Scotland's death rate in March higher than five year average

Its statistics point to an ongoing surge in deaths from "other" causes - which can cover everything from suicides and falls to medical emergencies such as sepsis - for the increase. 

The NRS report for March 2023 shows that there were a total of 5,646 deaths registered in Scotland last month.

This was up from 5,105 in February but down from more than 6,700 in January. 

Heart disease and dementia were the main causes of death in Scotland in March (Image: NRS)

Compared to the five-year average, the number of deaths recorded in March showed an increase of 10 per cent - up by 526 - continuing the pattern seen during 2022. 

NRS calculates the excess death rate for 2023 against the average for the same month in 2017, 2018, 2019, 2021 and 2022. 

It excludes 2020 due to the abnormally high numbers of deaths which occurred in the early stages of the Covid pandemic. 

In March, the most common causes of death were ischaemic heart diseases (668 deaths) and dementia, including Alzheimer's disease (576 deaths).

READ MORE: Are excess death rates in Scotland really soaring? 

Covid remained among the ten most common causes of death, but was the "underlying" cause for just 217 deaths last month compared to 397 in March 2022. 

Around half of the people who died in March died in hospital, but the numbers of people dying at home remains much higher than pre-pandemic levels and was 17% higher than the five-year average in March.

People aged 80 or older accounted for 62% of the excess deaths registered in March.

Overall, there were 2,895 deaths in adults over 80 - roughly half the total for the month - but deaths in this age group were also 13% higher than the five-year average. 

Separate analysis by the NRS looks at the death rate per 100,000 people. 

This enable statisticians to tracks trends over time because it adjusts for changes in demographics which inevitably lead to an increase in the number of deaths - such as an ageing population or an increase in the population size. 

Using this analysis, the age-standardised mortality rate (ASMR) for March was 1,199 deaths per 100,000 people. 

This is 4% higher than the five-year average - meaning that there were 46 'extra' deaths per 100,000. 

Covid was the underlying cause for roughly 46 deaths per 100,000, compared to 88 per 100,000 in March 2023. 

Graphs shows Scotland's excess mortality over time, by number of deaths (light purple) and the death rate measure known as ASMR (dark purple) (Image: NRS)

The analysis shows also declines in the mortality rates from cancer, dementia, and respiratory diseases compared to the five year average. 

In the case of cancer, the mortality rate in March was 1.7% lower than the five-year average with five fewer deaths than expected per 100,000 people. It was also down by 8% compared to March 2017. 

This may partly reflect improvements in cancer treatments, particularly the growth in availability of life-extending immunotherapies on the NHS. 

READ MORE: Why are deaths from cancer in Scotland lower in 2022 than before the pandemic?

For dementia and Alzheimer's disease, the mortality rate was down by 1.8% compared to the five-year average, with the death rate from respiratory diseases down by 1.5%. 

The 4% increase in the mortality rate is mainly being driven by 'other' causes, with a smaller uptick in circulatory causes. 

According to the NRS data, the mortality rate from circulatory causes - which includes heart disease, strokes, heart attacks, blood clots and other vascular conditions - was 305.7 per 100,000 in March 2023.

That compares to a five-year average of 303.2 per 100,000 - an increase in the mortality rate of 0.8%. 

In contrast, the mortality rate from 'other' causes was up 13% on the five-year average.

There were nearly 300 'other' deaths per 100,000 people in March - 34 more than expected when compared to previous years. 

READ MORE: A&E delays and excess deaths - is this the new normal?

This miscellaneous category covers anything that is not included in the other groupings, so can be anything except cancer, Covid, circulatory or respiratory causes, or dementia deaths. 

Julie Ramsay, a vital events statistician with NRS, said: “Deaths increased to higher than average levels during March after being at relatively normal levels during February.

"Our data shows that ischaemic heart disease was found to be the most common cause of all deaths in March.

"It was also the most common cause of death for men, however for women the most common cause was Alzheimer’s Disease or other types of dementia”.