The Death Rate

The Death Rate

• The death rate is the number of deaths per thousand of the population per year.
• In 1900, the death rate was 19, whereas by 2012 it had more than halved, to 8.9.
• The death rate had already begun falling from about 1870 and continued to do so until 1930.
• It rose slightly during the 1930s and 1940s – the period of the great economic depression, followed by World War II – but since the 1950s it has declined slightly.
• 

Reasons for the Decline

• According to Tranter (1996) over 75% of the decline in deaths between 1850 to 1970 were caused by a fall in the number of infectious diseases, such as diphtheria, measles, smallpox, typhoid and above all tuberculosis.
• Deaths from infectious disease were most common in the young and most of the decline in the death rate occurred among infants, children and young adults.
• By the 1950s, so-called ‘diseases of affluence’ (wealth) such as heart disease and cancers had replaced infectious diseases as the main cause of death. These degenerative diseases affect the middle aged and old more than the young.
• It is also possible that the population began to develop some natural resistance or that some diseases became less virulent (powerful).
• 

Improved Nutrition

• Thomas McKeown (1972) argues that improved nutrition has accounted for half of the reduction to the death rate, and was particularly important in reducing TB.
• Better nutrition increased resistance to infection and increased the survival chances of those who did become infected.
• Criticisms of McKeown;
• does not explain why females, who receive a smaller share of the family food supply, lived longer than males
• fails to explain why deaths from some infectious diseases, such as measles and infant diarrhoea, actually rose at a time of improving nutrition
• 

Medical Improvements

• Before the 1950's, despite some important innovations, medical improvements played almost no part in the reduction of deaths from infectious disease.
• After the 1950's, improved medical knowledge, techniques and organisation did help to reduce death rates. Advances included the introduction of antibiotics, immunisation, blood transfusion, improved maternity services, as well as the setting up of the National Health Service in 1948.
• More recently, improved medication, bypass surgery and other developments have reduced deaths from heart disease by one-third.
• 

Smoking and Diet

• According to Harper, the greatest fall in the death rate has been caused by less people smoking.
• However, in the 21st century, obesity has replaced smoking as the new lifestyle epidemic. For example, in 2012, one quarter of all UK adults were obese.
• although obesity has increased dramatically, deaths from obesity have been kept low as a result of drug therapies.
• Harper suggests that we may be moving to an ‘American’ health culture where lifestyles are unhealthy but where a long lifespan is achieved by use of costly medication.
• 

Public Health Measures

• In the 20th century, more effective central and local government with the necessary power to pass and enforce laws led to a range of improvements in public health and the quality of the environment.
• These included improvements in housing (producing drier, better ventilated, less overcrowded accommodation), purer drinking water, laws to combat the adulteration of food and drink, the pasteurisation of milk, and improved sewage disposal methods.
• Similarly, the Clean Air Acts reduced air pollution, such as the smog that led to 4,000 deaths in five days in 1952.
• 

Other Social Changes

• Other social changes have also played a part in reducing the death rate. These include;
• The decline of dangerous manual occupations such as mining
• Smaller families reduced the rate of transmission of infection
• Greater public knowledge of the causes of illness
• Lifestyle changes, especially the reduction in the number of men who smoke.
• Higher incomes, allowing for a healthier lifestyle.
• 

Life Expectancy

• Life expectancy refers to how long on average a person born in a given year can expect to live.
• As the death rate has fallen, life expectancy has increased. For instance;
• Males born in England in 1900 could expect on average to live until they were 50 (57 for females).
• Males born in England in 2013 can expect to live for 90.7 years (94 for females).
• Over the past two centuries, life expectancy has increased by about two years per decade.
• Lower life expectancy in 1900 may have been caused by high infant mortality. We can see that life expectancy has improved because a baby born today is more likely to reach its 65th birthday than a baby born in 1900 had of reaching its 1st birthday.
• The future?
• If the trend to greater longevity (long lifespan) continues, Harper predicts that we will soon achieve ‘radical longevity’, with many more centenarians (people aged over 100).
• Currently there are about 10,000 in the UK; by 2100 there are projected to be one million.

Class, Gender and Region

• Despite the overall reduction in the death rate, there are still some significant class, gender and regional differences in the death rate.
• For example, women generally live longer than men – although the gap has narrowed due to changes in employment and in lifestyle (such as more women smoking).
• Those living in the North and Scotland have a lower life expectancy than those in the South.
• Working class men in unskilled or routine jobs are nearly three times as likely to die before they are 65 compared with men in managerial or professional jobs.
• According to Walker (2011), those living in the poorest areas of England die on average seven years earlier than those in the richest areas.
•