The number of excess deaths in the UK has increased by some measures, and a new petition is now calling for an investigation. Are current mortality levels likely to be an outlier – or are we seeing a longer lasting trend? 

 

At the end of January, the UK had seen 30 consecutive weeks of excess mortality, according to the Continuous Mortality Investigation. The high number of deaths has meant that a petition has been started to bring the government to investigate the root causes of the increase and produce a report. At the time of writing, the petition had 21,551 signatures. 

 

While the 2020 and 2021 pandemic years have been regarded as outliers by actuaries, the excess mortality seen in 2022 is more indicative of what will happen over the next few years, some believe. 

 

“Mortality has been persistently higher than in 2019 for much of that period, with excess mortality being higher than Covid-19 mortality in recent months. This suggests that mortality in 2022 may be indicative of future mortality to some extent,” the Continuous Mortality Investigation said at the start of February. 

 

   

The Office for National Statistics says that looking at the excess mortality in 2022 based on provisional data, deaths in England were 6.3% above average, whereas age-standardised mortality rates were 0.7% below average. How excess deaths are measured can differ; the ONS is now working with the Office for Health Improvement and Disparities, which uses a different measure. 

   

    

 

Stuart McDonald, who chairs the Actuaries Response Group, part of the Institute and Faculty of Actuaries, says it is important to know that some of the excess deaths stem from the fact that the population is ageing, with old people representing a higher proportion now.  

 

However, he points out that according to the CMI, even an age-standardised view shows that last year, 31,000 more people died in the UK as a whole, than did in 2019. The group where deaths increased the most in relative terms were working age adults. 

 

“That’s a significant excess. It’s not as large as we saw in the first and second waves of Covid-19, but it was fairly consistent throughout the second half of 2022,” says McDonald. “Obviously no-one can categorically say what would have happened to life expectancy absent the pandemic but my view and, I believe, the majority view in the actuarial profession, is that we would have expected mortality rates to continue to fall, as they have done for hundreds of years.” 

     

While deaths would normally reduce in spring, following a seasonal pattern, this was not true last year, when deaths effectively stayed at winter levels. 

 

“We’ve got this constant pressure that’s being driven by the direct and indirect effects of Covid. Omicron is explaining some but not all of the excess,” McDonald says. 

 

The pandemic – along with other causes – has meant that accessing healthcare has become much more difficult, with record wait times for ambulances and in accident and emergency departments. 

 

“There are good studies showing a link between A&E wait times and mortality. That's been a problem throughout the second half of the year,” says McDonald. 

 

He also points to missed and delayed diagnoses, with recent research sponsored by the British Heart Foundation saying nearly half a million people missed out on being put on blood pressure medication between March 2020 and July 2021. 

 

“That will result in more strokes and heart attacks occurring,” he predicts. “We also know that cardiovascular risks are higher after viral infections.” 

 

All these things are contributing, says McDonald – and as if that was not enough, the cold snap in combination with high energy prices is affecting people’s health as well. 

 

“If you go back to pre-central heating days, we used to see much bigger [mortality] spikes in winter,” he notes. 

 

The combined factors are unlikely to go away quickly. Actuaries are therefore reducing their cohort life expectancy assumptions, and slower progress in period life expectancy will further fuel this. 

 

 

When it comes to defined benefit pension schemes, the fact that they produce a regular income can also be seen in the health of DB recipients. 

 

“Members of DB schemes can be somewhat insulated from some of these [population health effects] though not from all of these,” McDonald observes, as even the best private healthcare does not replace NHS emergency services. 

 

But “different stakeholders have different priorities for how much prudence they want to allow for”, he notes, and so each pension fund will build in mortality according to stakeholders’ views. 

 

DB memberships need to be looked at separately from general population data, agrees Mark Sharkey, head of pension strategy, global, at Club Vita. “Using population level statistics could be potentially misleading for pension funds when setting assumptions,” he says. 

 

The firm has a dataset it says represents a quarter of the DB pensioner population. Its latest analysis, going up to 2020, shows that DB pensioners were more resilient to the pandemic in 2020 than the general population. It also found that within that dataset, excess mortality was driven more strongly by regional variations than by level of affluence.  

 

For the general population, affluence is seen as a key factor, as more deprived groups were more impacted by the pandemic in 2020 and 2021. However, this was no longer the case in 2022, and whether it is also true for the DB pensioner population is not yet known; analysis of more recent DB pensioner mortality figures will be available later this year. 

 

To stress test liabilities and longevity assumptions, Club Vita has come up with four possible scenarios, explains its head of pensions, Jill Gallagher. This ranges from a healthcare decline scenario – leading to a 5% fall in liabilities – to a healthcare improvement scenario, where lessons learnt from the pandemic lead to medical breakthroughs, with a 2% increase in pension obligations as a result.  

 

Like all things in the future, longevity improvements remain uncertain. What is clear is that since the start of the pandemic, longevity assumptions “are no longer something the scheme actuary just scribbles into the back of the valuation report each year, rather a risk the fund needs to monitor”, says Sharkey. “The pandemic was a catalyst.”