A growing number of middle-aged Britons are dying...And it's not due to chronic disease, researchers say

Man in a hospital bed

Drug-related deaths are thought to be driving up the midlife mortality rate in the UK

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Adam Chapman

By Adam Chapman


Published: 21/03/2024

- 16:58

The UK is falling behind its high-income peers with midlife mortality increasing for people aged 45-54

Britain has been lurching from one health crisis to the next. First came the pandemic, then the backlog caused by the pandemic. And dementia is a ticking time bomb.

Many of these problems are not unique to Britain, of course, but the UK does stand out on one significant measure.


Middle-aged Britons are dying in greater numbers than many of their rich-world peers, a shocking new study shows.

The study, published in the International Journal of Epidemiology, also found death rates among 25-54 year olds are stagnating instead of improving.

Midlife mortality among 25-44-year olds also rose in Canada since 2013 alongside small increases for males of the same age range in Poland and Sweden, although these increases were far smaller than in the US.

Middle-aged man getting examined in a hospital bed

The UK has also seen stalling improvements in cardiovascular disease and cancer

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What explains this uptick in midlife mortality?

"Rising midlife mortality in the UK appears to be due to increases in drug-related deaths combined with stalls rather than continued improvements in cardiovascular disease mortality, " explained Professor Jennifer Dowd, lead author and Deputy Director of LCDS and the Demographic Science Unit.

She told GB News: "Drug-related mortality is still at much lower levels than in the US, except for Scotland, where recent levels rival the extreme situation in the US. It will be important to continue to monitor trends in drug-related deaths and better understand why the overall health of Britons at midlife may be getting worse instead of better."

It comes after a BMJ study published last year found that from 2001 to 2019, Scotland had suffered increases in drug-related mortality comparable with the USA, while Canada and other UK constituent nations did not see dramatic increases.

While the UK performed relatively well on external causes of death such as suicide, homicide and traffic accidents, this was countered by stalling improvements in cardiovascular disease and cancer, and increasing drug deaths.

How the researchers gathered their findings 

The study found that by 2019 younger females (25-44 year olds) in the UK fared worse than all high-income peers, except the US, and even some of the Central and Eastern European countries.

Using annual mortality data from the World Health Organization (WHO) Mortality Database, the study compared trends in midlife mortality for adults aged 25-64 years between 1990 and 2019 across 15 major causes of death in 18 high-income countries, including the US and UK, and seven Central and Eastern European countries.

Over the past three decades, the study found that most of these countries have experienced significant declines in midlife mortality from all possible causes of death, known as all-cause mortality.

US improvements, however, were slower and interrupted by recent periods of stalling and reversals, depending on age and sex. As a result, by 2019, the US saw all-cause mortality rates that were 2.5 times higher than the average of other high-income countries studied.

Worsening midlife mortality in the US was driven by several causes of death, including highly preventable ones such as transport accidents, homicide, suicide and drug overdoses. For example, drug-related deaths in the US increased up to 10-fold (depending on sex and age group combination) between 2000 and 2019, diverging tremendously from other countries.

Young woman in hospital bed

The study also found that by 2019 younger females (25-44 year olds) in the UK fared worse than all high-income peers

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Doctor Katarzyna Doniec, corresponding author of the study and Postdoctoral Researcher at LCDS and the Demographic Science Unit said: "Over the past three decades midlife mortality in the US has worsened significantly compared to other high-income countries, and for the younger 25 to 44 year old age-group in 2019 it even surpassed midlife mortality rates for Central and Eastern European countries. This is surprising, given that not so long ago some of these countries experienced high levels of working-age mortality, resulting from the post-socialist crisis of the 1990s."

The study highlights the health disadvantage of younger US females aged 25-44 years old who were the only group across the 25 countries studied to experience higher mortality rates in 2019 than in 1990.

Professor Dowd said: "Our study adds to the evidence that UK mortality is increasingly diverging from its high-income peers, especially for younger women. The causes of this worsening health will be important to understand going forward."

The study concludes that mortality declines witnessed in other high-income countries imply significant room for mortality improvement in both the US and UK.

The study did not cover the years of the COVID-19 pandemic, when the life expectancy gap between the US and high-income countries widened further.

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