Dramatic rise in drug-related deaths fuels worsening UK health compared to other nations

A new Health Foundation report reveals troubling trends in death rates in the UK when compared with 21 other high-income countries, as well as finding deep inequalities in health between different parts of the UK.

Drawing on new research commissioned from the London School of Hygiene & Tropical Medicine, the data suggest improvements in UK death rates slowed down significantly in the 2010s, more so than in most of the 21 other high-income countries studied. By 2023, female mortality rates in the UK were 14% higher than the median of peer countries, with male mortality rates 9% higher.

The research reveals significant inequalities across the UK. Scotland, Wales and Northern Ireland all have higher mortality rates than England, with Scotland performing particularly poorly. In 2021, only the US had a worse mortality rate than Scotland among the countries studied, while mortality rates were 20% higher in the North East and North West of England than in the South West.

The relative worsening of death rates among the working age population is particularly stark. In 2023, female mortality rates for people aged 25–49 years were 46% higher than the median of the other countries studied, and male rates were 31% higher. Only Canada and the US experienced a similar worsening of death rates among this age group during the 2010s. Poorer working age health in the UK is leading to lower labour force participation and acting as a drag on growth.

Among the top three causes of death for people aged 25–49 years, death rates for cancers and circulatory diseases improved between 2001 and 2019. In contrast, death rates from external causes (deaths due to injuries, poisonings and violence) worsened, accounting for between 70–80% of the difference in UK death rates at this age compared to the median of the countries studied over this period.

The research found that this is being fuelled by a shocking rise in drug-related deaths, with the rate of drug-related deaths in the UK more than 3 times higher in 2019 than the average of peer countries. It also found stark geographic inequalities in drug-related deaths.

In 2019, the drug-related mortality rate among 25–49-year-olds in Scotland was around 4 times higher than in England. Within England, the drug-related mortality rate in the North East was 3.5 times higher for males and almost 4 times higher for females than in London.

With the UK's health comparing increasingly poorly with other high-income countries, the Health Foundation is calling for a new strategy to tackle health inequalities, alongside long-term action to rebuild the nation's health and promote economic recovery in areas of long run industrial decline.

Dame Jennifer Dixon, Chief Executive of the Health Foundation, said:

'The findings of this research are a wake-up call. The UK's health is fraying and falling further behind other high-income nations, particularly for working age people, and with damaging consequences for the economy.

'Improvements are both possible and are urgently needed. Action is needed to boost prevention, tackle drugs seriously, invest in public health services and address risk factors such as smoking, alcohol, and poor diet.

'Stronger measures to boost left behind areas and combat drug-related deaths are also essential to stem the shocking rise in drug-related deaths in Scotland and the North East in particular.

'The government's health mission promised such an approach, but progress has been slow. It is possible to reverse the UK's increasingly poor health, but only with bold and concerted action over the long term, and it needs to start now.'

Professor David Leon, who led the research at the London School of Hygiene & Tropical Medicine (LSHTM), said:

'Our analysis highlights that mortality rates in almost all parts of the UK (with the exception of London) have increasingly lagged behind the progress made by nearly all other high-income countries. While there are particularly worrying trends in Scotland and the North East of England, this deterioration in the UK’s position is truly a national problem – requiring action from central as well as devolved governments.

'What is particularly disturbing about our findings is that the risk of dying among adults in the prime of life – those who have not yet got to age 50 – has been increasing in the UK for over a decade while in most other peer countries it has declined. This is shocking as most mortality between the ages of 25–49 years is in principle avoidable. More attention must be paid to providing better services to deal with substance abuse and mental health, as well as taking steps to deal with the causes of these multiple forms of self-harm.'

Media contact 
Jessica Clinkett 
jessica.clinkett@health.org.uk 
020 7664 464