rural mortality

In view of the ongoing challenge of providing accessible and consistent (esp in terms of employees) care for the elderly in rural areas this depressing article gives food for thought. It tells us:

England and Wales have seen the biggest jump in the number of deaths a year for a whole generation, a public health expert suggests.

Professor Dominic Harrison says this must act as a “strong warning light” and suggests cuts to local authority social care budgets could be partly to blame. Public Health England says it is monitoring the provisional data. And its officials say a particularly bad strain of flu and an ineffective vaccine may be behind the rise.

Professor Harrison’s own analysis backs up figures in the Health Service Journal which suggest there have been 5.6% more deaths in England and Wales in 2015 than in the previous year – the biggest increase in the national death rate since the 1960s.

Though the final figures – which take changes in population size into account – will not be released by the Office for National Statistics until the summer, experts say more needs to be done to understand the reasons behind the spike and urge public health experts to focus on wider factors.

Professor Harrison, director of public health in Blackburn and Darwen and adviser to Public Health England, also points to a separate report by Public Health England which reveals a large number of local authorities showed a fall in life expectancy at age 85 in 2014.

Taken together he says the figures suggest “something is making the population more vulnerable to death.” And he says the findings are unlikely to be fully explained by winter infections or a rise in the elderly population.

Professor Harrison says reductions in local authority social care budgets in England have particularly affected preventative care services that would normally provide daily one-to-one contact for elderly people. Cuts to meals on wheels services, for example, could mean more elderly people go through entire days without seeing anyone else, and if they are ill this would mean they deteriorate without anyone noticing, he says.

He adds: “One of the things this data might be telling us is that that it is just not possible for the health and social care system to contain costs, improve quality, reduce inequality and improve outcomes within such a rapidly diminishing resource envelope.”

David Buck, senior fellow in public health at the King’s Fund, agrees that wider issues such as changes to pensions, must be taken into account.

Professor John Newton, chief knowledge officer at PHE added: “There is often no obvious pattern to this but it is clearly important to keep a close eye on the trends, and consider a range of possible explanations.”In 2015, the monthly death figures suggest cold weather and flu may have played a part in the high numbers of deaths in the early part of the year.”