Jun 20, 2022
In this episode Miles is joined by Dr James Tucker and Sarah Caul MBE to talk about how and why the Office for National Statistics count births and deaths, and what current fertility trends might mean for the future population. They look at the impact of popular culture on the most common baby names in England and Wales, and discuss the new significance of a dataset that was itself buried for 50 years.
Transcript:
MILES FLETCHER
I’m Miles Fletcher and this episode of ‘Statistically Speaking’, the official ONS podcast, is literally a matter of life and death. Specifically how and why we count births and deaths and what those numbers are telling us. We'll talk about the possible impacts of declining fertility rates in the UK and of children being born to older parents. And at the other end of life we'll look at the new significance of a dataset that was itself almost buried for 50 years
I'm joined here at ONS by two people who lead on all our data around births and deaths - Head of Analysis in our health and life events teams, James Tucker, and our very own Head of Mortality, Sarah Caul MBE, honoured for her work during the pandemic about which we will talk later.
Starting with you then James, at the
beginning as it were, with births - how does the ONS gather
information about the number of children being born in England and
Wales week in, week out?
JAMES TUCKER
So the registration of births is a
service that's carried out by local registration services in
partnership with the general register office in England and Wales
and the good thing about this, from the perspective of having
a really nice complete dataset, is that birth registrations are
actually a legal requirement, giving us a really comprehensive
picture of births in the countries.
MF
So we gather the numbers, we add them
up, what do we do with the information then?
JT
So there's a couple of ways that we look
at the data. One is to simply look at the number of births per
year. So for example, we're looking at about 600,000 births per
year at the moment. But an alternative approach is to use what we
call the ‘total fertility’ rate, which is basically the average
number of live children that women might expect to have during
their childbearing lifespan. So it's a better measure than simply
looking at the trends in the number of births because it accounts
for changes in the size and age structure of the
population.
MF
So it has a sort of multi-dimensional
value then statistically that you can use to infer various
things about the age at which people are likely to have children,
and how many they're likely to have.
JT
That's exactly right. So we've seen some
changes in the total fertility rate in recent years. So if you've
heard the expression 2.4 children as describing the average
number of children per family it's now considerably lower than
that. In fact, it hit a record low in 2020 when the total fertility
rate was 1.58.
MF
That's a sharp decline. In fact, though,
you've got to go as far back as 1970, when the current series
began, that's when it really was 2.4. What's really striking is if
you look at that graph, the decline that happened between 1970 and
about 1977 - very sharp decline there. Do we know what happened
during that period? What were the factors driving that
particularly?
JT
I think there can be all sorts of
socio-economic factors affecting the fertility rate: improved
access to contraception, reduction in mortality rates of children
under five, which can result in women having fewer children. And
also, more recently, as we've seen the average age of mothers going
up, we might see some lower levels of fertility due to difficulties
conceiving because of that postponement in
childbearing.
MF
Sarah, I can see you want to come in on
this.
SARAH CAUL
So my mother had three children by the
time she was 30, and growing up I would just assume that that was
the route I was going to take because it was what I've known. I am
now 31 and I think if I was pregnant, that thought would scare
me. I don't think I've grown up enough to have a child. I’m a dog
mum, but those don't come into the statistics.
MF
So there was a bit of fanciful talk
about people in lockdown finding - how should we put it delicately?
- you know, things to do with their time, and that might lead to a
boom in births. But that didn't really transpire?
JT
The increase in 2021 would actually
coincide with conceptions across the second and third lockdowns. So
yes, there was some speculation that people may have had enough of
board games and were occupying their times in other ways, but I
think it's actually more likely that it's a result of people
delaying having children earlier on in the pandemic because of the
uncertainty that was around at that point. And then towards the end
of 2020 people had moved on from that and we saw a bit of an
increase.
MF
Nonetheless though, historic data shows
that there is a most common time of the year for conceptions to
take place and that has something to do with the festive period,
doesn't it?
JT
That's right. So the most common
birthday is generally - almost always in fact - towards the end of
September. So it doesn't take a statistician to work out that means
the most popular time to conceive is over the Christmas and New
Year periods. So that could be due to the Christmas festivities,
but it might be also be something a bit less romantic than that.
Some people, for example, might consider that there's an advantage
to children being older in their year in school for
example.
MF
The ONS also publishes the list of most
popular baby names every year, and it is apparently one of the most
downloaded and most popular bits of content on the ONS website.
James, a lot of people scoff at this as an exercise. Is there
any value in this list of baby names? Or is it something the ONS
just produces because people like it?
JT
As you say it is one of our most popular
releases and I think people use it to inform their own choices of
names, and it can also tell us some really interesting things about
culture in the country at the time. The top of the league table
hasn't been that interesting, to be honest. So Oliver and Olivia
have been the most popular names for the last few years, but it's
beneath that that there's some really interesting trends emerging.
So there's always a lot of interesting names that are going
extinct. For example, last year, it was picked up a lot in the
press about the name Nigel, which joined the list of critically
endangered names like Gordon, Carol and Cheryl, and we do also see
some really interesting influences of popular culture. And also
royal babies always have a big influence. Some of the interesting
ones from the last few years - we've seen some more Maeves and
Otis’, which are characters from the TV series ‘Sex Education’, and
even some Lucifers from the series of the same name. But
generally you'd expect there to be positive associations with baby
names so you do almost always see an influence of royal babies -
we've already seen that with George but might be predicting a rise
in Archies with Prince Harry’s son.
MF
And it’s quite interesting, seeing the
cyclical thing with names that you might have associated with
previous generations coming back into popularity, and Archie is a
great example of that, isn't it? Sarah was one of the most popular
girls names for a long time, certainly in the 80s and the 90s. But
Sarah it's dropped out of the top 100 altogether.
SC
It has dropped down, but there's a
Sarah in every single generation in my family. I think we're
all named after each other. So my family is doing its best to
keep it alive.
JT
Just a bit of a question for you. Where
would you put the name Miles in the ranking?
MF
Well, it’s probably not in the top 100
James.
JT
Yeah, I'm afraid it's not quite top 100
material, but it is number 144. There were 390 Miles in 2020.
And it's actually been on a bit of a roll recently. So that's the
highest ranked it's been since 2002.
MF
Perhaps it’s the growing popularity of
this podcast James, or maybe something else at work. Anyway... One
thing worth noting about this before we move on, it should be
pointed out that producing the baby names list is not an expensive
exercise for the ONS.
JT
No, the data is very straightforward to
collect. It's just a matter of compiling it into something that can
be easily accessible and interesting for people to look
at.
MF
And it's also one of the reasons that we
don't compare the spelling of different names, because there's this
long running thing isn't there about how if you added up the
different spellings of the name Muhammad, then that would be
the most popular boys name in England. That's not something the ONS
does because, quite simply, we're just seeing the spelling that
people enter on the system.
JT
Yeah, that's exactly right. And I think
increasingly that could become even more of a task to compile
those, because we're seeing an increasing use of shortened versions
of names or alternative spellings. And if we were to try to compile
those into one then that would definitely increase the time that we
spent on it.
MF
Well, there you are, everything you need
to know about baby names and - more seriously - the measurement of
births and fertility. Plenty more information of course on the ONS
website.
With that, we must turn to the other end
of life, and that is measuring deaths - a topic which has been very
much in the news for the last couple of years since the outbreak of
the pandemic. Right at the centre of that has been my colleague
Sarah Caul, who's sat with us this afternoon. Sarah, you're
recognised for your achievements during that period with an MBE,
official honour, which you collected from Windsor
Castle.
SC
It was definitely very surprising. I
wasn't expecting it, but I'm very thankful for it. It's quite a
proud moment in my life. If you ever see my mum, she'll just scream
at you: “My daughter’s got an MBE”, so that's always
nice.
MF
Recognised now then as an authority in
this area - it's fair to say that the ONS was publishing this list
of weekly deaths very quietly, almost unnoticed, for many years.
And then of course, sadly, that changed at the start of the
pandemic.
SC
With ‘weekly deaths’ it did have a small
audience, to the point where they were considering actually not
publishing it anymore. Pre-pandemic it wasn't a very large part of
my job, because it was just something very quick and easy to do. My
main analysis would be on annual data - we release annual data the
summer after the end of the reference period. We would look at
different causes of death and see where we could investigate
further to help monitor the picture of what people are dying from,
and if that can be prevented.
MF
That all changed of course March / April
2020 with the arrival of COVID-19.
SC
We started quite early thinking of what
we could do with COVID and we added just one line into the
spreadsheet, which was the number of deaths. It went from something
like five to over 100 in one week and we were like “okay, we have
to do a lot more of this now”. It just grew bigger and bigger
because we were having more and more deaths and we needed to get
out, as quick as possible, as much information as we could. We
would be doing something that would usually take us months to
do in a matter of days, every week. And we're actually still doing
it to the same level now because we are still seeing COVID death -
it hasn't completely gone away.
MF
Incredible demand for information from
government, from everybody, of course - desperately concerned about
what was happening. There was suddenly this incredible focus and
attention, and huge pressure, on you to get those numbers out very
quickly.
SC
Those first few months were quite a
blur, because we were publishing weekly and monthly and were
constantly adapting and constantly trying to figure out what people
were interested in seeing. And getting that information out into
the public domain is probably the most challenging time that I've
had here. I don't think I've ever worked at that pace before. But
we have got so many experts in the health analysis and life events
area that we're in. We had expert coders, experts in different
causes of death. It was great to see everybody come together and
work really well together. Despite the enormous amount of pressure,
we were having to deliver things that would normally take us months
in days, and sometimes hours.
MF
Your team were actually among the
first to see the full impact, because there wasn't so much
testing going on among people who have been infected. And it was in
those mortality figures that the real impact was first being
revealed.
SC
It wasn't until our death certificate
information came out, because testing was so limited in the early
days, that you could kind of see the impact, and see how quickly it
was increasing.
MF
How do we gather those
numbers?
SC
So when somebody dies, the informant -
or family member usually - will register the death, usually within
five days, but depending on if it needs to go to a coroner, it
could take months or even years to register that death. And we
don't know about a death until it is registered. When that
information gets put through all of the causes of death listed on
the death certificate comes through to us at the same time with an
assigned underlying cause of death, as well as contributory cause
of death. So we have all of that information on each and every
death registered in England and Wales.
MF
And it's very important to understand
you can have more than one cause of death because this is very
relevant to understanding how many people might actually have died
because of COVID.
SC
The majority of deaths, regardless of
cause, have more than one cause listed on the death certificate
because you have complications, and one cause could lead to another
cause. So the way we categorise it is deaths ‘due to’ COVID - where
COVID was the underlying cause of death or any other condition -
and then deaths ‘involving’ it - so where it was mentioned on the
death certificate as the underlying cause or a contributory
factor.
MF
Do you think a lot of people were
actually confused by that?
SC
One of the things that people struggled
to understand sometimes during the pandemic was that this is a
different number to the public health measure. So somebody could
test positive for COVID-19 but not have COVID-19 on the death
certificate, because it didn't contribute to the death. So the
example that gets told quite a lot is if somebody tests positive
and then gets hit by a bus, it's very unlikely that COVID will
be mentioned on the death certificate.
MF
And that's absolutely vital in
understanding how many people have died ‘from’ COVID as opposed to
a death ‘involving’ COVID.
SC
Yeah, so it's very important.
The public health measure’s great because it's really fast,
and it gives us a more instant knowledge of what's happening. Our
statistics come out about 11 days later, but it's where COVID
contributed to the death, and not just was present time of
death
MF
That helps us to really understand what
the mortality impact of COVID-19 has been so far.
SC
It is really important. So from the
start of the pandemic to the week ending 13th of May, we know
there's about 195,000 death certificates that had COVID on them,
and that's the whole UK as we've worked with colleagues in Northern
Ireland and Scotland to bring a UK figure together, as usually we
only report on England and Wales. And then that enabled us to do
further investigations about who was most at risk of dying from
COVID. And we did a lot by age, place of death and any breakdowns
we thought possible to try and help identify those most at
risk.
MF
Another great strength you might say of
the ONS numbers is the comprehensive nature of the way the
information is gathered centrally and reported very quickly. And
that was evident during the pandemic when you saw the UK numbers
coming along and influencing policy decisions really quite rapidly,
compared to similar countries around the world. Central to that is
the whole concept of ‘excess deaths’. That's a good objective
measure of impact, regardless of what doctors have written on the
death certificate. Sarah, tell us how that works, particularly what
is its statistical value, and what's it been
saying?
SC
We use ‘excess deaths’, which is the
number of deaths we see in a period compared to what we would
expect - and to get the expected number we use an average of the
previous five years. By doing this, it takes into account the
direct and indirect impact of COVID, so we have a fuller measure.
It's really useful as well for international comparisons, because
we're not relying on everybody recording deaths in the same way.
It's just a straightforward “how many deaths above what we would
expect are we seeing?”
MF
And what has it shown so far - what has
been the impact on excess deaths?
SC
So we've seen quite a high number of
excess deaths during the pandemic. In 2020, we saw over 75,000 more
deaths than we were expecting originally. In 2021 that is lower -
we saw around 54,000 deaths more than we'd expect. And currently to
date for 2022 we are seeing the number of deaths slightly below
what we'd expect looking at our five year average.
MF
Do we know yet - at the least the early
indications - for what this might all mean for life
expectancy?
SC
We have released some life expectancy
statistics for 2018 to 2020 as we do three-year combined, and we do
see a bit of a dip in the last year because of the high number of
deaths in 2020, which was due to the pandemic. We're still seeing
the numbers are significantly higher than at the start of our time
period, which was 2001 to 2003. Somebody in England in 2018 to 2020
would live to about 79 years as a male, or 83 years as a female.
Whereas in 2001 to 2003 it was more like 76 years old for males and
81 years old for females.
MF
So in recent history we've seen these
really quite pronounced increases in life expectancy for men and
women.
SC
People are living longer. It’s increased
more for males than it has for females. It's reducing that
inequality gap, because we do see that women do tend to live
longer.
MF
Do we know why men are catching up with
women in terms of life expectancy? Is it lifestyle, nature of work
perhaps?
SC
There is a lot more of a decline in
heart diseases, and especially in males, so I think that could
indicate healthier choices, which would then increase
somebody's life expectancy.
MF
Another important concept when
understanding how the ONS looks at mortalities is the whole
question of ‘avoidable deaths’. So how does that work and what is
it been telling us?
SC
So ‘avoidable mortality’ is defined as a
cause of death that is either preventable - so for example COVID
and appendicitis is included in this – or are treatable - so this
would be different types of cancer. For those aged under 75 in
2020, 22.8% of all deaths in Great Britain were considered
avoidable. This is around 153,000 deaths out of 672,000. The
categories where we've seen the biggest increase since the start of
our time series was alcohol and drug related disorders, which is
the only group of causes where the mortality rate is significantly
higher in 2020 when compared to 2001. But the biggest driver of
avoidable mortality would be the cancers.
MF
So those figures for avoidable death
might suggest then that there is still considerable disparity in
life expectancy between different groups.
SC
So we see through our data that
those living in the most deprived areas have a substantially higher
rate of death from avoidable causes - with deaths due to COVID-19,
drugs and alcohol being notably higher in the most deprived areas.
Avoidable deaths accounted for 40% of all male deaths in the most
deprived areas of England, compared to 18% in the least deprived
areas in 2020. And then we see the difference again for females. It
was 27% of deaths in 2020 in the most deprived areas, and then 12%
in the least deprived areas. So this gap in avoidable mortality
between the most and least deprived areas - it's actually at its
highest level since 2004 for males, and since the data began in
2001 for females.
MF
James what are the factors that are
driving those disparities which are, on the face of it, pretty
serious?
JT
The difference between the most and
least deprived areas is one of the most striking statistics we
produce actually. And I think it really shows the importance of
looking beyond those top level figures. And that's the ability we
have here to look at the minute detail of the data. I mean,
there's all sorts of factors that can go into life expectancy. So
there are things like access to health care, nutritional aspects -
there's plenty of things that can drive that gap, but it's really,
really striking and definitely needs looking into.
MF
What's the direction of our work in this
area? Because for some areas are we not seeing actually a sustained
reversal of life expectancy, not just shorter life expectancy, but
one that's actually getting shorter.
JT
I think you mentioned earlier Miles
about how this mortality data had kind of risen from obscurity I
think. During the COVID pandemic the spotlight has been shone
on deaths and Coronavirus itself, but really there's going to be a
period where we're really going to have to make best use of that
data to look at the indirect effects of Coronavirus as well. So,
take for example just within the pandemic we saw a big increase in
alcohol related deaths in 2020, and that tallies with other
research that shows that patterns of drinking have changed during
that time with heavy drinkers drinking more. So beyond the
pandemic as well - we're looking at things like delays to treatment
times for certain diseases. So there’s plenty of analysis still to
do on the impacts of the pandemic.
MF
Deep in the recesses of the ONS data
though, the causes of deaths that are recorded - some of them are,
you have to say, they're unusual, they're quite remarkable.
Sarah, can you give me some examples of some of the most unusual
deaths that have been recorded?
SC
So I’ve got a few of the least common
causes of death, and I don't want to scare anyone - the numbers
that I've got here are over an eight year period, so they're very
rare. So I don't know if you want to see if you can take a guess at
how many people are ‘bitten or stung by non venomous insects and
other non venomous arthropods’?
MF
People attacked by bees and wasps, that
kind of thing.
SC
Not because they're venomous, but
because of the incident themselves.
MF
Well I'd like to think there was a very
small number. I don't know - over an eight year period -
hopefully less than 50 or so?
SC
It was less than 50. It was 12 - which
is more than I was expected. Another one we have is ‘fall
involving ice skates, skis, roller skates, or
skateboards’?
MF
Can be very dangerous. I don't know,
5?
SC
Three! Very good guess. I for some
reason thought it would be more than being bitten or stung by an
insect. We've got ‘victim of lightning’?
MF
Rare again. Highly unusual. I don't
know... 10?
SC
Seven! You're quite good at the guesses.
I’m very impressed.
MF
You know, you hang around the ONS long
enough and you start to get a feel for these things. What do
we think is the most unusual cause of death that we've
recorded?
SC
We've got a lot that only have one
death. One of the ones that springs to mind is ‘bitten by rat’. I
did expect more people to die from that than some of the other ones
we've got, like ‘contact with powered lawnmower’. But I guess
that's quite a dangerous thing to do, especially if you're like me
and start doing it in your flip flops. So yeah,
dangerous.
MF
Definitely not recommended.
So we've looked at births and we've
looked at deaths. But what's the balance between the two at the
moment, James, and what's the impact on our population of all this
overall?
JT
Population change is driven by the
number of live births and the number of deaths and the balance
between those, but also the migration that takes place each year.
So the difference between the number of births and the number of
deaths is a component known as ‘natural change’. Over the last
decade or so, although we've generally seen more births
than deaths, we've actually seen a narrowing of the gap. So
all else being equal, that means that the population growth will
slow. Also, we did actually see a blip in 2020 when for the first
time for a while the deaths exceeded births, but that's going to be
due to the very high number of deaths that we sadly had from
Coronavirus in that year.
MF
And that was highly unusual - the first
time in many years we've seen that.
JT
Yes, that's right. So the general trend
has been more births than deaths and we've seen a return to
that in 2021.
MF
Well, there we are, proof that the ONS
really does cover us from the cradle to the
grave.
‘Statistically Speaking’ comes to you from the Office for National Statistics. I’m Miles Fletcher, thank you very much for listening. Join us for the next episode, which you can hear by subscribing to this podcast on Spotify, Apple podcasts and all the other major podcast platforms.
Our producers at the ONS are
Julia Short, and Steve Milne.
ENDS