Mortality in 2015: A Year of Two Halves

2015 started with stories of overcrowded hospitals and unacceptable delays for treatment in the acutely ill. Here, we review how mortality changed across European populations over the year.

When it comes to mortality, there are few effective boundaries across Europe. Although there is some variation across countries, a similar pattern is seen for excess mortality over time within large geographical areas. This is illustrated clearly by data published by Euro MOMO(external link), the European monitoring of excess mortality for public health action website, that collates weekly data from 15 European countries.

The website tracks the number of deaths and excess mortality since 2011 for all ages and for the 0 to 4 years, 5 to 14 years, 15 to 64 years and 65 and older age groups, from Belgium, Denmark, Estonia, Finland, France, Greece, Hungary, Ireland, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland and the UK (with England, Scotland, Wales and Northern Ireland reported separately).

Mortality was higher than normal in the first half of 2015, with up to 50,000 deaths or more per week(external link) reported across the contributing countries, compared with peak values of around 45,000 deaths per week over the previous two winters. Overall mortality is largely driven by deaths in the oldest age group, who contributed up to 45,000 deaths per week to the total. The number of deaths has been falling slowly but steadily among young children since 2011, and, although the 15 to 64 year old age group experienced an increase in deaths over each winter compared with summer months, the number of deaths during the first half of 2015 was lower in this group than in the winters of 2012 and 2013, and only slightly more than in 2014.

The charts showing the z-score,(external link) or mortality as a deviation from the baseline, clearly show the peak in excess winter mortality in 2012, 2013 and 2015 for all age groups aged 15 and older. It is interesting to see how the winter peak in early 2014 was present only in the 15 to 64 year old age group and not in older adults, which may have contributed to the much higher peak than normal the following year in the elderly, as the greater numbers of frail elderly finally succumbed. Although there was another smaller peak around weeks 25 to 32, mortality has been particularly low in the older ages and overall during the last few weeks of 2015, with the particularly mild weather a likely contributing factor.

Euro MOMO Z-score graphs for mortality across Europe 2011-2015

The Euro MOMO site also shows weekly z-score data by country as charts(external link) or maps(external link). These show that the high mortality in early 2015 was largely seen in Western Europe, in particular Portugal, Spain, the UK, France, Belgium and Switzerland, with the Scandinavian countries and Estonia experiencing no worse than usual mortality.

The recent low mortality will eventually catch up with the elderly populations again, and there will no doubt be scare stories in the media when this regression towards the mean happens, with greater demands on health services. In international mortality, as in so many areas of life, everything evens out eventually.

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