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What the Health Profile for England shows us about the wider impacts of COVID-19 on health

Today we have published the Health Profile for England 2021 report.

The Health Profile for England report provides the most comprehensive look at the state of the nation’s health.

Like in previous year’s reports, this update looks at a range of population health data, such as smoking and obesity, but it also provides an early epitome of the impact of the COVID-1 9 pandemic on many aspects of health and health inequalities.

Here we look at five important points the report makes about how the nation’s health has been affected either directly or indirectly by the pandemic.

Mortality are greater than previous years

In 2020, COVID-1 9 was “the worlds leading” underlying cause of death among males, changing congestive heart failure, and the second largest cause of death among girls after dementia and Alzheimer’s disease. By the end of June 2021, 132,053 demises had been registered with COVID-1 9 mentioned on the death certificate among England residents.

Between 21 March 2020 and 2 July 2021, demises were 1.14 times higher than expected across England, based on data for the previous five years.

Deaths were higher than expected in all age groups over 25 but were particularly high in people living in deprived orbits( 1.17 times greater) and in the Black and Asian population( 1.50 times greater ), indicating the disproportionate impact of the pandemic on these groups. This can be found in figures 1 and 2 below.

Figure 1: Cumulative excess mortality ratio, by distres, England, week culminating 27 March 2020 to week aiming 2 July 2021

Source: PHE Excess mortality in England weekly reports

Figure 2: Cumulative excess death ratio, by ethnic group, England, week objective 27 March 2020 to week ceasing 2 July 2021

Source: PHE Excess mortality in England weekly reports

Dementia deaths increased, and diagnoses worsened

Dementia and Alzheimer’s disease remained the leading cause of death in England in females and the third largest in males. Deaths from dementia continued to increase in 2020 and dementia was reported as the primary pre-existing health state in 26% of all deaths involving COVID-1 9 between March and June 2020.

By June 2021, there were around 35,000 fewer people aged 65 and over with a diagnosis of dementia. Although increased mortality among parties with dementia during the course of its pandemic may be a factor, this is also likely due to reduced access to services where diagnosis makes place.

Very few GP referrals were made to Memory Assessment Assistance in the first lockdown and by September 2020 referrals were down by 25% of those expected. It is estimated that there were 10,000 missed referrals up to March 2021.

Health services were not used as much

During the pandemic, hospital admissions, A& E appearances and the number of GP consultations are still down, particularly in the first waving of the pandemic.

Surveys show that half of people with a worsening state milieu between May 2020 and January 2021 did not seek treatment, most commonly because they did not want to put pressure on the NHS or were concerned about catching COVID-1 9.

This has meant that new identifications for some diseases this year were much down compared with previous years. This includes cancer, for which there is indeed 16% less identifications between April and December 2020 than in the corresponding period in 2019, as seen in Figure 3 below.

Figure 3: Monthly new cancer diagnosis, working days adjusted, England, January 2018 to April 2021

Source: National Cancer Registration& Analysis Service, PHE COVID-1 9 rapid cancer enrollment and care data . Date retrieved: 06/08/ 2021 Note: Source data may be revised in future informs. This is most likely to affect the later months in the time series.

This reduced contact with health services may mean that preventative medication has been missed but could also lead to long-term health complications and an increase in deaths in the future, meaning that we can still expect to see the impact of COVID-1 9 in years to come.

Children’s improvement may have suffered

Children’s education has been severely stopped during the pandemic. From 23 March 2020 until June 2020, most institutions in England were closed to children other than those with parents who were keyworkers or “whos” classed as vulnerable.

Whilst the full wallop of the pandemic on child health and development is still not known and will not be known for some time, initial studies suggest that children who started school in the Autumn 2020 term needed additional subscribe when compared with children in previous school year and that learn has suffered to some degree for most pupils and year groups, especially primary and most underprivileged students.

Almost all schools have indicated that they are concerned about young pupils’ communication and language development, personal, social and feelings occurrence and levels of literacy as children were not experiencing the social interactions that they are generally would, such as play dates and interacting with grandparents.

In 2020, one in six children aged five to 16 times were identified as having a probable mental disturbance, increasing from one in nine in 2017. Children and young adults with a probable mental disturbance were more likely to say that lockdown had offset “peoples lives” worse.

Increased alcohol intake among heavy drinkers likely drove an increase in alcoholic liver demises

There has been an unprecedented increase in alcohol-specific demises( fatalities which were caused by alcohol use ), mainly due to increased alcoholic liver cancer death. In 2020, alcohol-specific deaths increased by 20% comparison with 2019. Although alcohol-specific mortality rates have been increasing in recent years, this represented a significant acceleration in the upward trend.

A recent PHE report monitoring booze uptake and distress during the course of its pandemic noted that the increase in alcoholic liver malady mortality was’ likely to be due to increased uptake among an previously at-risk group of heavy drinkers’.

Increased mortality has impacted on life expectancy…

The high number of deaths due to COVID-1 9 generated life expectancy in England to fall in 2020, by 1.3 years for males to 78.7 years and 0.9 years for girls to 82.7 years. This is the lowest life expectancy since 2011 for males and females.

The pandemic has exacerbated existing inequalities in life expectancy by deprivation to the largest we have seen in two decades, which is as far back as our data proceeds. The divergence between “the worlds largest” and least expropriated areas in England in 2020 was1 0.3 times for males, one year larger than in 2019, and 8.3 times for females, 0.6 years larger than in 2019, as Figure 4 shows.

Figure 4: Life expectancy, by gender and deprivation decile, England 2019 and 2020

Source: PHE Wider Impacts of COVID-1 9 on Health( WICH) tool

COVID-1 9 was the cause of death that contributed most to this gap, nonetheless, higher death from congestive heart failure, lung cancer, and chronic lower respiratory diseases in deprived provinces remained important contributors. You can read more about how life expectancy changed in 2020 here.

We will continue to monitor the impacts of the pandemic on the nation’s health as a priority as additional health data becomes available.

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