School of Geography and the Environment, University of Oxford, Oxford OX1 3QY, UK.
Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF.
J R Soc Med. 2024 May;117(5):172-181. doi: 10.1177/01410768231209001. Epub 2023 Nov 21.
The number of deaths occurring in private homes in England and Wales had been rising for years, increasingly rapidly from 2020. Media stories and research linked decomposing bodies found in private homes with pandemic-related social isolation. We aim to explore whether these incidents are one-offs or part of a wider trend.
Descriptive analysis of publicly available Office for National Statistics (ONS) data.
England and Wales.
All residents of England and Wales, 1979 to 2020.
Using data from the Office for National Statistics, we calculate European Age Standardised Rates for deaths coded as R98 ('unattended death') and R99 ('other ill-defined and unknown causes of mortality') in the 10th version of the International Classification of Diseases (ICD-10), and the corresponding codes in ICD-9, by sex and age group from 1979 (when ICD-9 began) to 2020. These are proxy markers for deaths where decomposition precludes attribution of a specific cause at postmortem.
While mortality from all other causes decreased from 1979 to 2020, the opposite was seen for deaths from R98 and R99 (or 'undefined deaths'), with men more affected than women. There was a sharp rise in these deaths in both sexes but in men particularly in the 1990s and 2000s, coinciding with a time when overall mortality was rapidly improving.
The increase in people found dead from unknown causes suggests wider societal breakdowns of both formal and informal social support networks. They are concerning and warrant urgent further investigation. We call on national and international authorities to consider measures that would make it possible to identify these deaths more easily in routine data.
在英格兰和威尔士，私人住宅中的死亡人数多年来一直在上升，自 2020 年以来上升速度越来越快。媒体报道和研究将在私人住宅中发现的腐烂尸体与大流行期间的社会隔离联系起来。我们旨在探讨这些事件是个别情况还是更广泛趋势的一部分。
对公开的英国国家统计局 (ONS) 数据进行描述性分析。
英格兰和威尔士。
1979 年至 2020 年期间居住在英格兰和威尔士的所有居民。
使用英国国家统计局的数据，我们根据性别和年龄组计算了欧洲年龄标准化死亡率，死亡率编码为 R98（“无人看管的死亡”）和 R99（“其他未明确和未知原因的死亡率”）在国际疾病分类第 10 版（ICD-10）中，以及 ICD-9 中的相应代码，从 1979 年（ICD-9 开始）到 2020 年。这些是死后无法确定特定原因的死亡率的代理指标。
虽然 1979 年至 2020 年期间所有其他原因导致的死亡率下降，但 R98 和 R99（或“未定义的死亡”）导致的死亡率却出现了相反的情况，男性受影响甚于女性。这两种性别的此类死亡人数都急剧上升，但在男性中特别是在 20 世纪 90 年代和 21 世纪初，这与整体死亡率迅速提高的时期相吻合。
死于未知原因的人数增加表明正式和非正式社会支持网络都出现了更广泛的社会崩溃。这些情况令人担忧，需要紧急进一步调查。我们呼吁国家和国际当局考虑采取措施，以便更轻松地在常规数据中识别这些死亡。
