Question to the Cabinet Office:

To ask His Majesty's Government how many deaths that occurred in England and Wales in the past four years mentioned gambling anywhere on the death certificate.

The information requested falls under the remit of the UK Statistics Authority.

Please see the response attached from the National Statistician and Chief Executive of the UK Statistics Authority.

The Rt Rev. the Lord Bishop of St Albans

House of Lords

London

SW1A 0PW

25 July 2023

Dear Lord Bishop,

As National Statistician and Chief Executive of the UK Statistics Authority, I am responding to your Parliamentary Questions asking how many deaths occurred in England and Wales in (1) 2019, (2) 2020, (3) 2021 and (4) 2022 where malnutrition was either the cause of death or was mentioned anywhere on the death certificate (HL9519); and how many deaths that occurred in England and Wales in the past four years mentioned gambling anywhere on the death certificate (HL9520).

The Office for National Statistics (ONS) publishes statistics on deaths registered in England and Wales. Mortality statistics are compiled from information supplied when deaths are certified and registered as part of civil registration. Causes mentioned on the death certificate are converted to International Classification of Diseases (ICD) codes, with the underlying cause of death defined as the disease or injury that initiated the events that directly lead to the death. At the ONS, we use the term “due to” to refer to the underlying cause of a death and the term “involving” where a cause is mentioned anywhere on the death certificate.

The ICD codes for malnutrition are E40 to E46, which come under the endocrine, nutritional, and metabolic diseases sub-chapter. This consists of:

• E40- Kwashiorkor

• E41- Nutritional Marasmus

• E42- Marasmic kwashiorkor

• E43- Unspecified severe protein-energy malnutrition

• E44- Protein-energy malnutrition of moderate and mild degree

• E45- Retarded development following protein-energy malnutrition

• E46- Unspecified protein-energy malnutrition

Table 1 shows the number of deaths due to and involving malnutrition ICD-10 codes, that occurred from 2019 to 2022, and were registered by 7 July 2023, in England and Wales. Deaths due to malnutrition are very uncommon; mortality data and hospital admissions both show that malnutrition is usually accompanied with several other diagnoses. Further information on the nature of malnutrition as a cause of death can be found on our blog [1] .

The ICD codes for gambling consist of:

• Z72.6- Gambling and betting

• F63.0- Pathological gambling

There were no deaths in the past four years involving gambling ICD-10 codes registered in England and Wales. While these codes exist, they are likely to be used only in the case of medically diagnosed gambling addiction. To identify some deaths involving gambling, we can also use the coroner’s text report from deaths registered involving suicide (ICD codes X60 to X84, Y10 to Y34). It is possible that more suicides were related to gambling, but this cannot be definitively stated, as not all the circumstances are necessarily known or reported in the death registration by the coroner. Table 2 shows the number of deaths where gambling was mentioned in the coroner’s text, that occurred from 2019 to 2022, and were registered by 31 December 2022 [2] , registered in England and Wales.

Yours sincerely,

Professor Sir Ian Diamond

Table 1: Numbers of deaths due to and involving malnutrition, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [3,4,5,6].

Source: Office for National Statistics

Table 2: Numbers of deaths involving intentional self-harm and events of undetermined intent where gambling was mentioned in the coroner’s text, deaths occurring from 1 January 2019 to 31 December 2022, England and Wales [4,7,8].

Source: Office for National Statistics

[1] https://blog.ons.gov.uk/2018/02/14/deaths-involving-malnutrition-have-been-on-the-rise-but-nhs-neglect-is-not-to-blame/

[2] For information on the impact of registration delays please see: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/impactofregistrationdelaysonmortalitystatisticsinenglandandwales/latest

[3] Figures are for deaths occurring in each period and registered by 7 July 2023.

[4] Figures include deaths of non-residents.

[5] International Classification of Diseases 10th edition (ICD-10) codes are as follows; E40, Kwashiorkor; E41, Nutritional marasmus; E42, Marasmic kwashiorkor; E43, Unspecified severe protein-energy malnutrition; E44, Protein-energy malnutrition of moderate and mild degree; E45, Retarded development following protein-energy malnutrition; E46, Unspecified protein-energy malnutrition.

[6] Number of deaths by ICD-10 code are available through our explorable dataset NOMIS from 2013 onwards, this can be accessed here: Nomis - Official Census and Labour Market Statistics - Nomis - Official Census and Labour Market Statistics (nomisweb.co.uk)

[7] Figures are for deaths occurring in each period, and registered by 31 December 2022; death registration data for 2023 are provisional and do not yet provide coroner’s text information.

[8] International Classification of Diseases 10th edition (ICD-10) codes are as follows; X60 to X84 and Y10 to Y34.