FOI ref: FOI/2022/3822
You asked
You publish datasets detailing pre-existing conditions of people who died due to covid-19 here:
Pre-existing conditions of people who died due to COVID-19, England and Wales
In the accompanying notes you define a pre-existing condition as:
"the last health condition mentioned on the first part of the death certificate (the direct sequence of events leading to death) when it is recorded on a lower line to, and therefore clearly preceding, the coronavirus (COVID-19); and all mentions in the second part, which are independent contributory factors in the death. Mentions of fatigue and 'old age' (with ICD-10 codes R53, R54) were excluded as these are generally not valid medical conditions for death certification on their own."
Could you please provide, for deaths due to covid-19 (ie covid-19 was the underlying cause of death) in England and Wales from the first recorded covid-19 death in 2020 to the end of December 2021, counts of how often each of the 20 leading pre-existing conditions appeared in:
Part I of the death certificate
Part II of the death certificate
For example, in 2020, Dementia and Alzheimer's Disease appeared 18,420 times as pre-existing condition. How many of those mentions appeared in Part I, and how many in Part II? And so one for the other 20 leading pre-existing conditions, for 2020 and 2021.
I am confident that this data should be available, because there is one dataset here
Deaths registered in private homes, England and Wales
that lists, in Sheet 9a, "Number of deaths in private homes by leading causes mentioned in part II of death certificates by sex, England and Wales" but this only covers deaths in private homes, only Part II mentions, and only covers 2020 and part of 2021 (it also says "by sex", but that breakdown does not appear to be present, and is not required).
What I am after is the counts for all deaths (wherever they occurred) due to covid-19, for 2020 and 2021.
If only "mentioned in Part II" is available, is it reasonable to assume that Part I mentions can be calculated by subtracting the Part II mentions from the total number of pre-existing conditions eg Dementia and Alzheimer's disease appeared 18,420 as a pre-existing condition in 2020, and of those (say) 9,000 were in Part II, therefore 9,420 appeared in Part I in 2020?
Please supply whatever data you have in a xls/xlsx spreadsheet.
We said
Thank you for your request.
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.
Please see our Pre-existing conditions of people who died due to COVID-19 dataset, which may help answer part of your request. In reference to this dataset, COVID-19 would always appear in Part 1 of the death certificate and the leading pre-existing conditions published are based on what was recorded in Part 2.
The Deaths registered in private homes dataset is based on all causes of death (no specific cause of Part 1), but provides details of the leading conditions that contributed to the death in Part 2.
Should you wish to request any further analysis outside of the information available above, this would need to be created as bespoke analysis. Therefore, we would advise consulting with the Health Data customer service desk, who will be able to discuss your request further. Such services would be subject to legal frameworks, disclosure controls, resources and agreement of costs. If you would like to request this bespoke dataset, please contact health.data@ons.gov.uk to discuss your enquiry further. Please note, there may be a charge for this work which would be subject to our charging policy.