidable mortality in England and Wales in 2022, though the neoplasm ASMR has steadily declined since 2001 for both nations.

• In England, the avoidable ASMR for children and young people (aged 0 to 19 years) has been rising since 2020: in 2022, it was 9.6 per 100,000 people, compared with 8.1 in 2020 and 9.1 in 2019; for Wales, the rate for children and young people was 8.7 per 100,000 people in 2022.

• In England, the 2022 treatable mortality ASMR (83.1 deaths per 100,000 people) is higher than the 2019 or 2021 rates (80.6 and 80.2 deaths per 100,000 people respectively).

Avoidable deaths are defined as either preventable or treatable for those aged under 75 years, in line with the international avoidable mortality definition.

In 2022, 21.7% of all deaths in England and 22.7% of all deaths in Wales were considered avoidable (117,498 deaths of 540,333 in England, and 8,114 of 35,694 deaths in Wales). In 2021, 23.8% of all deaths in England and 24.5% in Wales were considered avoidable (130,641 deaths out of 549,349 for England, and 8,854 out of 36,135 for Wales).

In 2022, these were 238.1 and 273.8 deaths per 100,000 people in England and Wales, respectively, both lower than 2021 figures. The age-standardised mortality rates (ASMRs) for avoidable deaths in 2021 were 263.3 deaths per 100,000 people in England, and 296.9 deaths per 100,000 people in Wales (Figure 1).

Of the avoidable deaths in 2022 in England and Wales, 65.1% could be attributed to conditions considered preventable (81,791.5 deaths), and of avoidable deaths in 2021, 69.5% could be attributed to preventable conditions (96,893 deaths).

For both England and Wales separately, the preventable mortality ASMR in 2021 was higher than 2020, the 2022 ASMR was lower than 2021, but the 2022 ASMR remained higher than 2019 rates. As with the rates observed prior to the coronavirus (COVID-19) pandemic, the preventable mortality ASMR in Wales remains higher than the England rate for these latest years.

Of the avoidable deaths in 2021 in England and Wales, 30.5% could be attributed to treatable conditions (42,602 deaths), and of avoidable deaths in 2022, 34.9% could be attributed to treatable conditions (43,820.5 deaths). Coronavirus (COVID-19) has been assigned as a preventable cause of death, in line with the international avoidable mortality definition.

As with years prior to the pandemic, England's 2021 and 2022 treatable mortality ASMRs are lower than the rates in Wales for the same years. In England, the 2022 treatable mortality ASMR (83.1 deaths per 100,000 people) is higher than the 2019 or 2021 rates (80.6 and 80.2 deaths per 100,000 people, respectively).

A new category, “Provisional assignment of new diseases”, was created by the Organisation for Economic Co-operation and Development (OECD) in the international definition of avoidable mortality in 2020, to include COVID-19 as an avoidable cause of death. There are no other causes of death within the category. COVID-19 is classified as a preventable cause of death, as it can be mainly avoided through effective interventions before its onset. Both England and Wales had higher rates of avoidable age-standardised mortality rate (ASMR) for COVID-19, in 2021, than their 2020 rates, with 42.1 deaths per 100,000 people in England and 38.5 deaths per 100,000 people in Wales. Rates were much lower in 2022, with 9.7 deaths per 100,000 people and 9.5 deaths per 100,000 people in England and Wales, respectively.

Neoplasms (cancers) are classified as an avoidable cause of death. Some cancers, including lung, liver and skin cancers, are classified as preventable. Others, including breast cancer and testicular cancer, are classified as treatable. This means these causes of death are considered to be avoidable through timely and effective healthcare interventions after their onset.

Neoplasms remain the leading cause of avoidable mortality, but the avoidable mortality rates for neoplasms have continued to decline in England and Wales (Figure 2). In 2022, the ASMR for neoplasms was 75.3 per 100,000 people in England and 84.1 per 100,000 people in Wales, compared with 79.0 and 89.1 in 2019, respectively.

The mortality rate for alcohol-related and drug-related deaths has continued to increase in England and Wales. In England, the ASMR for alcohol-related and drug-related deaths was 25.9 per 100,000 people in 2022, compared with 21.3 in 2019. In Wales, the ASMR for alcohol-related and drug-related deaths was 30.2 per 100,000 people in 2022, compared with 24.2 in 2019.

Preventable mortality

Preventable mortality refers to causes of death that can be mainly avoided through effective public health and primary prevention interventions (that is, before the onset of diseases or injuries, to reduce incidence).

Treatable mortality

Treatable mortality refers to causes of death that can be mainly avoided through timely and effective healthcare interventions, including secondary prevention and treatment (that is, after the onset of disease, to reduce case-fatality).

Avoidable mortality

Avoidable mortality refers to deaths that are preventable or treatable.

Age-standardised mortality rates

Age-standardised mortality rates are used to allow comparisons between populations that may contain different proportions of people of different ages.

Figures are calculated using death registration data for England and Wales held by the Office for National Statistics (ONS), published in our Deaths registered in England and Wales bulletin.

Defining avoidable mortality

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in our Avoidable mortality in the UK QMI.

A strength of avoidable mortality is:

• the avoidable mortality definition used by the Office for National Statistics means that our statistics are internationally comparable as well as comparable between local administrations and over time at national and subnational level

A limitation of avoidable mortality is:

• that cause-of-death data do not account for coding changes that occurred in 2011 and 2014

Accredited official statistics

These accredited official statistics were independently reviewed by the Office for Statistics Regulation. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled "Accredited official statistics".

For more on accredited official statistics, read the Office for Statistics Regulation guidance.