Causes of Death

This topic area covers statistics and information relating to causes of death in Hull including local strategic need and service provision. Further information on deaths is available under different specific diseases within Health Factors under Adults, and under Stillbirths and Infant Mortality under Pregnancy, Infants and Early Years within Children and Young People. Further information on where people die (hospital, care home, at home, etc) can be found under Palliative and End of Life Care under Health Factors under Adults. Further information relating to the causes of death where there is an excess number of deaths in Hull which contribute to the reduced life expectancy in Hull when compared to England and to the reduced life expectancy in the most deprived areas of Hull compared to the least deprived areas of Hull can be found within Life Expectancy and Healthy Life Expectancy under Population.

This page contains information from the Office for Health Improvement & Disparities’ Fingertips. Information is taken ‘live’ from the site so uses the latest available data from Fingertips and displays it on this page. As a result, some comments on this page may relate to an earlier period of time until this page is next updated (see review dates at the end of this page).

Headlines

• There were 33 stillbirths in Hull which occurred during 2020-22 which gave a rate of 3.5 per 1,000 stillbirths and live births which was slightly lower than England at 3.9 stillbirths per 1,000 stillbirths and live births.
• There were 39 infant deaths (under one year of age) that were registered in Hull over the three year period 2020-22, and the rate at 4.2 per 1,000 live births was slightly higher than England (3.9 deaths per 1,000 live births).
• The mortality rate among children aged 1-17 years was higher in Hull (11.0 deaths per 100,000 population) compared to England (10.4) but lower than the region (12.1). There were an average of six deaths among children aged 1-17 years per year that were registered between 2020 and 2022 in Hull.
• During 2021-23, there were 8,062 deaths that were registered among Hull residents with 2,068 among men under 75 years, 2,172 among men aged 75+ years, 1,245 among women under 75 years and 2,577 among women aged 75+ years.
• The main causes of death of deaths that were registered during 2021-23 were cardiovascular disease (26.3%) with just under a half of these deaths (12.0%) from coronary heart disease. Cancer accounted for just under one-quarter of all deaths (24.5%) with lung cancer accounting for just under three in ten of these deaths (7.0%). Respiratory disease accounted for one in eight deaths (12.2%) with more than half of these due to bronchitis, emphysema and chronic obstructive pulmonary disease (6.2%). Dementia accounted for one in fourteen deaths (7.0%), and COVID-19 accounted for one in seventeen deaths (6.0%). However, among all deaths which occurred between 27 March 2021 (first death from COVID-19) and the end of 2021, the percentage of deaths from COVD-19 was 14.5% or one in seven deaths.
• Deaths from the following causes appear to have decreased over time: infant deaths prior to the age of 28 days, and deaths from certain infectious and parasitic diseases, lung cancer, mesothelioma cancer, breast, cervical and ovary cancer among women, epilepsy, heart failure, stroke, aortic aneurysms and smoking-related deaths.
• Deaths from the following causes appear to have increased over time: pancreas cancer, malignant melanoma, prostate cancer, diabetes, dementia, Parkinson’s disease, Alzheimer’s disease, coronary heart disease, deaths from falls, drug poisoning and deaths wholly attributable to alcohol as well as deaths related to alcohol.
• There had been just over 2,500 deaths each year that were registered during 2018 and 2019 prior to the COVID-19 pandemic, but the number of deaths registered during 2020 increased to 2,866 for Hull residents. The numbers decreased to 2,720 for 2021, to 2,691 for 2022 and to 2,651 for 2023, but are still higher than prior to the pandemic. In 2023, 44 deaths were registered that were due to COVID-19 so whilst there was still a potential impact for 2023, COVID-19 did not account fully for the higher number of deaths in 2023.
• The impact of the pandemic on the mortality rates was more noticeable among men compared to women. Furthermore, the causes of death also differed slightly between 2017-19 and subsequently. In some cases, it would appear that the vulnerable and frail who were the most likely to die, died of COVID-19 rather than existing medical conditions such as cancer, dementia, coronary heart disease, heart failure, stroke, chronic obstructive pulmonary disease, and chronic kidney disease. Mortality rate appeared particularly high for people with dementia as the number of people who had dementia as the underlying cause or as a secondary cause of death was higher.
• The premature (under 75) age-standardised mortality rate was very high in Hull with 516 deaths registered during 2020-22 per 100,000 population compared to 355 per 100,000 population for England. The rate in Hull was fourth highest out of the 295 lower-tier local authorities in England. The mortality rate from premature deaths considered to be preventable was also very high in Hull being fifth highest among lower-tier local authorities in England.
• Almost a half of male (49%) deaths and just under one-third (33%) of female deaths were premature among deaths registered during 2021-23. Of the premature deaths, 59% of male and 46% of female deaths were considered to be from causes considered to be preventable.
• There was large variability in mortality rates among the different geographical areas across Hull whether this was defined on the basis of wards or deprivation.
• For deaths registered during the four years 2020-2023, the under 75 year directly standardised mortality rate ranges from 269 to 1,054 per 100,000 population across Hull’s 21 electoral wards. The wards with the highest levels of deprivation had the highest mortality rates. People living in the most deprived fifth of areas of Hull have a premature mortality rate of 975 per 100,000 population compared to 449 per 100,000 population for people living in the least deprived fifth of areas of Hull.

The Population Affected – Why Is It Important?

Because everybody dies, it is common to examine and compare rates for premature mortality which is defined as dying before the age of 75 years. It is also possible to examine mortality rates from deaths which are considered preventable such as deaths from suicide and accidents, liver disease from excessive alcohol, lung cancer deaths caused by smoking, etc. Mortality rates have generally been decreasing, but it is important to examine rates from specific causes and for specific groups to determine if rates are falling equally fast for all causes and different groups, and are falling to the same degree as England and comparator areas. However, in practice, it is necessary for the rate in Hull to fall at a faster rate than England to reduce the inequalities gap.

Years of life lost (YLL) measures the number of years of life lost for each person who dies prematurely (before the age of 75 years). It can be used to examine different causes contributing to the total YLL for all persons dying or the average YLL for each person who dies, by cause of death.

Analysis of deaths and mortality rates involve analysing the data contained on death certificates. For the majority of these analyses, the time period relates to the time period in which the death was registered rather than when the death occurred. More timely mortality information can be presented if date of registration is used to define the time period as there can be considerable delay (up to a year or more) for some deaths which require further investigation and/or a coroner’s inquest. Deaths can only be registered once the cause of death is known or has undergone investigation. This means that deaths from specific causes such as drug poisoning or possible suicide can have relatively long delays in death registration, and the majority of these deaths occur at younger ages compared to other deaths. All analyses on this page are based on date of registration unless otherwise specified.

On the whole the number of deaths that occurred in a specified year will be similar to the number of deaths registered during that same year. Some deaths will occur in one year, but registered in the next year. In most cases, the numbers will balance out. However, this is not always the case, and if there are increased delays with local coroner investigations for some reasons such as staff illness or vacancies then it is possible that the numbers do not balance out as well. It is also possible that the increased number of deaths during the pandemic and the winter of 2020/21 increased the length of the registration process for some deaths which result in more deaths which had occurred in 2020 being registered in 2021 compared to other years.

The Hull Picture

Stillbirths, Infant Mortality and Deaths Among Children

The rate of stillbirths in Hull was 3.5 per 1,000 live births and stillbirths which occurred over the three year period during 2020-22, and the rate was slightly lower than England (3.9 stillbirths per 1,000 live births and stillbirths).

For deaths registered during 2020-22, the infant mortality rate (deaths registered under one year of age) in Hull was 4.2 per 1,000 live births which was slightly higher than England (3.9 deaths per 1,000 live births) although there was no statistically significant difference between Hull and England.

Since 2012-14, the rate of stillbirths has been higher in Hull than England, and it was statistically significantly higher for the three year periods from 2013-15 to 2015-17. However, the stillbirth rate has decreased in Hull since then and at a faster rate than the decrease observed nationally, so the rate in Hull is now lower than England for the first time since 2012-14.

There were 33 stillbirths in Hull during 2020-22 giving an average of 11 per year.

The infant mortality rate in Hull has been reasonably comparable to England over the last couple of decades, although there has been year-on-year variability. Since 2015-17, the infant mortality rate was been consistently higher than England, although for the entire period 2001-03 to 2020-22, the rate in Hull has not been statistically significantly different than the rate in England.

Further information on stillbirths and infant deaths is available under Stillbirths and Infant Mortality under Pregnancy, Infants and Early Years within Children and Young People where further information is presented for neonatal deaths (under 28 days) and postnatal deaths (28 days or older but less than one year).

The mortality rate among those aged 1-17 years in Hull for deaths registered during 2020-22 is higher than England, but lower than the average across the Yorkshire and Humber region. Information is not presented for local authorities with low numbers due to confidentiality issues.

There are a small number of deaths among those aged 1-17 years in Hull so the directly standardised rate per 100,000 population varies year-to-year (standardised to the European Standard Population). There were 18 deaths among those aged 1-17 years in Hull registered over the three year period 2020-22 equating to an average of six deaths per year.

Deaths by Age

Percentage of Deaths at Different Ages

The Office for Health Inequalities & Disparities’ Fingertips provides information on the percentage of deaths by age. In 2020, Hull had a much higher percentage of all deaths among persons aged under the age of 65 years compared to other local authorities in the region. Part of this may be due to Hull’s younger age structure compared to other areas, but is also due to the increased mortality rate among younger people in Hull due to increased levels of risk factors for ill health and disease.

The percentage of deaths which occurred at ages 85+ years has been around one-third (33%) between 2012 and 2020 although there has been some year-on-year variability. The percentage has been consistently lower than England and the Yorkshire and Humber. The percentage increased from 30.9% in 2019 to 32.4% in 2020, and whilst this might be attributable to COVID-19 as mortality rates from COVID-19 were much higher with increasing age, the latest percentage of 32.4% is not dissimilar to previous years (2012 to 2015). The percentage in 2020 at 32.4% is lower than all years except 2011, 2014 and 2019.

The percentage of deaths which occurred between the ages of 75 and 84 years has reduced between 2012 and 2020, but the decrease was more marked earlier in the decade. There was relatively little difference in the percentages between 2019 and 2020 which could be considered surprising given the higher mortality rates among the elderly due to COVID-19.

The percentage of deaths which occurred at ages 65-74 years has remained relatively constant around 18% between 2015 and 2018 but was slightly higher in 2019. The rate fell back to just over 18% between 2019 and 2020 so is not too dissimilar to the percentages between 2015 and 2018.

There has also been relatively little change in the percentage of deaths which occurred under the age of 65 years in Hull with the percentage being around 20% with the exception of 2018 when it fell to 17.1%. There does not appear to have been any change to the percentages between 2019 and 2020.

Mortality Rates By Age

The Office for Health Improvement & Disparities’ Fingertips presents mortality rates by age, and it illustrates that the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) are much higher in Hull compared to other local authorities in the region, particularly so for the younger age groups.

Compared to England, for 2020, the mortality rate was 39% higher in Hull for all ages, 56% higher for under 65s, 43% higher for people aged 65-74 years, 40% higher for people aged 75-84 years and 30% higher for people aged 85+ years.

For all ages, the mortality rate in Hull gradually increased in Hull between 2011 and 2019 although the mortality rates were relatively high in 2017. The mortality rate was also much higher in 2020 with many more deaths due to the COVID-19 pandemic.

Mortality rates among those aged 85+ years has been increasing but there is year-on-year variability and there was a fall in the mortality rate between 2018 and 2019. For people aged 75-84 years, the mortality rate has been increasing but at a much lower rates of increase compared to those aged 85+ years, and there was no decrease in the mortality rate for people aged 75-84 years between 2018 and 2019 as there were for people aged 85+ years.

The mortality rates for people younger ages have been relatively constant over time although there is year-on-year variability.

All age groups showed an increase in the mortality rate for 2020, but it was less marked among those aged 65-74 years.

Over all age groups, the mortality rate increased between 2019 and 2020 by 14%, by 21% among those aged 85+ years (although by 9% between 2018 and 2020), by 12% among those aged 75-84 years, by 5% among those aged 65-74 years and by 12% among those aged under 65 years.

Mortality from COVID-19 was particularly high among the most frail individuals with comorbidities which are likely to be older people, although being frail or having pre-existing medical conditions was not necessarily a pre-cursor, and some apparently well and healthy individuals did die from COVID-19.

The mortality rate increased by 12% among those aged 65 years, and it is speculated that this was due higher rates of people in this age group working – particularly men at the top end of this age group – although it could also be because younger people were less likely to shield, less willing to shield or feeling that needed to shield less than older people.

Location of Deaths

The aim of palliative care and end of life services is to enable patients with advancing progressive life limiting illness to be cared for and to die in their preferred place of care with optimal pain and symptom management, supported by skilled staff. It is generally recognised that too many people die in hospital and that this might not be their preferred place of death, and a proportion of these people might prefer to die at home provided that the right care is in place.

Further information can be found under Palliative and End of Life Care under Health Factors under Adults, which includes the percentage of Hull residents who die in hospital, in care homes, at home, in hospices and elsewhere.

Trends in the Total Number of Deaths

Numbers by Year of Occurrence

Based on the year in which the death occurred, in the late 1990s, there were around 2,900 deaths each year, but this fell to a low of just over 2,300 deaths for the three year period 2010 to 2012. Since 2012, the number of deaths has increased but has remained around 2,500 deaths each year although it was slightly higher in 2017. However, the marked increase in 2020 and to a lesser extent in 2021 can be seen with the increased mortality rate during the COVID-19 pandemic. The number of deaths in 2022 is still high relatively to the numbers immediately prior to the pandemic. The number of deaths in 2023 is slightly higher than pre-pandemic levels.

As at October 2024, the number of deaths registered that occurred during 2023 should be almost complete, but there might be a handful of deaths which occurred during 2023 or earlier years that have not yet been registered.

Prior to 2016, for most years, there were more deaths among Hull women than there were among Hull men. The number of men and women in Hull’s population has been around 50% but there has generally been a slightly more older women in Hull which will influence the total number of deaths. However, between 2016 and 2023 with the exception of only 2018, the total number of deaths among men has been higher.

The higher mortality rate from COVID-19 during 2020 and 2021 is evident with a higher number of deaths overall and particularly so for men. Compared the average number of deaths between 2017 and 2019, the mortality rate was 15.5% higher among men and 7.6% higher among women for 2020, 9.3% higher among men and 2.5% higher among women for 2021, 5.3% higher among men and 4.3% higher among women for 2022, and 7.6% higher among men and 1.3% lower among women for 2023.

Numbers by Year of Death Registration

As the majority of analyses use the number of deaths registered in the year rather than the number which occurred in that year, the number of deaths registered in each year is presented below.

A similar pattern occurs for males and females based on year of registration as observed based on year of occurrence.

Deaths by Cause of Death

Total Number of Deaths by All Main Causes of Death

During the three year period 2021-23 there were 8,062 deaths that were registered among Hull residents of which 2,068 where among men aged under 75 years, 2,172 among men aged 75+ years, 1,245 among women aged under 75 years, and 2,577 among women aged 75+ years. The top five causes of death are summarised after the causes of death table.

The number of deaths by main underlying cause are given below for deaths which were registered during the three year period 2021-23. Some numbers have been replaced by asterisks because the number of deaths is too small to present. In these cases the number has been added to the ‘Other causes’ category, and have not been added to associated categories such as ‘Other cancers’, ‘Other respiratory disease’ or ‘Other external causes’ etc as it would then be possible to calculate the small numbers by subtraction from the totals. Furthermore, alcohol-specific deaths (deaths wholly attributable to alcohol) and drug poisoning deaths can also be classified as deaths from suicide and underdetermined injury if they involve alcohol or drugs respectively.

Alcohol-related and smoking-related deaths use attributable fractions and are the sum of a number of causes of death (for instance, over 80% of deaths from chronic obstructive pulmonary disease are directly attributable to smoking so this measure is the sum of 80% of all these COPD deaths as well as all other causes which are smoking related). See Alcohol Attributable Fractions and Smoking Attributable Fractions within the Glossary.

As the total number of deaths for suicide, drugs and alcohol-specific causes of deaths overlap as well as the numbers for alcohol-related and smoking-related, the sum of the causes in the table sum to more than the total number of deaths at the bottom of the table.

There were around 38 deaths that were registered every month during 2021-23 that were smoking-related representing 16.9% of all deaths in Hull.

There were on average 13 deaths registered each month during 2021-23 that were due to COVID-19 representing 6.0% of all deaths in Hull, although the percentages did differ by gender and age (males under 75: 5.3%, males 75+: 7.3%, females under 75: 4.1%, and females 75+: 6.4%). Further analysis of the mortality data in relation to the COVID-19 pandemic is given below.

Overall, 2,118 deaths were caused by cardiovascular disease (26.3%) and the largest category within cardiovascular disease was coronary heart disease (further information is available under Cardiovascular Disease under Health Factors within Adults).

There were 1,977 deaths due to cancer (24.5%) with the lung cancer being the cancer site with the largest number of deaths (further information is available under Cancer under Health Factors within Adults).

There were 981 deaths from respiratory disease (12.2%) with the largest cause bronchitis, emphysema and other chronic obstructive pulmonary disease (further information is available under Respiratory Disease under Health Factors within Adults).

There were 563 deaths caused by dementia representing 7.0% of all deaths (further information is available under Dementia under Health Factors within Adults).

There were 77 deaths from suicide or undetermined injury among those aged under 75 years with a very small number of deaths from this cause among those aged 75+ years (further information is available under Suicide and Self-Harm under Health Factors within Adults).

There were 39 infant deaths under the age of one year (further information is available under Stillbirths and Infant Mortality under Pregnancy, Infants and Early Years within Children and Young People).

There were 483 deaths due to COVID-19 that were registered during 2021-23. Further information relating to the COVID-19 pandemic can be found under Coronavirus (COVID-19) under Health Factors under Adults, although further more detailed information relating to mortality from COVID-19 is presented below.

Underlying cause of death (ICD code) for deaths registered 2021-23	Males <75	Males 75+	Females <75	Females 75+	Total	Percentage
Infant (<1 year)	20		19		39	0.5
Certain infectious and parasitic disease (A00-B99)	22	20	13	21	76	0.9
Lip, oral cavity and pharynx cancers (C00-C14)	17	7	7	4	35	0.4
Oesophagus cancer (C15)	40	19	14	17	90	1.1
Colorectal cancer (C18-C20)	54	60	32	40	186	2.3
Pancreas cancer (C25)	38	23	30	29	120	1.5
Lung cancer (C33-C34)	150	140	123	152	565	7.0
Malignant melanoma (C43)	9	3	6	5	23	0.3
Mesothelioma cancer (C45)#	7	10	*	*	*	*
Breast cancer (C50)#	*	*	64	53	*	*
Cervical cancer (C53)			14	3	17	0.2
Ovary cancer (C56)			20	18	38	0.5
Prostate cancer (C61)	32	104			136	1.7
Kidney cancer (C64)	22	14	7	3	46	0.6
Bladder cancer (C67)	16	32	10	11	69	0.9
Brain cancer (C71)	15	7	16	5	43	0.5
Leukaemia (C91-C95)	25	18	8	5	56	0.7
Other malignant neoplasms of the lymphoid, haematopoietic and related tissue (C81-C96)	25	28	18	37	108	1.3
Other cancers (C00-C99)	88	78	92	122	380	4.7
In situ, benign and unknown status neoplasms (D00-D49)	9	13	4	12	38	0.5
Diseases of the blood and immune system (D50-D99)#	*	*	*	10	*	*
Diabetes (E10-E14)	20	26	19	46	111	1.4
Dementia (F00-F03)	15	181	16	351	563	7.0
Parkinson’s disease (G20)	11	43	5	34	93	1.2
Alzheimer’s disease (G30)#	*	61	*	92	*	*
Epilepsy (G40)#	10	*	*	*	*	*
Other diseases of the nervous system (G00-G99)#	28	15	26	25	94	1.2
Hypertensive disease (I10-I15)	21	28	10	56	115	1.4
Coronary heart disease (I20-I25)	361	300	111	195	967	12.0
Heart failure (I50)	6	23	6	27	62	0.8
Stroke (I60-I69)	67	125	45	166	403	5.0
Aortic aneurysm (I71)	14	23	5	18	60	0.7
Other cardiovascular disease (Ioo-I99)	73	86	53	158	496	6.2
Influenza and pneumonia (J10-J18)	51	90	29	101	271	3.4
Bronchitis, emphysema and chronic obstructive pulmonary disease (J40-J44)	108	132	98	158	496	6.2
Asthma (J45)#	*	*	8	8	*	*
Other respiratory disease (J00-J99)#	24	67	21	81	193	2.4
Digestive system diseases (non-alcohol K00-K99)#	84	83	64	110	341	4.2
Diseases of the skin, subcutaneous tissue, musculoskeletal and connective system (L00-M99)	13	16	15	46	90	1.1
Genitourinary system diseases (N00-N99)	15	43	21	56	135	1.7
Deaths caused by transport vehicles (V00-V99)	20	0	5	0	25	0.3
Deaths caused by falls (W00-W19)	19	31	8	39	97	1.2
Suicide and undetermined injury (X60-X84, Y10-Y34 excluding Y33.9)#	69	*	21	*	*	*
Other external causes of death (V00-Y99)#	32	11	7	15	65	0.8
COVID-19 (U07.1-U07.2)	109	158	51	165	483	6.0
Other causes of death	64	34	25	69	192	2.4
Drug poisoning#	129	*	44	*	*	*
Alcohol-specific#	95	*	33	*	*	*
Alcohol-related#	239	44	71	23	378	4.7
Smoking-related#	402	410	218	329	1,359	16.9
Total over three years	2,068	2,172	1,245	2,577	8,062	100.0

The top five causes of death based on the causes listed in the above table (excluding the ‘other cancer’ and ‘other circulatory disease’ categories) are given below. Coronary heart disease, lung cancer, chronic obstructive pulmonary disease and COVID-19 are the main causes of death for men together with with drug poisoning for men aged under 75 years and dementia for men aged 75+ years. For women, coronary heart disease and chronic obstructive pulmonary disease are both within the top five causes of death but the remaining three top causes do differ. Smoking-related causes feature heavily among both men and women with both lung cancer and chronic obstructive pulmonary disease in the top causes (next on the list with 51 deaths for women aged 75+ years) and coronary heart disease as a top five cause although a smaller percentage of coronary heart disease deaths are attributable to smoking (15% for men and 10% for women compared to 85% for men and 69% for women for lung cancer and over 80% for both men and women for chronic obstructive pulmonary disease).

The top five causes of death among males aged under 75 years are as follows (average number of deaths registered each year between 2021-23):

1. Coronary heart disease (120)
2. Lung cancer (50)
3. Drug poisoning (43)
4. COVID-19 (36)
5. Chronic obstructive pulmonary disease (36)

The top five causes of death among males aged 75+ years are as follows (average number of deaths registered each year between 2021-23):

1. Coronary heart disease (100)
2. Dementia (60)
3. COVID-19 (53)
4. Lung cancer (47)
5. Chronic obstructive pulmonary disease (44)

The top five causes of death among females aged under 75 years are as follows (average number of deaths registered each year between 2021-23):

1. Lung cancer (41)
2. Coronary heart disease (37)
3. Chronic obstructive pulmonary disease (33)
4. Breast cancer (21)
5. Non-alcoholic diseases of the digestive system (21)

The top five causes of death among females aged 75+ years are as follows (average number of deaths registered each year between 2021-23):

1. Dementia (117)
2. Coronary heart disease (65)
3. Stroke (55)
4. COVID-19 (55)
5. Chronic obstructive pulmonary disease (53)

Prior to the COVID-19 pandemic for deaths registered over the three year period 2017 to 2019 (excluding ‘other cancers’), the top causes were the same albeit in a different order with stroke instead of COVID-19 as a top five cause of men (both ages) and influenza and pneumonia as a top five cause for women aged 75+ years instead of COVID-19. Further analysis of the mortality data in relation to the COVID-19 pandemic is given below.

Trends in Average Number of Deaths Per Year

Whilst there is year-on-year variability in the number of deaths by underlying cause, although it is possible that there have been changes in the way the deaths are coded or more emphasis or awareness of different conditions which could influence the underlying cause over time.

In the following table the average deaths for each two year period is given (so the numbers do not add up to the figures above in the ‘total deaths in last three years’ table above).

Deaths from specific causes appear to have decreased over time:

• Infant deaths (<28 days): deaths were lower for 2022-23.
• Certain infectious and parasitic diseases: a tendency for the number to decrease over time although the 2022-23 has the second joint highest number but prior to that the numbers were relatively low compared to the three periods before that and especially compared to 2010-11 when numbers were particularly high.
• Lung cancer: deaths were lower for 2022-23 although the trend is not totally clear and could have been influenced by the pandemic.
• Mesothelioma cancer: appears to have reduced slightly over time.
• Breast cancer: the numbers are lower in 2022-23
• Cervical cancer: appears to have reduced slightly over time, although the numbers are second joint highest for 2022-23.
• Ovary cancer: appears to have reduced slightly over time.
• Epilepsy: appears to have reduced slightly over time with numbers for 2010-13 higher than for 2014-23.
• Heart failure, stroke and aortic aneurysms: all appears to have reduced slightly over time.
• Senility: deaths from this ’cause’ have reduced but this is simply denotes better recording of cause of death.
• Smoking-related deaths have deceased from an average of around 500 deaths per year for deaths registered during 2014-19 to around 450 deaths per year for deaths registered during 2020-23. Despite the decrease, smoking-related deaths represent a significant percentage of the overall deaths in Hull.

Deaths from specific causes appear to have increased over time:

• Pancreas cancer: the numbers registered during 2020-23 are much higher than those for 2010-19.
• Malignant melanoma: the numbers are higher for 2022-23 but this could be random variation as the numbers are relatively small (see Small Numbers in the Glossary).
• Prostate cancer: the numbers have increased in recent years with numbers higher for 2016-23 compared to 2010-15 although some of this could be associated with better recording of the underlying cause of death.
• Diabetes: the numbers have increased in recent years with numbers higher for 2018-23 compared to 2010-17, and whilst some of this could be associated with better recording of the underlying cause of death, the prevalence of diabetes is increasing with the age of the population and levels of excess weight in the population.
• Dementia, Parkinson’s and Alzheimer’s disease: the numbers have increased over time likely associated with the ageing population although it is also possible that these conditions are better recorded. Whilst the numbers dying from dementia decreased in 2022-23, it is possible that this is due to the pandemic (see below).
• Coronary heart disease: the numbers are much higher for 2022-23.
• Disease of the skin, subcutaneous tissue, musculoskeletal and connective system re higher for 2022-23, but this could be associated with better recording.
• Deaths from falls: the numbers are considerably higher for 2022-23, and it is possible that this could be better recorded as the circumstances of resulting injuries (e.g. hip fractures) have been better recorded.
• Drug poisoning: whilst there was a spike in 2017 due to the introduction of a very toxic ingredient (carfentanyl/fentanyl) into the local drug supply (predominantly heroin) which was cut off swiftly, the number of deaths registered during the four year period 2020-23 has drastically increased.
• Alcohol-specific: the number of deaths from conditions wholly attributable to alcohol has increased sharply in the last four years with half as many deaths again on average each year for 2020-23 compared to 2018-19.
• Alcohol-related: the numbers have increased with numbers particularly over the last four years.

Impact of the COVID-19 pandemic on the underlying cause of death:

• The frail and vulnerable were more susceptible to dying from COVID-19, and these might have included people with pre-existing disease or who were more susceptible from dying from coronary heart disease, strokes or influenza and pneumonia in a ‘normal’ year. In 2020 and 2021, and to a lesser extent subsequently, many of these frail and vulnerable people died from COVID-19 so this meant that the numbers of people dying from other conditions reduced for 2020 and 2021. This was particularly the case for dementia, chronic obstructive pulmonary disease, and influenza and pneumonia. However, in the case of influenza, there was less influenza circulating over the winter of 2020 due to the lockdowns and less social mixing during the COVID-19 pandemic, and the most vulnerable were more likely to die from COVID-19 rather than influenza or pneumonia. In the case of chronic obstructive pulmonary disease, and influenza and pneumonia, the numbers have increased for 2022-23 but have not ‘returned’ to levels seen prior to the pandemic. Patients with dementia were more likely to die in 2020 and 2021 . It is likely that this was because they were more likely to live in care homes where mortality rates from COVID-19 were higher and that there were increased difficulties with social distancing among people with dementia. The prevalence of dementia in the community has reduced and this is likely to have been because of the higher mortality rate. So with the reduced prevalence, it is perhaps not surprising that there are fewer deaths recorded from dementia in 2022-23. Further information is given below and within Dementia under Health Factors under Adults.

There was a 7.2% increase in the total number of deaths registered in the four years prior to the pandemic (2016 to 2019) compared to the four subsequent years during and after the main waves of the COVID-19 pandemic (2020 to 2023). However, there were some large changes in the number of deaths by cause with a number of causes having changes of 25% or more between the two periods. Only two causes of death had a reduction in the number of deaths by this magnitude which were deaths from influenza and pneumonia which reduced by 29% and deaths from larynx cancer which reduced by 25%. The total number of deaths from Alzheimer’s disease increased by 84% (but could be due to better diagnosis coding) with increases also observed for drug poisoning (+54%), hypertensive disease (+40%), falls (+40%), alcohol-specific (+33%), other circulatory disease (+26%), diseases of the skin, subcutaneous tissue, musculoskeletal and connective system (+26%), and asthma (+25%).

It is also possible to examine this by gender and age, but in some cases the number of deaths are small Some of the changes may be due to random variation due to small numbers (see Small Numbers in the Glossary for more information), better coding of specific diseases and conditions, or could be real changes that have been resulting from a number of years prior to the pandemic. Other changes could be more directly related to the pandemic such as fewer deaths from influenza and pneumonia due to less social mixing during the pandemic, or frail and vulnerable people dying from COVID-19 instead of other diseases and conditions as mentioned above.

Among males aged under 75 years, among those causes with 10 or more deaths for 2016-19 and 2020-23, the total number of deaths reduced by more than 40% between 2016-19 and 2020-23 for none of the causes within the table, but but increased by more than 40% for COVID-19, stomach cancer (+82%), hypertensive disease (58%), pancreas cancer (+56%), drug poisoning (+48%), kidney cancer (+40%) and non-alcoholic diseases of the digestive system (+40%).

Among males aged 75+ years, among those causes with 10 or more deaths for 2016-19 and 2020-23, the total number of deaths reduced by more than 40% between 2016-19 and 2020-23, for none of the causes, but increased for COVID-19, Alzheimer’s disease (+133%), deaths caused by falls (+84%) and kidney cancer (+42%).

Among females aged under 75 years, among those causes with 10 or more deaths for 2016-19 and 2020-23, the total number of deaths reduced by more than 40% between 2016-19 and 2020-23 for none of the causes, but increased by more than 40% for COVID-19, drug poisoning (+79%), diseases of the genitourinary system (+75%), diseases of the skin, subcutaneous tissue, musculoskeletal and connective system (+54%), hypertensive disease (+45%) and pancreas cancer (+41%).

Among females aged 75+ years, among those causes with 10 or more deaths for 2016-19 and 2020-23, the total number of deaths reduced by more than 40% between 2016-19 and 2020-23 for none of the causes, but increased by more than 40% for COVID-19, hypertensive disease (+43%), deaths caused by falls (+58%), Parkinson’s disease (+63%) and Alzheimer’s disease (+76%).

Underlying cause of death (ICD 10): average deaths registered per year	2010-11	2012-13	2014-15	2016-17	2018-19	2020-21	2021-23
Infant (<1 year)	17	15	14	18	13	16	11
Certain infectious and parasitic diseases (A00-B99)	35	25	24	26	21	19	26
Lip, oral cavity and pharynx cancers (C00-C14)	12	15	11	14	12	9	15
Oesophageal cancer (C15)	25	31	22	31	32	35	25
Stomach cancer (C16)	31	30	26	20	24	19	24
Colorectal cancer (C18-C20)	65	64	65	67	61	66	63
Pancreas cancer (C25)	28	38	30	37	28	40	40
Larynx cancer (C32)	6	6	5	6	4	5	3
Lung cancer (C33-C34)	197	187	219	209	182	194	182
Malignant melanoma (C43)	4	8	9	6	6	5	10
Mesothelioma cancer (C45)	12	10	7	7	6	8	5
Breast cancer (C50)	43	43	50	42	48	48	37
Cervical cancer (C53)	9	6	4	5	4	3	6
Ovary cancer (C56)	16	17	13	18	9	11	14
Prostate cancer (C61)	36	36	33	48	50	43	45
Kidney cancer (C64)	13	16	16	14	15	16	16
Bladder cancer (C67)	20	18	25	26	21	19	26
Brain cancer (C71)	12	19	19	13	15	13	15
Leukaemia (C91-C95)	18	19	18	22	15	17	18
Other malignant neoplasms of the lymphoid, haematopoietic and related tissue (C81-C96)	30	30	29	31	28	34	37
Other cancers (C00-C99)	104	116	98	102	114	126	124
In situ, benign and unknown status neoplasms (D00-D49)	16	17	13	12	15	14	12
Diseases of the blood and immune system (D50-D99)	3	6	4	7	7	5	7
Diabetes (E10-E14)	20	24	23	28	39	35	40
Dementia (F00-F03)	101	153	227	246	250	214	189
Parkinson’s disease (G20)	15	13	26	22	32	31	31
Alzheimer’s disease (G30)	15	21	29	24	34	47	60
Epilepsy (G40)	9	10	6	5	7	7	6
Other diseases of the nervous system (G00-G99)	22	29	33	32	34	31	31
Hypertensive disease (I10-I15)	29	19	25	34	29	51	37
Coronary heart disease (I20-I25)	317	304	311	317	289	294	340
Heart failure (I50)	29	30	15	19	19	17	22
Stroke (I60-I69)	164	167	176	173	162	144	130
Aortic aneurysm (I71)	28	28	22	29	22	23	21
Other cardiovascular disease (C00-C99)	106	107	105	97	99	119	127
Influenza and pneumonia (J10-J18)	125	106	115	124	124	69	108
Bronchitis, emphysema and chronic obstructive pulmonary disease (J40-J44)	167	174	202	200	228	152	181
Asthma (J45)	7	9	10	4	6	7	6
Other respiratory disease (J00-J99)	97	109	83	65	83	68	64
Digestive system diseases (non-alcoholic K00-K99)	106	105	109	108	93	101	118
Diseases of the skin, subcutaneous tissue, musculoskeletal and connective system (L00-M99)	22	28	23	24	22	24	33
Genitourinary system diseases (N00-N99)	47	52	50	45	39	38	48
Certain conditions originating in the perinatal period or congenital malformations and deformations and chromosomal abnormalities (P00-Q99)	5	4	8	5	6	4	4
Senility (R54)	14	11	11	14	13	15	3
Deaths caused by transport vehicles (V00-V99)	9	4	8	5	6	4	4
Deaths caused by falls (W00-W19)	21	8	14	19	19	14	39
Suicide and undetermined injury (X60-X84, Y10-Y34 excluding Y33.9)*	24	28	28	34	33	26	33
Other external causes of death (V00-Y00)	32	24	24	26	26	22	20
COVID-19 (U07.1-U07.2)	0	0	0	0	0	356	80
Other causes of death	23	16	20	26	29	28	45
Missing cause of death	0	0	0	0	5	0	0
Drug poisoning*	17	22	19	45	29	60	54
Alcohol-specific*	28	30	33	37	30	44	45
Alcohol-related*	91	97	93	111	99	119	128
Smoking-related*	461	462	501	507	498	442	465
Average annual totals	2,333	2,387	2,490	2,573	2,523	2,793	2,671

Deaths Due to COVID-19 Occurring in 2020 and 2021

An analysis of the local mortality data was undertaken in 2022 to examine the deaths from COVID-19 that occurred in 2020 and 2021. The analysis below also examines the secondary causes of death and goes some way into examining the potential competing causes of death among people who are frail and vulnerable. For example, it does appear that the mortality rate for people who had dementia increased during 2020 and 2021. This analysis has not been repeated for deaths that occurred in 2022 although there were still COVID-19 deaths occurring subsequently. The deaths below examine the numbers which occurred in the respective years, but in terms of death registrations, there were 388 deaths from COVID-19 that were registered during 2020, 323 in 2021, 116 in 2022 and 44 in 2023.

In 2020, there were a total of 2,910 deaths and 406 (14.0%) of these had COVID-19 as the underlying cause of death. There was also an additional 49 deaths where COVID-19 was mentioned on the death certificate but it was not the underlying cause of the death.

Among men aged 75+ years who died during 2020, almost one in five deaths were due to COVID-19 with around one in seven deaths due to COVID-19 among women aged 75+ years. Among those aged under 75 years, men were also more likely to have died from COVID-19 during 2020 compared to women.

Deaths occurring in 2020 only	Males <75	Males 75+	Females <75	Females 75+	Total
COVID-19 death	73	160	33	140	406
Total deaths	723	825	412	950	2,910
Percentage of COVID-19 deaths	10.1	19.4	8.0	14.7	14.0
COVID-19 mentioned but not main cause	8	14	2	25	49

There were fewer deaths from COVID-19 in 2021 compared to 2020 overall, but a higher percentage of deaths among those aged under 75 years were due to COVID-19 than for 2020. During 2020, there were a relatively high percentage of deaths in care homes which might account for the differences in the age distributions between 2020 and 2021. There were also more deaths with COVID-19 mentioned on the death certificate but where it was not the underlying cause in 2021 compared to 2020, but this could be due to better testing and detection of COVID-19 and changes to the information recorded on the death certificate over time.

Deaths occurring in 2021 only	Males <75	Males 75+	Females <75	Females 75+	Total
COVID-19 death	87	93	36	91	307
Total deaths	687	713	415	851	2,666
Percentage of COVID-19 deaths	12.7	13.0	8.7	10.7	11.5
COVID-19 mentioned but not main cause	15	23	11	20	69

Among the people who died from COVID-19 as the underlying cause of death during 2020 or 2021, there were some specific medical conditions which were recorded as secondary causes as the person had that medical condition or disease and some of these could have increased the risk of catching COVID-19 or reduced survival from COVID-19. Other secondary causes may have been secondary consequences of the COVID-19 virus, such as pneumonia and acute lower respiratory infection.

The following table gives the number of deaths from COVID and deaths from all other causes where specific medical conditions were mentioned on the death certificate as secondary or contributory causes of death, as well as the number of deaths where that medical condition or disease was the underlying cause of the death in 2020-21. The numbers for 2018-19 are also given for comparison purposes.

The table illustrates the number and pattern of deaths for those medical conditions most likely to appear as secondary causes of death where COVID-19 is given as the underlying cause of death so the table does not necessarily include all the main causes of death.

Note that a death could be in more than one row, for instance, if the underlying cause was COVID-19 but diabetes and obesity were both listed as secondary causes of death, then the death would be included within the 140 COVID-19 deaths with diabetes was a secondary cause and included within the 16 COVID-19 deaths where obesity was a secondary cause.

For instance, there were 429 deaths over the two year period 2020-21 where dementia was the underlying cause of death. Out of the 713 deaths from COVID-19 during 2020-21, 149 had dementia was mentioned as a secondary cause of death and an additional 228 deaths where the cause was not COVID-19 had dementia listed as the secondary cause of death.

	2020-21	2020-21	2020-21	2018-19	2018-19
	COVID deaths	Non-COVID deaths	All deaths	All deaths	All deaths
	Secondary cause	Secondary cause	Underlying cause	Secondary cause	Underlying cause
Cause of death (ICD 10 code)	Number	Number	Number	Number	Number
Cancer (C00-C99)	92	194	1,411	199	1,341
Diabetes (E10-E14)	140	595	67	531	78
Obesity (E66)	16	51	6	36	5
Dementia (F00-F03)	149	228	429	267	495
Parkinson’s disease (G20)	14	41	56	56	65
Alzheimer’s disease (G30)	24	37	95	25	67
Hypertension (I10)	134	740	22	656	15
Coronary heart disease (I20-I25)	115	490	591	532	578
Pulmonary embolism (I26)	29	163	17	157	13
Atrial fibrillation (I48)	95	448	61	408	48
Heart failure (I50)	70	564	33	592	39
Stroke (I60-I69)	55	255	290	280	322
Pneumonia (J12-J18)	422	510	134	674	236
Unspecified acute lower respiratory infection (J22)	39	189	45	206	56
Chronic obstructive pulmonary disease (J40-J44)	115	450	301	418	448
Asthma (J45)	32	57	17	37	12
Chronic kidney disease (N18)	96	503	11	562	18
All deaths	713	4,863	5,576	5,056	5,056

Compared to 2018-19, during 2020-21, there were more people in Hull who died with an underlying cause of death or as a secondary cause of death recorded for all diseases listed in the table except for Parkinson’s disease, stroke and chronic obstructive pulmonary disease. However, the percentage of deaths from these causes out of the total number of deaths was only higher for 2020-21 compared to 2018-19 for diabetes, obesity, Alzheimer’s disease, hypertension, pulmonary embolism, atrial fibrillation, pneumonia and asthma.

	2020-21	2020-21	2018-19	2018-19
	All deaths	All deaths	All deaths	All deaths
	Underlying or secondary cause	Underlying or secondary cause	Underlying or secondary cause	Underlying or secondary cause
Cause of death (ICD 10 code)	Number	Percentage	Number	Percentage
Cancer (C00-C99)	1,697	30.4	1,537	30.4
Diabetes (E10-E14)	802	14.4	607	12.0
Obesity (E66)	73	1.3	40	0.8
Dementia (F00-F03)	806	14.5	763	15.1
Parkinson’s disease (G20)	111	2.0	121	2.4
Alzheimer’s disease (G30)	156	2.8	91	1.8
Hypertension (I10)	896	16.1	672	13.3
Coronary heart disease (I20-I25)	1,196	21.4	1,107	21.9
Pulmonary embolism (I26)	209	3.7	172	3.4
Atrial fibrillation (I48)	604	10.8	460	9.1
Heart failure (I50)	667	12.0	632	12.5
Stroke (I60-I69)	600	10.8	602	11.9
Pneumonia (J12-J18)	1,066	19.1	910	18.0
Unspecified acute lower respiratory infection (J22)	273	4.9	263	5.2
Chronic obstructive pulmonary disease (J40-J44)	866	15.5	870	17.2
Asthma (J45)	106	1.9	46	0.9
Chronic kidney disease (N18)	610	10.9	581	11.5
Total number of deaths	5,576		5,056

Using the percentage of deaths with secondary cause of death for specific conditions in 2018-19 as a comparison, there were more deaths from COVID-19 with a secondary cause of death for cancer, diabetes, obesity, dementia, Parkinson’s disease, Alzheimer’s disease, hypertension, coronary heart disease, pulmonary embolism, atrial fibrillation, stroke, pneumonia, unspecified acute lower respiratory infection, chronic obstructive pulmonary disease, asthma, and chronic kidney disease.

A high percentage of COVID-19 deaths had dementia (21%), diabetes (20%), hypertension (19%), coronary heart disease (16%), chronic obstructive pulmonary disease (16%), chronic kidney disease (14%) or atrial fibrillation (13%) as a secondary cause of death, and almost six in ten of COVID-19 deaths had pneumonia listed as a secondary cause of death.

The percentage of people dying from some of these conditions as an underlying cause of death was lower in 2020-21 compared to 2018-19, which suggests that the people with these conditions were dying from COVID-19 rather than an existing medical condition, suggesting that the underlying cause of death was substituted with COVID-19 among some of the most vulnerable and frail people who were most at risk of death.

These local analyses suggested around 40 additional people who had dementia died compared to a ‘usual’ or ‘typical’ year, but the number of patients who were recorded as having dementia reduced from 2,293 in 2019/20 to 1,990 in 2020/21 – a reduction of 303 patients (see Dementia under Health Factors within Adults for more information). This suggests that the 40 additional deaths from dementia could be a significant underestimate given the size of the decrease in numbers on the GP disease registers. The populations differ though as the numbers from the GP registers are based on patients registered with Hull GPs and there are over 310,000 patients registered with Hull GPs whereas the local analysis used resident population estimates for Hull and it is estimated that there are around 269,000 residents of Hull.

	2020-21	2020-21	2020-21	2018-19	2018-19
	COVID deaths	Non-COVID deaths	All deaths	All deaths	All deaths
	Secondary cause	Secondary cause	Underlying cause	Secondary cause	Underlying cause
Cause of death (ICD 10 code)	Percentage	Percentage	Percentage	Percentage	Percentage
Cancer (C00-C99)	12.9	4.0	25.3	3.9	26.5
Diabetes (E10-E14)	19.6	12.2	1.2	10.5	1.5
Obesity (E66)	2.2	1.0	0.1	0.7	0.1
Dementia (F00-F03)	20.9	4.7	7.7	5.3	9.8
Parkinson’s disease (G20)	2.0	0.8	1.0	1.1	1.3
Alzheimer’s disease (G30)	3.4	0.8	1.7	0.5	1.3
Hypertension (I10)	18.8	15.2	0.4	13.0	0.3
Coronary heart disease (I20-I25)	16.1	10.1	10.6	10.5	11.4
Pulmonary embolism (I26)	4.1	3.4	0.3	3.1	0.3
Atrial fibrillation (I48)	13.3	9.2	1.1	11.7	0.8
Heart failure (I50)	9.8	11.6	0.6	11.7	0.8
Stroke (I60-I69)	7.7	5.2	5.2	5.5	6.4
Pneumonia (J12-J18)	59.2	10.5	2.4	13.3	4.7
Unspecified acute lower respiratory infection (J22)	5.5	3.9	0.8	4.1	1.1
Chronic obstructive pulmonary disease (J40-J44)	16.1	9.3	5.4	8.3	8.9
Asthma (J45)	4.5	1.2	0.3	0.7	0.2
Chronic kidney disease (N18)	13.5	10.3	0.2	11.1	0.4

Deaths With an Underlying Cause of Cancer, Respiratory Disease or Circulatory Disease

The Office for Health Improvement & Disparities’ Fingertips also presents the percentage of deaths with an underlying cause of cancer, respiratory disease or cardiovascular disease. In 2020, almost one-quarter of deaths had an underlying cause of cancer in Hull which was the same as England. Compared to England, slightly higher percentages of deaths in Hull had circulatory / cardiovascular disease as a secondary cause of death (21.8% versus 23.4%) and respiratory disease as a secondary cause of death (10.2% versus 11.4%).

This information is also available by age group and the trends over time are given within the Cancer, Cardiovascular Disease and Respiratory Disease under Health Factors within Adults.

Deaths From Communicable Diseases Including Influenza

The all-age mortality rate from a range of specified communicable diseases including influenza is slightly higher in Hull than England for 2020-22 but not statistically significantly so.

These communicable diseases cover certain infectious and parasitic diseases classified as the underlying cause of death as International Classification of Disease version 10 codes A00 to B99 and influenza which is coded as J09 to J11. 

There has been considerable year-on-year variability in the mortality rate from specified communicable diseases and influenza in Hull between 2001-03 and 2012-14, although since then the rate has been relatively constant in Hull at around 10-11 deaths per 100,000 population (just over 20 deaths registered each year). There were 73 deaths from specified communicable diseases and influenza among Hull residents that were registered during the three year period 2020-22.

Deaths From Suicide and Undetermined Injury

The Office for Health Improvement & Disparities’ Fingertips presents information on the directly age standardised mortality rate from suicide (10+ years) and undetermined intent (15+ years) among those aged 10+ years. Rates are given as deaths registered within the specified years per 100,000 population standardised to the European Standard Population.

For deaths registered over the three years 2021-23, the mortality rate from suicide and undetermined intent in Hull was 21% higher than England but the difference was not statistically significant (23% higher among men and 7% higher among women).

Further information on the trends over time is given within Suicide and Self-Harm under Health Factors within Adults.

All Deaths

The directly standardised number of deaths per 100,000 population (standardised to the European Standard Population) for all ages is the highest in the region for deaths registered during the three year period 2020-22, and is substantially higher than the national average, and fourth highest among lower-tier local authorities in England.

The rates in Hull are 30% in Hull compared to England for 2020-22.

The mortality rate in Hull steadily decreased by 14% between 2001-03 and 2010-12 from 1,408 deaths per 100,000 population to a low of 1,205 deaths per 100,000 population in 2010-12. However, since then the rate in Hull has steadily increased by 9% between 2010-12 and 2020-22, although the latest rate for 2020-22 at 1,313 deaths per 100,000 population is 7% lower than the rate in 2010-12.

In contrast, the rate in England decreased by 22% between 2010-12 and 2017-19 with a decrease for almost every year, although there has been an increase in England between 2017-19 and 2020-22 due to the pandemic. The mortality rate in England is 17% lower in 2020-22 than it was in 2010-12.

A similar patter occurred for men although the initial rate of decrease was greater. The mortality rate decreased in Hull by 20% between 2001-03 and 2010-12, before increasing by 12% between 2010-12 and 2020-22. The mortality rate in 2020-22 is 11% lower than the rate for 2001-03 for Hull whereas for England it is 20% lower.

Whilst the mortality rate for women followed a similar pattern, both the initial decrease and subsequent increase has not been as large as that for men. The mortality rate for women decreased by 11% between 2001-03 and 2011-13 before increasing by 6% between 2011-13 and 2020-22. The latest rate for 2020-22 is 6% lower than it was in 2001-03 for Hull whereas for England it is 17% lower.

The directly standardised number of deaths per 100,000 population for all ages is also available for single years of death registration.

With the ageing population, there has been an increase in the total number of deaths over time, although the actual increase in the mortality rate is not as marked as takes into account the age (within five year age bands), although the mortality rate increased sharply in 2020 due to the COVID-19 pandemic.

As illustrated graphically above, from the local mortality file there were also 2,720 deaths registered during 2021, 2,691 in 2022 and 2,651 in 2023. So numbers did reduce in 2021 and reduced again in 2022, but are still higher for 2023 than they were prior to the pandemic when there were just over 2,5000 per year (although slightly higher in 2017). Hull had the highest age standardised mortality rate among local authorities in 2017 and this was likely associated with the influenza strain that was predominant during the 2017/18 winter.

Premature Deaths (Under 75 Years) and Deaths Considered Preventable

Premature Deaths

The under 75 year standardised mortality ratio was 146 for Hull for 2016-20 so the premature mortality rate after adjusting for age was 46% higher in Hull compared to England.

There was a total of 4,984 deaths among Hull residents that were registered among those under the age of 75 years over the five year period 2016-20 giving an annual average number of deaths of 997 per year.

The directly standardised number of deaths per 100,000 population (standardised to the European Standard Population) for under 75 deaths is the highest in the region, and is substantially higher than the national average. Only three other local authorities (out of the 295 lower-tier local authorities) have higher premature mortality rates than Hull, namely, Blackpool (594 deaths per 100,000 population), Manchester (557) and Liverpool (524). Hart in Hampshire has the lowest premature mortality rate with 199 deaths per 100,000 population.

As mentioned above, there were 8,062 deaths registered for Hull residents between 2021 and 2023, and over four in ten (41.1%) of them occurred under the age of 75 years. Among the 4,240 male deaths, 2,068 (48.8%) were premature and among the 3,822 female deaths, 1,245 (32.6%) were premature.

The impact of the COVID-19 pandemic is clearly evident for both men and women with higher mortality rates among those aged under 75 years. The rate increased only slightly between 2017-19 and 2018-20 with one year of data from the pandemic included for 2018-20, but increased by a higher percentage between 2017-19 and 2019-21 as two years of data from the pandemic was included. During 2020, there were 388 COVID-19 deaths registered among Hull residents, 323 during 2021, 116 during 2022 and 44 COVID-19 deaths registered during 2023. The mortality rate also increased between 2019-21 and 2020-22 for both men and women (that is, there was a higher mortality rate for 2022 compared to 2019).

Percentage of Deaths Occurring Prematurely

The percentage of deaths which occurred prior to the age of 75 years has been decreasing in the decade prior to the COVID-19 pandemic, although increased for deaths which were registered in 2021 (although the percentage was slightly lower in 2020 compared to 2019 for both men and women).

Period of death registration	Males (% aged <75)	Females (% aged <75)	Persons (% aged <75)
1996-98	52.6	33.8	42.9
1997-99	52.3	32.1	41.9
1998-00	53.1	31.7	42.2
1999-01	51.7	30.9	41.3
2000-02	50.6	30.2	40.2
2001-03	49.8	28.4	38.8
2002-04	49.2	29.3	38.8
2003-05	49.2	29.9	39.2
2004-06	48.7	31.1	39.6
2005-07	48.1	30.2	38.9
2006-08	48.1	30.8	39.3
2007-09	48.4	30.6	39.5
2008-10	49.0	30.8	39.9
2009-11	48.1	30.4	39.2
2010-12	45.9	30.0	37.8
2011-13	45.2	28.6	36.8
2012-14	44.9	28.4	36.5
2013-15	45.4	28.9	37.0
2014-16	45.1	30.1	37.6
2015-17	45.5	30.0	37.8
2016-18	45.3	29.3	37.4
2017-19	45.9	29.9	38.1
2018-20	45.4	30.1	38.0
2019-21	47.5	31.7	40.0
2020-22	48.3	32.0	40.6
2021-23	48.8	32.6	41.1

Premature Deaths by Cause of Death

The number of deaths by age (<75 years or 75+ years) have been examined above, and the top causes of death were listed for males and females separately.

Premature Deaths From Causes Considered to be Preventable

The directly standardised number of deaths per 100,000 population (standardised to the European Standard Population) for under 75 deaths considered preventable is the highest in the region, and is substantially higher than the national average.

The rate in Hull is fifth highest of lower-tier local authorities in England after Blackpool (310 deaths per 100,000 population), Manchester (305), Liverpool (280) and Middlesbrough (272) for men and women combined. For males, the rate is third highest after Blackpool (398 deaths per 100,000 population) and Manchester (386), and for females the rate in Hull is 16th highest (with Knowsley having the highest rate with 223 deaths per 100,000 population).

There has been around 1,400 deaths among those aged under 75 years from causes that were considered to be preventable over the three year periods prior to the COVID-19 pandemic. COVID-19 has been added as a preventable cause and accounts for a sizable percentage of the premature deaths from causes considered to be preventable (15% for males and 13% for females based on local analyses). However, it is also likely that there will be indirect impacts from COVID-19 in terms of mortality on other causes due to reduced and slower access to healthcare.

There were 8,278 deaths in total among Hull resident registered during 2020-22 including 3,359 (41%) of them that were among residents aged under 75 years. Overall, there were 1,768 deaths among those aged under 75 years that were from causes that were considered to be preventable equating to 53% of all premature deaths and 21% of all deaths.

In 2017-19 prior to the pandemic, there were 1,440 premature deaths from causes that were considered to be preventable, 2,932 premature deaths and 7,701 deaths in total. So there was a 23% increase in the total number of premature deaths from causes considered to be preventable in Hull between 2017-19 and 2020-22. However, as total number of deaths, total number of premature deaths and total number of premature deaths from causes considered to be preventable all increased between 2017-19 and 2020-22, there was not a great deal of differences in the percentage of deaths from causes considered to be preventable between 2017-19 and 2020-22. In 2017-19, the premature deaths from causes considered to be preventable accounted for 49% of all premature deaths and 19% of all deaths.

Between 2001-03 and 2017-19, the decrease in the premature mortality rate from causes considered to be preventable in Hull was 13% compared to 26% for England. The rates increased between 2017-19 and 2020-22 by 18% for Hull and by 20% for England. Over the entire period 2001-03 to 2020-22, the mortality rate has increased in Hull by 3%, but decreased for England by 11%.

For men over the period 2020-22, there were 4,345 deaths including 2,099 premature deaths, and 1,191 premature from causes considered to be preventable. Thus premature from causes considered to be preventable accounted for 57% of premature deaths and for 27% of all deaths from all ages.

Among men, the premature mortality rate from causes considered to be preventable gradually decreased from 364 to 289 deaths per 100,000 population between 2001-03 and 2010-12, but remained relatively static around 290 deaths per 100,000 population until 2017-19 before increasing to sharply to 364 deaths per 100,000 population for 2020-22 due to the pandemic. The latest mortality rate for 2020-22 is virtually identical to what it was in 2001-03 for Hull, but 15% lower for England. Between 2001-03 and 2017-19 the rate of decrease was lower in Hull compared to England (20% versus 29%), and between 2017-19 and 2020-22 the rate of increase was higher in Hull compared to England (25% versus 20%) so this accounts for why the decrease for the entire time period is greater for England.

For women over the period 2020-22, there were 3,933 deaths including 1,260 premature deaths and 577 premature from causes considered to be preventable. Thus premature from causes considered to be preventable accounted for 44% of premature deaths and for 15% of all deaths from all ages.

For women, whilst there has been some year-on-year variability in the premature mortality rate for causes considered to be preventable between 2001-03 and 2017-19, the rate remained relatively unchanged with the majority of periods – particularly after 2005-07 – having a mortality rate between 160 and 170 deaths per 100,000 population. The rate increased for Hull women between 2017-19 and 2020-22 due to the pandemic but the increases were smaller than those observed for Hull men (8% versus 25%).

The mortality rate for England showed a consistent decrease between 2001-03 and 2017-19, but the subsequent increase due to the pandemic for England was greater than Hull women (8% versus 21%).

The latest mortality rate for 2020-22 is 7% higher compared to the rate in 2001-03 for Hull women, but for England, the rate is 4% lower.

Preventable Deaths By Main Causes of Death

Number of Deaths by Cause of Death

It is possible to examine the causes of death among the premature deaths from causes considered preventable from the local mortality data. The overall numbers do differ slightly from those presented by the Office for Health Improvement & Disparities on Fingertips with 1,179 male and 575 female premature deaths from causes considered preventable from Fingertips registered during 2020-22 compared to 1,190 for males and 578 for females in the local analysis.

Using local mortality information, there were 1,213 male and 579 female premature deaths from preventable causes that were registered during 2021-23. It is possible to examine the top causes previously examined (ignoring ‘other’ categories).

Among males, the top causes of premature deaths from causes considered to be preventable were as follows with the average number of deaths per year registered during 2021-23 given in brackets:

1. Coronary heart disease (60)
2. Lung cancer (50)
3. Drug poisoning (43)
4. COVID-19 (36)
5. Chronic obstructive pulmonary disease (36)
6. Alcohol-specific (32)
7. Suicide and undetermined injury (23)
8. Oesophagus cancer (13)

Almost one-quarter of premature male deaths from causes considered to be preventable were due to cancer (24.4%), 23.4% due to drug poisoning, alcohol-specific conditions and/or suicide and undetermined injury, 19.3% due to cardiovascular disease and 9.4% due to respiratory disease. There were 109 deaths from COVID-19 over the three year period which was 9.3% of the total preventable deaths. Overall, there were 270 from external causes over the three year period representing 22.3% of all premature deaths from causes considered to be preventable.

Among females, the top causes of premature deaths from causes considered to be preventable were as follows with the average number of deaths per year registered during 2021-23 given in brackets:

1. Lung cancer (41)
2. Chronic obstructive pulmonary disease (33)
3. Coronary heart disease (19)
4. COVID-19 (17)
5. Drug poisoning (15)
6. Alcohol-specific (11)
7. Stroke (8)
8. Suicide and undetermined injury (7)

Almost one-third of premature female deaths from causes considered to be preventable were due to cancer (32.0%), 16.2% due to drug poisoning, alcohol-specific conditions and/or suicide and undetermined injury, 14.9% due to cardiovascular disease and 18.0% due to respiratory disease. There were 51 deaths from COVID-19 over the three year period which was 9.1% of all preventable deaths. Overall, there were 81 from external causes over the three year period representing 14.0% of all premature deaths from causes considered to be preventable.

In the period 2020-22 which included the higher mortality rate from COVID-19, there were 174 male and 77 female premature deaths from COVID-19 that were considered to be preventable which represented 15% and 13% of all premature deaths from causes considered to be preventable. COVID-19 was to top cause of premature deaths considered to be preventable among men for deaths registered during 2020-22 and third highest cause for women after lung cancer and chronic obstructive pulmonary disease.

Mortality Rates by Cause of Death

The Office for Health Improvement & Disparities’ Fingertips also presents the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) for all under 75 deaths and under 75 deaths considered to be preventable for the following causes: cancer, cardiovascular disease, liver disease and respiratory disease. Mortality rates are also presented for COVID-19 which is a cause of premature death considered to be preventable with mortality rates given for all ages and for under 75s. They also present the mortality rate from a range of specified communicable diseases, including influenza and mortality rate from suicide and undetermined intent with both of these measures relating to all ages and not just for under 75s.

Trends over time can be found within Coronavirus (COVID-19), Cancer, Cardiovascular Disease, Respiratory Disease and Suicide and Self-Harm within Health Factors under Adults. As there is not a JSNA webpage for liver disease, the trends over time are presented below.

COVID-19

Mortality rates due to COVID-19 (underlying cause) and involving COVID-19 (underlying cause or mentioned as a secondary cause of the death certificate) were statistically significantly higher in Hull compared to England.

Trends over time and mortality rates for men and women separately can be found within Coronavirus (COVID-19) within Health Factors under Adults.

Cancer

The premature mortality rates from cancer in Hull are significantly higher than England and are the highest in the region for 2020-22 (except for premature mortality from causes considered preventable among women where three other local authorities have marginally higher rates).

Trends over time can be found within Cancer within Health Factors under Adults.

Cardiovascular Disease

The premature mortality rates from cardiovascular disease in Hull are significantly higher than England and are the highest in the region for 2020-22 for men and among the highest for women.

Trends over time can be found within Cardiovascular Disease within Health Factors under Adults.

Liver Disease

The premature mortality rate from liver disease in Hull is significantly higher than England for persons for 2020-22.

The mortality rates for men and women separately, and the mortality rates from liver disease considered to be preventable are higher in Hull than England, but they are not statistically significantly different from England. For 2020-22, the rates in Hull are also not the highest across the region in contrast to cancer and cardiovascular disease.

Between 2003-05 and 2019-21, the premature mortality rate from liver disease has been relative constant in Hull at around 22-23 deaths per 100,000 population with around 45-50 deaths per year. The mortality rate has increased to 25.1 deaths per 100,000 population for deaths registered during 2020-22 which is among the highest rate over the period. The total number of deaths registered during 2020-22 at 164 is the highest over the entire period.

Of the 164 premature liver disease deaths registered during 2020-22, 145 or nine in ten (88%) of them were considered to be preventable.

The premature mortality rate from liver disease considered to be preventable has been just under 20 deaths per 100,000 population between 2013-15 and 2018-20, but has increased to 22.2 deaths per 100,000 population for 2020-22 which is the highest rate since 2001-03.

Among men, the premature mortality rate for liver disease has also increased for 2020-22, and the rate is now the highest it has been in over a decade with 106 deaths in total over the three years.

A very high percentage (93%) of the premature mortality rate for liver disease were considered to be preventable among Hull men.

For women, there appears to be slightly more variability over time in the mortality rate, and whilst the rate has decreased between 2019-21 and 2020-22 in contrast to men, the rate has been relatively high during the last two years. The mortality rate for the last two years has been 18 deaths per 100,000 population or more, and it has not been this high since 2010-12 for women in Hull.

For women, 46 of the 58 premature deaths from liver disease which were registered during 2020-22 were considered to be preventable which at 79% is lower than for men (where 93% were from causes considered to be preventable).

Respiratory Disease

The premature mortality rates from respiratory disease in Hull are significantly higher than England. The rates are also among the highest in the region, particularly for women and particularly for premature mortality from respiratory disease from causes considered to be preventable.

For deaths registered during 2020-22, the premature mortality rates from respiratory disease in Hull was 75% higher than England (68% higher for men and 83% higher for women) and the premature mortality rate from respiratory disease from causes considered to be preventable was 98% higher in Hull compared to England (89% higher for men and 106% higher than women – that is more than double the rate in Hull compared to England for women).

Trends over time can be found within Respiratory Disease within Health Factors under Adults.

Premature Deaths Across Hull’s Wards

The mortality rates and causes of death differ substantially across the 21 wards in Hull.

For deaths registered during the four years 2020-23, the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) for all under 75 deaths varies between 269 and 1,054 deaths per 100,000 population across Hull’s 21 electoral wards. Thus under 75 year age standardised mortality rates are 3.9 times higher in Central ward than they are in Kingswood ward.

There is a strong association with deprivation. Kingswood, Holderness, Boothferry and Bricknell are the four least deprived wards in Hull and they have the lowest mortality rates. St Andrew’s & Docklands, Orchard Park, Central, Marfleet, North Carr and Newington & Gipsyville are the six most deprived wards and they have among the highest premature mortality rates.

The premature mortality rates for people living in Central, St Andrew’s & Docklands, Marfleet, Newington & Gipsyville and Orchard Park are all statistically significantly higher than the Hull average, whereas the premature mortality rates for Kingswood, Holderness, Boothferry, Bricknell, West Carr and Ings are all statistically significantly lower than the Hull average.

The pattern is very similar across the wards for men with the mortality rates with age standardised premature mortality rates ranging from 330 to 1,300 deaths per 100,000 population across Hull’s wards for deaths registered during 2020-23. The premature mortality for men living in St Andrew’s & Docklands is 3.9 times higher than for men living in Kingswood.

A very similar pattern in the premature mortality rates occurs for women across Hull’s wards with mortality rates ranging from 273 to 828 deaths per 100,000 population for deaths registered during 2020-23. Female premature mortality rates are three times higher in Central than they are in Kingswood.

More information is also available in within our Ward Profiles under Place.

Preventable Deaths Across Hull’s Wards

For deaths registered during 2020-23, the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) for all under 75 deaths from causes considered preventable also varies significantly across Hull’s 21 electoral wards.

There is more than a three-fold difference in the standardised mortality rates across the wards with a mortality rate of 123 per 100,000 population for Kingswood compared to 408 for St Andrew’s & Docklands.

Premature mortality rates from causes considered to be preventable are statistically significantly higher than the Hull average for residents of St Andrew’s & Docklands, Central, Marfleet and Newington & Gipsyville.

There is a similar pattern for men with the premature mortality rate from causes considered preventable ranging from 180 per 100,000 population in Holderness to 539 per 100,000 population in St Andrew’s & Docklands.

For women, the mortality rates range from 95 to 287 per 100,000 population with Boothferry having the lowest rate and Central having the highest rate. There were fewer than 10 premature deaths from causes considered preventable in Kingswood, and it is not possible to produce a statistically robust estimate of the mortality rate with fewer than ten deaths across all age groups.

Premature Deaths By Local Deprivation Fifth

As noted above across the wards, there is a strong association between premature mortality and deprivation.

For deaths registered during 2020-23, the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) for all under 75 deaths ranges from 449 deaths per 100,000 population for people living in the least deprived fifth of areas of Hull to 975 deaths per 100,000 population for people living in the most deprived fifth of areas of Hull. The mortality rate in the most deprived fifth of areas of Hull is around 2.2 times the age standardised premature mortality rate of those living in the least deprived fifth of areas of Hull.

Mortality rates are higher among men, but a very similar pattern occurs. The premature mortality rate is 548 per 100,000 population among men living in the least deprived fifth of areas of Hull compared to 1,210 per 100,000 population among men living in the most deprived fifth of areas of Hull.

Among women, the mortality rate in the most deprived fifth of areas of Hull is also around 2.1 times the age standardised premature mortality rate of those living in the least deprived fifth of areas of Hull with the mortality rate ranging from 353 to 747 per 100,000 population across the deprivation fifths for premature deaths registered during 2020-23.

More information is also available in within our Ward Profiles under Place.

Preventable Deaths By Local Deprivation Fifth

For deaths registered during 2020-23, the directly standardised mortality rates per 100,000 persons (standardised to the European Standard Population) for all under 75 deaths from causes considered preventable also varies significantly across Hull based on the Index of Multiple Deprivation local fifths.

For men and women combined, the premature mortality rate from causes considered preventable was just over two and a half times higher in the most deprived fifth of areas of Hull (368 deaths per 100,000 population) compared to the least deprived fifth of areas of Hull (143 deaths per 100,000 population).

A similar pattern was observed for men with the premature mortality rate from causes considered to be preventable ranging from 201 deaths per 100,000 population for people living in the least deprived fifth of areas of Hull to 492 deaths per 100,000 population for people living in the most deprived fifth of areas of Hull.

For women, the premature mortality rate from causes considered to be preventable ranging from 87 deaths per 100,000 population for people living in the least deprived fifth of areas of Hull to 241 deaths per 100,000 population for people living in the most deprived fifth of areas of Hull.

Strategic Need and Service Provision

Whilst reducing the number of deaths and increasing life expectancy is important, this needs to be achieved in conjunction with improvements in the quality of life. This is particularly so with the ageing population and the increased demand on scarce resources.

Health inequalities is a huge issue in Hull with large differences in the number of premature and preventable deaths across different geographical areas in Hull. Inequalities are also present in many other areas such as those associated with education, economic activity, lifestyle and behaviour risk factors, housing, social, etc. There is considerable work already occurring in Hull to address these inequalities, but there is still a long way to go with mortality and life expectancy inequalities tending to increase rather than reduce. COVID-19 has impacted greatly on mortality and increased inequalities in Hull.

Resources

Office for Health Improvement & Disparities’ Fingertips: https://fingertips.phe.org.uk/

Updates

This page was last updated / checked on 3 October 2024.

This page is due to be updated / checked in October 2025.