Deaths from heart failure, COVID-19 and suicide by Welsh county

FOI Ref: FOI/2022/3512

You asked

1) Please provide deaths from heart failure/disease in certain counties in Wales from 1 March 2020 to 1 January 2022. I am only interested in the figure of people who died from heart failure/disease which is listed on their cause of death on their death certificate.

2) Please provide the actual number of deaths due to COVID alone from 1 March 2020 to 1 January 2022. The figure I am after is 'people who have died from COVID and who have had COVID written as the cause of death on their death certificate'. I would like to know the figure from each county as a separate value.

3) Please provide the number of people who have died by suicide in certain counties in Wales from 1 March 2020 to 1 January 2022. I am only interested in the figure of people of which suicide is the cause of death on their death certificate

The counties I am interested in are listed below, same counties for each of my three requests:-

•       Anglesey/Sir Fon
•       Blaenau Gwent
•       Bridgend
•       Caerphilly
•       Cardiff
•       Carmarthenshire
•       Ceredigion
•       Conwy
•       Denbighshire
•       Flintshire
•       Glanmorgan
•       Gwynedd
•       Merythr Tydyffl
•       Monmouthshire
•       Neath Portalburt
•       Newport
•       Newport City
•       Pembrokeshire
•       Powys
•       Rhondda Cynon Taff
•       Swansea
•       Torfaen
•       Wrexham

We said

Thank you for your request.

Our mortality data comes from the information collected at death registration.

All the conditions mentioned on the death certificate are coded using the International Classification of Diseases, Tenth Revision (ICD-10).

From all of these causes an underlying cause of death is selected using ICD-10 coding rules.

The underlying cause of death is defined by WHO as:

a) the disease or injury that initiated the train of events directly leading to death, or

b) the circumstances of the accident or violence that produced the fatal injury

Deaths from heart failure/disease:

There are numerous ICD-10 codes related to heart disease and heart failure such as:

• I20 - I25 - ischaemic heart disease

• I26 - I28 - Pulmonary Heart disease and diseases of pulmonary circulation

• I30 - I52 - Other forms of heart disease (including I30 - Acute Pericarditis, I33 Acute and subacute endocarditis, I40 Acute myocarditis, I42 Cardiomyopathy and I50 Heart failure).

Alternative, you could elect to use Leading cause groupings such as:

• LC08 - Cardiac Arrest
• LC09 - Cardiac Arrhythmias
• LC10 - Cardiomyopathy
• LC15 - Chronic rheumatic heart diseases
• LC24 - Heart failure and complications and ill-defined heart disease.
• LC30 - Ischaemic Heart diseases
• LC37 - Pulmonary heart disease and diseases of the pulmonary circulation

The list is not exhaustive, and a full breakdown is available using the ICD-10 manual.

Annual data for 2020 is available in our explorable dataset available on our NOMIS webservice. Please see the following instructions for using this service:

• Select the geography (England and Wales, regional or by local authority).  
• Select Age - All ages or 5-year age bands.  
• Select Gender - Total or Male/Female  
• Select rates - All deaths, rates or percentage of population for example.  
• Select cause of death (ICD10 code search is available or select by Leading cause group).  
• Select format (Excel or CSV for example)

Our NOMIS webservice will be updated with 2021 data following the finalisation of the data, which will be done when our Deaths Registered series is published in July 2022. Currently, we do publish leading causes of death provisional data for Wales as part of our monthly mortality analysis which does include heart disease. This is accessible via the following link: Monthly Mortality Analysis Dataset.

If this does not meet your needs, we can create a custom output. Please note, 2021 data will be provisional and subject to change. This is to allow the inclusion of deaths referred for Coroner investigation, which typically have a registration delay. Further information on late registrations is available in our Impact of registration delays on mortality statistics in England and Wales bulletin. Special extracts and tabulations of mortality data for England and Wales are available to order, subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate. Such enquiries would fall outside of the Freedom of Information regime and can be made to: Health.Data@ons.gov.uk.

The medical certificate of cause of death has two parts, Part 1 contains the sequence of health conditions or events leading directly to death, while Part 2 can contain other health conditions that contributed to the death but were not part of the direct sequence. Deaths due to COVID-19 usually have COVID-19 mentioned in Part 1 and may have consequences of COVID-19, such as pneumonia, mentioned in lines above. The presence of conditions listed as consequences of COVID-19 are not underlying conditions and are not counted in our method to describe pre-existing conditions mentioned in deaths due to COVID-19.

We define pre-existing conditions as those mentioned in Part 2 of the medical certificate of cause of death. If COVID-19 is mentioned in Part 1 on lines above other conditions also mentioned in Part 1, the last condition mentioned in Part 1 is also considered a pre-existing condition. We don't know exactly how many people who died from COVID-19 had no pre-existing health conditions, only how many did not have a pre-existing condition mentioned on the death certificate. A contributor to the cause of death is expected to have increased the likelihood of death, but this does not mean that the death would have been avoided in its absence.

We would also recommend reading our recent blog on this subject, accessible via the following link: To say only 17,000 people have died from COVID-19 is highly misleading | National Statistical (ons.gov.uk)

We hold the following analysis, which provides data showing deaths from COVID-19 with no pre-existing conditions. Data is available from March 2020 to December 2021: Pre-existing conditions of people who died due to COVID-19, England and Wales.

January data will be published as part of Quarter 1 2022 release in April 2022.

Suicide data:

Our statistics are based on the date of registration, therefore our latest annual Suicides in England and Wales release is based on 2020 death registrations.

Using the Customise my Data Service, we have produced the following table, which shows suicides registered from January 2020 to December 2020 by local authority in England and Wales.

If this does not meet your needs, we can create a custom output for suicide registrations in England and Wales using your specific date range. Special extracts and tabulations of mortality data for England and Wales are available to order (subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate).

Such enquiries would fall outside of the Freedom of Information regime and should be made to: Health.Data@ons.gov.uk.

Suicide data for 2021 and 2022:

Most suicides require an inquest, where a coroner investigates the death. The amount of time it takes to hold an inquest causes a lag between the date of death and the date of death registration, referred to as a registration delay. Registration delays for deaths caused by suicide tend to be 5 to 6 months on average.

We do produce provisional suicide data for England on a quarterly basis, with the latest update including deaths that have been registered from July to September of 2021. This is for deaths registered in 2021, and due to the registration delay described above, most of these deaths would have occurred in 2020.

Provisional November and December 2021 data will be published in April 2022. As such, this information is considered exempt under Section 22(1) of the Freedom of Information Act 2000, whereby information is exempt from release if there is a view to publish the information in the future. Furthermore, as a central government department and producer of official statistics, we need to have the freedom to be able to determine our own publication timetables. This is to allow us to deal with the necessary preparation, administration, and context of publications. It would be unreasonable to consider disclosure when to do so would undermine our functions.

This exemption is subject to a public interest test.

We recognise the desirability of information being freely available and this is considered by ONS when publication schedules are set in accordance with the Code of Practice for Statistics. The need for timely data must be balanced against the practicalities of applying statistical skill and judgement to produce the high quality, assured data needed to inform decision-making. If this balance is incorrectly applied, then we run the risk of decisions being based on inaccurate data which is arguably not in the public interest.  This will have an impact on public trust in official statistics in a time when accuracy of official statistics is more important to the public than ever before.

If you would like to discuss your request further, please contact Health.Data@ons.gov.uk.