Causes of Death in Hull

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).

In July 2022, Clinical Commissioning Groups (CCGs) ceased to exist and were replaced by the Integrated Care System. Data will still be available at CCG level for some time after July 2022 so this page continues to refer to CCGs and Hull CCG, and continues to present data at the CCG geographical level. Six local CCGs were also combined to form the Humber, Coast and Vale geographical area, which has also ceased to exist. It has been replaced by the Humber and North Yorkshire ICS. However, data will still be available at Humber, Coast and Vale geographical level, and will be presented within our JSNA.

Headlines

• There were 38 stillbirths in Hull which occurred during 2019-21 which gave a rate of 4.0 per 1,000 stillbirths and live births which was similar to England at 3.9 stillbirths per 1,000 stillbirths and live births.
• There were 40 infant deaths (under one year of age) that were registered in Hull over the three year period 2018-20, 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 lower in Hull compared to England with a total of 16 deaths between 2018 and 2020.
• During the three year period 2019-21, there were 8,130 deaths among Hull residents with 2,058 among men under 75 years, 2,247 among men aged 75+ years, 1,208 among women under 75 years and 2,617 among women aged 75+ years.
• The main causes of death during 2019-21 were cardiovascular disease (24.3%) with just under a half of these deaths (10.9%) from coronary heart disease. Cancer accounted for just under one-quarter of all deaths (23.7%) with lung cancer accounting for around three in ten of these deaths (7.2%). Respiratory disease accounted for one in eight deaths (12.0%) with more than half of these due to bronchitis, emphysema and chronic obstructive pulmonary disease (6.1%). Dementia accounted for one in twelve deaths (8.3%), and COVID-19 accounted for one in eleven deaths (8.8%). 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.
• During the three year period 2017-19 there were 7,709 deaths among Hull residents of which 1,441 were among people aged under 75 years and were 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.
• 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.
• The under 75 year directly standardised mortality rate ranges from 325 to 793 per 100,000 population across Hull’s 21 electoral wards. The wards with the highest levels of deprivation have the highest mortality rates. People living in the most deprived fifth of areas of Hull have a premature mortality rate of 713 per 100,000 population compared to 289 per 100,000 population for people living in the least deprived fifth of areas of Hull.
• There have been an increased number of deaths since March 2020 to Hull residents due to COVID-19. This influenced the underlying and secondary causes of death. 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.

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.

The Hull Picture

Stillbirths, Infant Mortality and Deaths Among Children

The rate of stillbirths in Hull was 4.0 per 1,000 live births and stillbirths which occurred during 2019-21, and the rate was only marginally higher than England (3.9 stillbirths per 1,000 live births and stillbirths).

For deaths registered during 2018-20, the infant mortality rate (deaths under one year of age) in Hull was 4.2 per 1,000 live births which was higher than England (3.9 deaths per 1,000 live births) although there was no statistically significant difference between Hull and England.

The rate of stillbirths was significantly higher than England in the three year periods from 2013-15 to 2015-17, and whilst the rate has decreased in Hull since then, and whilst it is slightly higher than England for 2019-21 it is not statistically significantly higher. There were 38 stillbirths in Hull during 2019-21 giving an average of 13 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. The infant mortality rate was been consistently higher than England (but not statistically significantly so) since 2015-17, and whilst it decreased by 16% between 2017-19 and 2018-20, the rate is still higher than England, although it is the same as the Yorkshire and Humber average.

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 2018-20 is among the lowest across Yorkshire and Humber. 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 16 deaths among those aged 1-17 years in Hull over the three year period 2018-20, and the mortality rate was lower than both England and the Yorkshire and Humber.

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 for Clinical Commissioning Groups (CCGs). In 2020, Hull had a much higher percentage of all deaths that occurred under the age of 65 years compared to other CCGs within Humber, Coast and Vale. Part of this may be due to Hull’s younger age structure compared to other local CCGs, 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 CCGs within Humber, Coast and Vale, particularly so for the younger age groups.

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. 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 more marked among those aged 85+ years.

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

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 this increased markedly in 2020 and 2021 due the COVID-19 pandemic. In 2020, the number of deaths at 2,910 was the second highest it had been since 1999. The number of deaths in 2021 reduced from 2020, but was still higher than 2018 and 2019.

Deaths by Cause of Death

Total Number of Deaths by All Main Causes of Death

During the three year period 2019-21 there were 8,130 deaths among Hull residents of which 2,058 where among men aged under 75 years, 2,247 among men aged 75+ years, 1,208 among women aged under 75 years, and 2,617 among women aged 75+ years.

The number of main underlying deaths by cause for 2019-21 are given below for deaths which occurred over the three year period 2019-21. Some numbers have been replaced by asterisks because the number of deaths is too small to present. In these cases the number has been presented elsewhere (in the ‘other’ category). The totals are not provided the these causes of death because 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. The total number of deaths for each of these three causes of death are given and this means due to these overlapping categories, the total deaths from all the causes in the table sum to more than the total number of deaths at the bottom of the table.

Overall, 1,924 deaths were caused by cardiovascular disease (23.7%) 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 1,972 deaths due to cancer (24.3%) 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 980 deaths from respiratory disease (12.1%) 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 678 deaths caused by dementia representing 8.3% of all deaths during 2019-21 (further information is available under Dementia under Health Factors within Adults).

There were 82 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 43 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).

During the three year period 2019-21, there were 713 deaths due to COVID-19. 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 (2019-21)	Males <75	Males 75+	Females <75	Females 75+	Total	Percentage
Infant (<1 year)	20		23		43	0.5
Drug poisoning* (1)	122	*	44	*	*	*
Alcohol-specific* (1)	80	*	35	*	*	*
Oesophagus cancer	51	22	11	17	101	1.2
Colorectal cancer	66	57	37	45	205	2.5
Pancreas cancer	38	22	28	20	108	1.3
Lung cancer	185	131	132	137	585	7.2
Breast cancer (1)	*	*	76	71	*	*
Prostate cancer	31	110			141	1.7
Other cancers	228	209	181	214	832	10.3
Diabetes	20	26	24	45	115	1.4
Dementia	19	219	25	415	678	8.3
Parkinson’s disease (2)	13	38	*	31	*	*
Alzheimer’s disease (2)	9	49	*	71	*	*
Other diseases of the nervous system	42	19	34	23	118	1.5
Hypertensive disease	39	25	15	47	137	1.7
Coronary heart disease	300	273	84	233	890	10.9
Stroke	80	129	46	183	438	5.4
Other cardiovascular disease	92	140	59	168	459	5.6
Influenza and pneumonia	43	86	21	99	249	3.1
Bronchitis, emphysema and COPD	122	129	92	155	498	6.1
Other respiratory disease	31	77	29	96	233	2.9
Digestive system diseases (non-alcohol)	72	71	61	89	293	3.6
Genitourinary system diseases	9	37	10	57	113	1.4
Suicide and undetermined injury*	65	*	17	*	*	*
Other external causes of death	36	40	16	41	133	1.4
Drug poisoning* (3)	122	*	44	*	*	*
Alcohol-specific* (3)	80	*	35	*	*	*
COVID-19	160	253	69	231	713	8.8
Other causes of death	95	74	46	129	344	4.2
Total over three years	2,058	2,247	1,208	2,617	8,130	100.0

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.

The number of infant deaths under the age of one year, and deaths from colorectal cancer, pancreas cancer, lung cancer, diseases of the digestive system (non-alcohol related) and from suicide and undetermined injury has remained relatively static between 2010 and 2021, although there has been year-on-year variability.

The average annual number of deaths from the following causes has generally increased over time for oesophagus cancer, breast cancer, diabetes, Alzheimer’s disease and drug poisoning, and the numbers have generally been decreasing for coronary heart disease.

The number of deaths by underlying cause differed slightly for some causes of death for 2020 and 2021 due the COVID-19 pandemic. There had been relatively static numbers of people dying from stroke and influenza and pneumonia between 2010 and 2019, but numbers decreased during the COVID-19 pandemic. The numbers had also been relatively static for hypertensive disease and alcohol-specific conditions (wholly attributable to alcohol) over time, but the numbers from these two causes of death increased during the COVID-19 pandemic.

The number of deaths from prostate cancer, dementia, Parkinson’s disease, and bronchitis, emphysema and chronic obstructive pulmonary disease (COPD) has generally been increasing in Hull over time, but during the COVID-19 pandemic the numbers dying from these four causes decreased in Hull.

This is perhaps not too surprising as each year people who are more vulnerable and frail are more likely to die, and these are more likely to have died from COVID-19 during the pandemic, and therefore did not die of other conditions which older, more vulnerable, frail people are more likely to die from such as stroke, influenza and pneumonia, and dementia. In a care home, it is possible that social mixing was reduced among residents without dementia, but it was more difficult among residents with dementia. 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 pneumonia.

Underlying cause of death	2010-11	2012-13	2014-15	2016-17	2018-19	2020-21
Infant (<1 year)	17	14	16	17	14	15
Oesophageal cancer	25	31	22	31	33	35
Colorectal cancer	69	65	68	70	65	69
Pancreas cancer	28	38	30	38	27	40
Lung cancer	196	187	221	211	179	196
Breast cancer	43	43	49	42	49	48
Prostate cancer	36	36	33	48	50	43
Other cancers	282	303	275	278	269	277
Diabetes	20	24	23	30	39	33
Dementia	101	152	229	250	248	214
Parkinson’s disease	15	14	25	22	33	29
Alzheimer’s disease	15	21	29	24	34	49
Other diseases of the nervous system	30	39	39	38	41	36
Hypertensive disease	29	20	24	36	28	52
Coronary heart disease	319	304	313	317	289	296
Stroke	164	167	175	177	161	145
Other cardiovascular disease	160	165	141	146	141	158
Influenza and pneumonia	126	106	118	124	124	68
Bronchitis, emphysema and COPD	168	174	204	204	224	152
Other respiratory disease	104	118	91	75	85	75
Digestive system diseases (non-alcohol)	105	106	111	110	91	102
Genitourinary system diseases	47	53	51	44	39	39
Suicide and undetermined injury*	25	31	31	31	32	28
Other external causes of death	45	33	43	50	56	37
Drug poisoning*	19	23	25	41	45	55
Alcohol-specific*	28	32	34	36	32	43
COVID-19	0	0	0	0	0	357
Other causes of death	123	110	104	122	110	111
Missing cause of death	0	0	0	1	4	0
Average annual totals	2,328	2,395	2,515	2,603	2,532	2,788

Deaths Due to COVID-19 Occurring in 2020 and 2021

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 slightly fewer deaths from COVID-19 in 2021 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 was 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

Further information can also be found the official UK Government website for data and insights on coronavirus which includes information at local authority level.

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 were 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 as the underlying cause of death or as a secondary cause of death from cancer, diabetes, obesity, dementia, Alzheimer’s disease, hypertension, coronary heart disease, pulmonary embolism, atrial fibrillation, heart failure, pneumonia, unspecified acute lower respiratory infection, asthma, and chronic kidney 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.

	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 2017-19 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 in the last six years the rate has been relatively constant at around 11 deaths per 100,000 population (just over 20 deaths per year).

Deaths From Suicide and Undetermined Injury

The mortality rate from suicide and undetermined injury in Hull is statistically significantly higher than England for men and for men and women combined for 2019-21.

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

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 occurred under the age of 75 years over the five year period 2016-20 giving an annual average number of deaths of 997 per year.

Premature Deaths From Causes Considered to be Preventable

In Hull, of the 7,709 deaths during 2017-19, 2,932 occurred prior to the age of 75 years (from the percentage of deaths by age trend charts from Fingertips displayed above), and 1,440 of these deaths were 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 mortality rate from causes considered to be preventable has been consistently decreasing in England and across the Yorkshire and Humber region (although there was a slight increase for the region between 2016-18 and 2017-19). In contrast, whilst the rate decreased in Hull between 2001-03 and 2011-13, the rate has increased since then. The increase in Hull since 2011-13 has been relatively consistent with only one decrease between 2015-17 and 2016-18.

However, the decrease between 2001-03 and 2010-12 was greater than the increase between 2010-12 and 2017-19, and as a result the mortality rate for 2017-19 in Hull is lower than it was in 2001-03. The mortality rate from causes considered to be preventable fell by 14% over the ten year period between 2001-03 and 2011-13, and has increased by 5% over the six year period 2011-13 to 2017-19. The inequalities gap between Hull and England has increased in recent years.

The pattern is similar for males with the mortality rate decreasing consistently for England and the region, compared to an initial decrease in Hull followed by a period where the mortality rate increased. The male mortality rate from causes considered to be preventable fell by 21% over the 11 year period between 2001-03 and 2012-14, and has increased by 6% over the five year period 2012-14 to 2017-19. Thus the mortality rate in 2017-19 is lower than the 2001-03, but the inequalities gap between England and Hull has increase over time.

There has been year-on-year variation in the mortality rate from causes considered to be preventable among women, but no real difference in the mortality rate between 2001-03 and 2017-19 with virtually identical mortality rates for 2001-03 (166 per 100,000 population) and 2017-19 (169 per 100,000 population). The mortality rate has been as low as 163 per 100,000 population for women (in 2011-13) and as high as 182 per 100,000 population (in both 2003-05 and 2004-06). In contrast, the mortality rate from causes considered to be preventable among women has decreased for England and for the region, thus increasing the inequalities gap for Hull women.

Premature Deaths and Preventable Deaths By Main Causes 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. 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 Cancer, Cardiovascular Disease, Respiratory Disease and Suicide and Self-Harm 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 2017-19.

Cardiovascular Disease

The premature mortality rates from cardiovascular disease in Hull are significantly higher than England and are the highest in the region for 2017-19.

Liver Disease

The premature mortality rate from liver disease in Hull is significantly higher than England for persons for 2017-19, although the mortality rates for men and women, and the mortality rates from liver disease considered to be preventable are higher in Hull than England they are not statistically significantly different from England. For 2017-19, the rates in Hull are also not the highest across the region in contrast to cancer and cardiovascular disease.