The rise in excess deaths reported since the end of the pandemic are not the result of a ‘pandemic hangover’ but instead part of a longer-term trend, according to new research from the University of Aberdeen.
After the Covid-19 pandemic, many countries, including the UK, continued to experience higher-than-expected mortality rates. This rise is commonly attributed to the pandemic’s effects on health and healthcare.
However, research led by the University of Aberdeen’s Dr Francisco Perez-Reche suggests this may not be the case.
The study, published in Public Health, investigated age-specific mortality trends in the UK and revealed a ‘concerning rise in mortality rates among middle-aged adults since 2012’.
The team investigated these pre-existing trends and their potential contribution to the elevated mortality rates seen after the Covid-19 pandemic and suggest that the pandemic is not the sole factor behind these increases.
The analysis shows that contrary to what was previously thought, mortality rates among middle-aged adults in the UK have actually been rising steadily since 2012 - eight years before the pandemic started. This trend may explain why excess deaths since the pandemic have not dropped as expected.
Currently Public Health planning considers primarily excess deaths. However, these methods can miss gradual increases, leading to an underestimation of the true scale of excess deaths over time.
The new analysis set out in this research combines pre-pandemic trends and excess deaths to provide a more accurate reflection of mortality rates in the population.
Dr Perez-Reche explains: “We know that after the pandemic, many countries, including the UK, report mortality rates that are consistently higher than would normally be predicted, and this is often attributed to the pandemic’s effects. Specifically, these excess deaths are attributed to healthcare backlogs, mental health and other health problems associated with the pandemic.
“However, less attention has been given to pre-pandemic mortality trends. This research examines age-specific all-cause mortality trends in the UK before and after the pandemic. Our findings reveal a concerning rise in mortality rates among middle-aged adults that began in 2012. This earlier trend likely contributed to the elevated mortality seen post-pandemic.
“What we are saying is that the elevated post-pandemic mortality rates in the UK may not be solely due to Covid-19, but also reflect a pre-existing rise in mortality rates among middle-aged adults that began in 2012.”
Dr Perez-Reche believes that public health experts should adjust the way in which excess deaths are recorded to account for these changing trends.
He said: “Before the pandemic, this steady rise in mortality rates among middle-aged adults indicated a persistent annual excess of deaths.
"While we’ve heard a lot about excess mortality during the pandemic, most methods for measuring it are designed to capture sudden spikes - like those seen with Covid-19 - where deaths quickly surpass usual trends. However, these methods can miss gradual increases, leading to an underestimation of the true scale of excess deaths over time.
“To improve public health responses and policy decisions, we recommend combining excess mortality estimates with overall death rates. This approach will provide a clearer, more complete picture of mortality trends.”
The research was funded by the UKRI Covid-19 Longitudinal Health and Wellbeing National Core Study through a Medical Research Council Fellowship (MR/W021455/1).