Leon · The Lancet. Public health 2019 · Comparative longitudinal vital statistics study · n=23 countries

Trends in life expectancy and age-specific mortality in England and Wales, 1970-2016, in comparison with a set of 22 high-income countries: an analysis of vital statistics data.

Cited 129 times in the scientific literature.

Level 3 - non-randomized controlled study

Longitudinal comparative demographic study using national vital statistics across 23 countries (by design analogy, not clinical CEBM).

PubMed 31677776 · doi:10.1016/S2468-2667(19)30177-X · record verified 2026-08-27

What was done

Annual mortality and life expectancy data from 1970 to 2016 from the Human Mortality Database were analyzed. Sex-specific life expectancy trends and age-specific mortality in England and Wales were compared with median values from a group of 22 high-income countries in western Europe, Australia, Canada, New Zealand, Japan, and the USA.

What was found

Male life expectancy in England and Wales tracked the median of comparator countries until 2011–2016, while female life expectancy remained below the median and was among the lowest analyzed. During 2011–2016, the rate of improvement in life expectancy slowed sharply for both sexes in England and Wales compared to more moderate slowdowns across the peer countries, widening the gap. Additionally, starting in the mid-2000s, mortality rates among adults aged 25–50 years in England and Wales became appreciably higher than in the comparator group. The abstract did not report specific numerical values.

Why it matters

This study shows that the post-2011 stalling of life expectancy improvement in England and Wales was among the worst among high-income peers and highlights an emerging excess mortality burden among young working-age adults.

Limits

The analysis relies on aggregate national-level vital statistics and cannot establish individual-level causal mechanisms. Specific cause-of-death breakdown and numerical point estimates or confidence intervals were not reported in the abstract. Attributions regarding smoking epidemic timing are ecological inferences.

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