Were there worrying levels of mortality in 2022? The consensus is there was, with different people blaming various factors for the elevated deaths – many of which are due to cardiovascular issues – since the spring, including missed treatment, the NHS crisis, Long Covid and the vaccines.
My colleague Dr. Noah Carl has been sounding a lonely note of calm, arguing in two recent posts that mortality in 2022 was not elevated once you take the ageing population into account.
He notes that “2022’s age-standardised mortality rate [ASMR] was the third lowest ever, and age-adjusted excess mortality was negative (fewer people died than normal, after taking account of ageing)”.
He allows that “the latter half of 2022 did see non-trivial excess mortality: the ASMR was about 5% higher than the five-year average”. However, he counters that “the first half of the year saw negative excess mortality: the ASMR was about 6% lower than the five-year average”. He suggest that this means “the positive excess mortality in the second half of the year could be due to ‘dry tinder’: fewer people died in the first half, so there were more at risk of dying in the second”.
The problem with Noah’s argument is that it rests entirely on the use of ASMR. ASMR is a modelled quantity that adjusts the raw data using the 2013 European Standard Population to “standardise rates“. The impact of these modelled adjustments on current excess death figures is huge. For instance, the ONS states that in 2022, the “second leading cause of excess death in 2022 was ischaemic heart diseases (2,383 excess deaths; 4.5% above average)”. However, once adjusted, the ASMR was “significantly lower than average (96.9 and 99.3 deaths per 100,000 people, respectively)”. Using the ASMR has more than wiped out a 4.5% excess in heart deaths – a concerning signal – and turned it into a below-average year where there is nothing to worry about.
The massive adjustments using the ASMR can be seen in the ONS chart of excess deaths for 2022 by month below, where the dark blue bars are the raw excess and the light blue bars are the ASMR excess.
It’s clear from this chart that, firstly, raw excess has been running high since March, and the annual figure (the bar on the far right) is only lower because of the lower excess during the winter in January and February. As was noted at the time, this was primarily a result of the mildness of Omicron and the absence of flu.
The second point is that the ASMR values are far below the raw data; the adjustments this model is making are immense, cutting excess figures to a fraction of their original value. So how confident can we be that such heavy adjustments are warranted?
It turns out, not very confident at all. The ASMR makes assumptions about how much older on average the population is getting each year and how frequently people are dying. Since the adjustments are large, this means the model assumes society is ageing very fast and this ageing is having a large impact on mortality rates that needs to be allowed for with heavy downward adjustments. So let’s check. Do crude annual mortality figures per 100,000 population show this claimed large impact of ageing?
Read More: Why 2022’s High Mortality is Real and Worrying
