Official Statistics

Public Health Outcomes Framework: commentary, November 2025

Published 4 November 2025

Applies to England

Background

The Public Health Outcomes Framework (PHOF) gives an overview of public health outcomes at national and local level, supported by a broader set of more detailed indicators. Local authorities can use the PHOF interactive web tool in Fingertips to access the data and assess progress in comparison to national averages and their peers, and develop their work plans.

New in this update

This update includes new data for 49 indicators. The commentary concentrates on mortality, early cancer diagnosis and loneliness. For a complete list of indicators that have been updated, see the PHOF indicator details table.

Summary of selected updated indicators

Trends in mortality rates by cause

A new timepoint has been added for 11 mortality indicators, providing new data for the 3-year average of 2022 to 2024. Data for 2020 to 2022 and 2021 to 2023 has also been revised in this update.

Infant mortality

This update shows that between 2021 to 2023 and 2022 to 2024 there was a small increase in the infant mortality rate which was not statistically significant. The rate in 2022 to 2024 was significantly higher than 2017 to 2019 (before the pandemic) but remains lower than 2001 to 2003 (the start of the time series).

Premature mortality (deaths under age 75)

The premature (age under 75) mortality rate from causes considered preventable fell significantly between 2021 to 2023 and 2022 to 2024. This followed an increase during the pandemic. The 2022 to 2024 rate remains significantly higher than 2017 to 2019.

Recent trends in premature mortality rates have not been consistent for leading causes of death. The premature mortality rate for cancer has been gradually declining since 2001 to 2003 (see figure 1). This has continued in recent years and the rate in 2022 to 2024 was significantly lower than the pre-pandemic rate in 2017 to 2019.

Premature mortality for cardiovascular disease and liver disease did not change significantly in 2022 to 2024, however, the rates were higher than in 2017 to 2019 (see figure 1).

Between 2001 to 2003 and 2022 to 2024, the premature mortality rate fell by 45% for cardiovascular disease, by 29% for cancer, and by 19% for respiratory disease (see figure 1). However, the premature mortality rate for liver disease increased by 31% in this period.    

Figure 1: age-standardised mortality rates for main causes of death, aged under 75, 2001 to 2003 to 2022 to 2024

Source: OHID, based on Office for National Statistics data

Communicable diseases

The mortality rate from a range of specified communicable diseases, including flu but excluding COVID-19, increased significantly between 2021 to 2023 and 2022 to 2024. This continued an upward trend since 2019 to 2021 and remains significantly higher than 2017 to 2019.

Percentage of cancers diagnosed at stages 1 and 2, C23

Monitoring the percentage of cancers diagnosed at an early stage can help assess improvements in cancer survival rates.

Specific public health interventions, such as screening programmes and information and education campaigns, aim to improve rates of early diagnosis.

In 2022, the percentage of cancers diagnosed at an early stage increased to 56.8%, compared with 54.4% in 2021. This represented the highest percentage over the previous 10 years.

Loneliness, B19

Loneliness can affect anyone, at any time, with a negative effect on community and individual wellbeing. When people feel lonely often or always, this is referred to as chronic loneliness. Chronic loneliness can have a serious effect on someone’s wellbeing and their ability to function in society.

The percentage of adults aged 16 and over in England who reported feeling lonely often or always in November 2022 to November 2024 was 7.0%.

Chronic loneliness was higher for women (7.7%) than men (6.0%), and highest in the youngest age group aged 16 to 24 years. In this group, the rate was 3 times higher at 11.6% than in people aged 65 to 74 years (3.2%) (see figure 2). However, the proportion in the 85 and over age group was relatively high at 7.4%.

Those living in the most deprived areas (12.9%) were 3 times more likely to report being lonely often or always compared to those in the least deprived areas (4.3%) (see figure 3).

Figure 2: chronic loneliness by age group, England, November 2022 to November 2024

Source: OHID, based on Adult Active Lives Survey data from Sport England

Figure 3: chronic loneliness by lower super output area (LSOA) deprivation decile

Source: OHID, based on Adult Active Lives Survey data from Sport England

Further information

The PHOF includes data for all indicators that have been updated.

The Smoking profile: November 2025 update includes a commentary with further details about the smoking prevalence indicators that have been updated in this release.

The Breastfeeding at 6 to 8 weeks after birth: April 2024 to March 2025 (annual 2024 to 2025), Child development outcomes at 2 to 2 and a half years: April 2024 to March 2025 (annual 2024 to 2025) and Health visitor service delivery metrics: April 2024 to March 2025 (annual 2024 to 2025) releases include commentaries with further details about the children’s 0 to 5 years public health indicators which have been updated in this release.

The National Child Measurement Programme 2024 to 2025 school year release includes a commentary with further details about the child obesity indicators that have been updated in this release.

For queries about this publication email pha-ohid@dhsc.gov.uk.

The next planned update is in February 2026.