A necessary end

Changes in causes of death

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The 20th century saw significant reforms aimed at improving living conditions for society in general and the poor in particular.

There were also considerable improvements in living standards and significant advances in medicine and our understanding of public health and diseases. These factors led to large increases in life expectancy and are also linked to changes in the most common causes of death.

In the 1900s classifications of death were poorly organised, resulting in over half of all deaths being assigned to ‘other causes’. However, for certain conditions recording practices are sufficiently similar to make valid comparisons, and these are shown in the chart.

In the century leading up to 1908, public health had been transformed. Smallpox and cholera were on the wane thanks to vaccination and better sanitation, and the 1875 Public Health Act had provided Britain with the most extensive public health system in the world. But rapid urbanisation meant sanitary conditions in inner cities often remained dire; most vaccines had not yet been developed; and penicillin, the first antibiotic, would not become widely available until after WWII.

As a result, the majority of deaths occurring in 1908 would today be characterised as preventable. In particular, infectious and parasitic diseases accounted for nearly a fifth of all deaths. With no acquired immunity, the young were particularly vulnerable to these, and a third of all deaths occurred in the under-fives; today, that figure is less than 1%. Measles killed 50,000 children that year, tuberculosis and whooping cough 40,000 each, and diphtheria 17,000. Diarrhoea and dysentery claimed the lives of a further 100,000 children. Today, it is unusual for these to kill anyone except those with serious underlying conditions.

Cancers were responsible for just 6% of deaths in 1908, and heart disease was not a significant cause of mortality at all. Although poor categorisation of such deaths may have affected these numbers, with life expectancy under 50, and fewer than one in ten living to 75, many simply did not live to an age where they became vulnerable to these conditions. By 1948 heart disease and cancer had become the main causes of death in England and Wales, and they remain so today, together accounting for 55% of all deaths in 2010.

Going, going... living longer changes the leading causes of death
The chart shows the most common causes of death as a % of all deaths in England and Wales.


The chart shows the most common causes of death as a % of all deaths in England and Wales

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