In this blog, Stuart McDonald provides insights into the causes of excess deaths that occurred after the pandemic and how this impacts DB pension schemes.

Last year, I wrote about the UK’s summer of excess deaths. I showed that only a minority of the excess deaths last summer were caused directly by Covid-19 and that deaths from cardiovascular causes were especially elevated, while other significant causes of death, including cancer and dementia, were at or below normal levels. I called for more granular data to be made available so as to better understand the profile of the excess deaths not directly caused by Covid-19.

So, I was delighted to have the opportunity this year to work with my LCP colleague Jonathan Pearson-Stuttard and co-authors from the Office for National Statistics and the Department of Health and Social Care on a more granular analysis of recent excess mortality in England than was previously possible. Our analysis draws on newly published data from the Office for Health Improvement and Disparities and has now been published in The Lancet Regional Heath.

Key findings of our analysis that are relevant to trustees and sponsors of defined benefit (DB) pension schemes are:

• Excess mortality has persisted into 2023, with age-standardised analysis from the Continuous Mortality Investigation showing 28,500 excess death registrations in the UK during the first six months of 2023. That is nearly 9% higher than expected.
• Middle-aged adults (50-64) are experiencing the highest excess mortality (15% excess), primarily driven by cardiovascular causes (33% excess).  
• In contrast, there is little or no excess from some other major causes of death – for example, cancer and dementia.
• Deaths in private homes are particularly elevated, with a 22% excess, compared to a 10% excess in hospitals and no excess in care homes.

Analysis by age, place and cause points to a number of factors driving recent excess mortality, including:

• worsening pressures on NHS urgent care services
• direct effects of Covid-19, both acute illness and longer-term cardiovascular harms
• disruption to chronic disease prevention, detection and management.

At the peak of the pandemic, pensioner age groups were most severely impacted. However, more recently, the biggest relative excess is at working ages. Whether this excess mortality persists as this cohort enters retirement age is a key question for trustees and sponsors of defined benefit pension schemes.

This analysis is important at a societal level – the trends and patterns that can be observed will inform population health management initiatives.

However, it is also incredibly important when setting mortality assumptions. We can combine an analysis of the profile of scheme membership with insights into what is driving excess deaths and how long this may persist into the future. This enables us to refine assumptions to reflect the membership of your scheme. Understanding how the pandemic and ongoing health system challenges are impacting your members puts you in the best position to adopt an assumption that is right for you.

For more information on recent trends in mortality and their impact on pension schemes, see our latest longevity report or contact me directly.