Other Background Information
This page provides some background information about the ‘avoidable mortality’ figures, which were produced using a definition that was developed by the Office for National Statistics (ONS) – refer to the ‘Definition of the Statistics’ page. Further background information is available from the ONS publications which are referred to on that page and on the ‘home’ page of this web section.
Caution is recommended when interpreting the figures. ‘Avoidable’ mortality is based on the concept that premature deaths from certain medical conditions should be rare, and, ideally, should not occur if there is timely and effective healthcare. It was designed to highlight areas of potential weakness in healthcare that could benefit from further investigation: where there are many premature deaths caused by conditions for which effective public health and medical interventions are available. However, it was not intended for use to assess possible differences in the effectiveness of healthcare systems.
While a particular cause of death may be considered ‘avoidable’ for the purpose of these figures, this does not mean that every death from that cause could be avoided. The relevant definitions say that ‘ … all or most deaths from that cause (subject to age limits if appropriate) could be avoided …’. It should be noted that:
- there is an upper age limit of 74 years for most of the causes of death included in the definition. This is because deaths at older ages are often difficult to attribute definitively to a single underlying cause, and because the likelihood of death is more affected by coexisting medical conditions and other factors.
- the reference to ‘or most’ means that there could always be some premature deaths from those causes. For example:
- even with early detection and the best possible treatment, the survival rate for a particular type of cancer may never be 100%;
- while the number of road deaths has dropped greatly from the peak levels seen from the mid-1960s to the end of the 1970s, and could well fall further in future, due to (for example) road safety measures and improvements in vehicle design, it is unlikely ever to be zero.
It must be remembered that these figures for ‘avoidable’ deaths, which are produced solely from the data that are recorded when a death is registered, cannot take into account factors such as a person’s lifestyle, how far a disease had progressed by the time it was diagnosed, and the likely effect, on the possibility of survival, of any other medical conditions that the person may have had. While some of the deaths from a particular cause might not have occurred had there been (for example) more timely or more effective healthcare, there would be others for whom that would not be the case, so it is not possible to say how many deaths were truly avoidable.
With advances in medical technology and wider public health interventions, deaths from a condition which was previously not ‘avoidable’ may become ‘avoidable’. This means that, when the list of what are considered ‘avoidable’ causes of death is updated, it may not be appropriate to produce figures for earlier years using the revised ‘avoidable mortality’ definition. For this reason, statistics are given here only for 2014 onwards, because that is the first year for which ONS has published figures based on what is now its current definition. ONS’s publication stated that it was not producing revised figures for earlier years based on that definition. National Records of Scotland understands that ONS plans to review the definition through consultation with users every 3-5 years.