Why were there 231 707 more deaths than expected in England between 2010 and 2018? An ecological analysis of mortality records.

BACKGROUND: Policy responses to the Global Financial Crisis emphasized wide-ranging fiscal austerity measures, many of which have been found to negatively impact health outcomes. This paper investigates change in patterns of mortality at local authority level in England (2010-11 to 2017-18) and the relation with fiscal austerity measures. METHODS: Data from official local authority administrative records are used to quantify the gap between observed deaths and what was anticipated in the 2010-based subnational population projections. Regression analyses are used to explore the relation between excess deaths, austerity and wider process of population change at local authority level. RESULTS: We estimate 231 707 total excess deaths, the majority of which occurred since 2014-15 (89%) across the majority of local authorities (91%). Austerity is positively associated with excess deaths. For working age adults, there is a clear gradient to the impact of austerity, whereas for older adults, the impact is more uniform. CONCLUSIONS: Fiscal austerity policies contributed to an excess of deaths for older people and widened social inequalities for younger populations. These results call for an end to all austerity measures and require further research into areas with the highest total excess deaths as a priority following the COVID-19 pandemic.

International and internal migration measured from the School Census in England.

The School Census is the only regularly updated dataset covering almost all of the population of a specific age, which records changes of address along with ethnicity and some family economic circumstances. It can be used to measure internal and international family migration as shown in this report. The School Census is suited to identify and quantify new local migration streams between censuses, successfully identifying the local distribution of Eastern European immigration in the decade since 2000. The measures do not provide a complete measure of migration, either internally or internationally. The exclusion of those outside the state school system means that internal migration is under-estimated, and international migration is approximately measured. The advantages of the School Census are its frequent updates, its fine geographical information, and its indicators of ethnicity and low family income, which powerfully complement other sources.

The stability of ethnic identity in England and Wales 2001-2011.

The instability of ethnicity measured in the national census is found to have doubled from the period 1991-2001 to the period 2001-2011, using the Longitudinal Study that links a sample of individuals' census records across time. From internal evidence and comparison with results from the Census Quality Survey and the Labour Force Survey, estimates are made of instability due to changing question wording, imputation of missing answers, proxy reporting, recording errors and changes in the allocation of write-in answers. Of the remaining instability, durable changes of ethnicity by individuals are thought to be considerably less common than changes due to a person's sense of identity not closely fitting the categories offered in the census question. The instability creates a net change in size of some ethnic groups that is usually small compared with the change in population between censuses from births, deaths and migration. Consequences for analysis of census aggregate and microdata are explored.

Stability and change in ethnic groups in England and Wales.

The Office for National Statistics (ONS) Longitudinal Study (LS) is an exceptional resource for exploring dynamic processes in individuals' lives for a representative sample of the population of England and Wales and across a thirty year period, including how those processes vary by ethnic group. However, analyses tend to assume a certain stability in the meaning of the ethnic group being studied: the insights into ethnic group differentiation are premised on the fact that the group has the same meaning over time. Here we show how the LS allows us to challenge such notions of group stability. This has practical implications for the ways we measure and conceive of Britain's minority ethnic groups. We illustrate this point with two examples: one exploring the change in ethnic group identification by the same individuals between 1991 and 2001, and the second exploring how loss to follow up is differentially experienced according to ethnic group. We provide some suggestions on the implications of this ethnic group instability for other research.