National Records of Scotland

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Avoidable mortality

Avoidable mortality

The Definition of the Statistics

For the purpose of these statistics, ‘avoidable’ mortality is the number of deaths for which the underlying cause is one for which all or most such deaths (subject to age limits if appropriate) are considered potentially avoidable through public health interventions or timely and effective healthcare. Note that:

  • not every death from such causes will be truly avoidable (for reasons which are given on the Other background information page);
  • the underlying cause of a death is defined as the disease or injury which initiated the chain of morbid events leading directly to the death, or the accident or act which produced the fatal injury.

These statistics were produced using a definition of ‘avoidable’ mortality which was developed by the Office for National Statistics (ONS) and was published by ONS in May 2016 in its ‘Revised Definition of Avoidable Mortality' available on the ONS website. This definition covers both:

  • ‘preventable’ mortality: a particular cause of death is counted as (potentially) preventable if it is thought (in the light of the understanding of the determinants of health at the time of death) that all or most deaths from that cause (subject to age limits if appropriate) could be avoided by public health interventions in the broadest sense;

and

  • ‘amenable’ mortality: a particular cause of death is counted as (potentially) amenable (treatable) if it is thought (in the light of medical knowledge and technology at the time of death) that all or most deaths from that cause (subject to age limits if appropriate) could be avoided through good quality healthcare.

For example:

  • transport accidents are considered to be ‘preventable’, but not ‘amenable’, because (for example) road safety education could reduce dangerous driving and other risky behaviour by road users, resulting in fewer fatal road accidents, whereas (it is assumed) there is much less scope to reduce road deaths by improving healthcare for people who have been involved in road accidents;
  • certain types of cancer (for example Hodgkin’s lymphoma) are considered ‘amenable’, but not ‘preventable’, because, while (it is thought that) nothing can be done to prevent their occurring, early detection and treatment should lead to a high survival rate;
  • ischaemic (coronary) heart disease is considered both ‘preventable’ and ‘amenable’ because (for example) public health education (for example encouraging exercise and discouraging smoking) could reduce the number of people who are at risk, and because early detection and treatment of heart- and circulation-related problems should lead to fewer heart attacks and to a higher survival rate for the disease.

For the purpose of these statistics, ‘avoidable’ deaths are all deaths from those causes that are counted as ‘preventable’ or ‘amenable’ or both. Each such death is counted only once in the figure for ‘avoidable’ mortality. However, in cases where a cause of death is counted as both ‘preventable’ and ‘amenable’, deaths from that cause are counted in both categories when figures for them are given separately. It follows that the total number of ‘avoidable’ deaths will be less than the sum of the numbers of ‘preventable’ and ‘amenable’ deaths. 

ONS’s ‘Revised Definition of Avoidable Mortality’ (referred to above) includes a detailed list of all the causes of death that are counted as ‘preventable’ and ‘amenable’ in its Appendix 1. For ease of reference, please refer to a copy of ONS's Appendix 1 (PDF 101Kb). It will be seen that, for most of those causes of death, only deaths in a particular age-range are counted as ‘preventable’ or ‘amenable’ (or both).

The causes of death that are counted as ‘avoidable’ for children and young people (defined, for the purpose of such statistics, as those aged 0 to 19, inclusive) are set out in that ONS publication’s Appendix 2. That list is based on the one in ONS’s Appendix 1, with:

  • age ranges like ‘0-74’ being restricted to ‘0-19’ (as Appendix 2 relates only to children and young people); and
  • no distinction between ‘preventable’ and ‘avoidable’ (as ONS did not consider it appropriate to split the relatively small number of deaths of children and young people in that way).

For ease of reference, please refer to a copy of ONS's Appendix 2 (PDF 93Kb).

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