Segment tool: statistical commentary, November 2025
Published 12 November 2025
Applies to England
© Crown copyright 2025
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This publication is available at https://www.gov.uk/government/statistics/segment-tool-november-2025-update/segment-tool-statistical-commentary-november-2025
Introduction
The Segment tool provides information on the causes of death and age groups that are driving inequalities in life expectancy at a local level. Targeting the causes of death and age groups which contribute most to the life expectancy gap should have the biggest impact on reducing inequalities.
New in this update
Data for 2022 to 2023 has been added. Data for 2014 to 2016 has been removed from the tool, but is still available in the ‘Segment tool: data tables, November 2025’, published alongside this commentary.
Main findings
In 2022 to 2023, provisional male life expectancy in England was 8.4 years lower in the most deprived fifth of areas compared with the least deprived fifth of areas. For female life expectancy, the gap was 6.6 years. These figures are smaller than the life expectancy gaps in 2020 to 2021 (8.8 years for the male gap and 7.1 years for the female gap).
The life expectancy gap is determined by higher mortality in deprived areas across a range of causes of death. For both sexes, higher mortality rates in the most deprived areas from cardiovascular disease (also known as circulatory disease), cancer and respiratory disease contributed almost 60% to the gap in life expectancy in 2022 to 2023 (see tables 1 and 2). Cardiovascular disease was the largest contributor: 26% (male), 22% (female).
Detailed findings
Cause of death
Besides the broad cause groups noted above, the tool also provides breakdowns for a more detailed set of causes of death. In 2022 to 2023, for both sexes, heart disease, chronic lower respiratory diseases and lung cancer were the specific causes which made the biggest contributions to the life expectancy gap.
Smoking and obesity are the main risk factors for these diseases. Although smoking prevalence has declined, people in the more deprived areas of England are still more likely to smoke than people in the least deprived areas. They are also more likely to be living with obesity.
The biggest change between data for 2022 to 2023 and the previous period of 2020 to 2021 is the size of the contribution of higher mortality in the most deprived areas from COVID-19 to the life expectancy gap. For both sexes, deaths from COVID-19 contributed 15% to the gap in 2020 to 2021 but only 3% in 2022 to 2023 (see tables 1 and 2). COVID-19 mortality made up 0.2 years of the gap for both sexes in 2022 to 2023, compared with 1.3 years of the male gap and 1.1 years of the female gap in 2020 to 2021.
As the contribution of COVID-19 to the life expectancy gap decreased in 2022 to 2023, the relative contribution of other broad causes of death consequently all increased, compared with 2020 to 2021 (see tables 1 and 2).
Table 1: breakdown of the male life expectancy gap between the most and least deprived fifth of areas in England, by cause of death, 2020 to 2021 and 2022 to 2023 (provisional data)
| Cause of death | 2020 to 2021 | 2022 to 2023 |
|---|---|---|
| COVID-19 | 14.8% | 2.6% |
| Cardiovascular | 22.9% | 25.9% |
| Cancer | 16.2% | 17.2% |
| Respiratory | 11.8% | 14.7% |
| Digestive | 8.4% | 9.2% |
| External causes | 10.1% | 11.3% |
| Mental and behavioural | 4.2% | 4.8% |
| Other | 9.9% | 11.7% |
| Deaths under 28 days | 1.6% | 2.5% |
| Gap in life expectancy (years) | 8.8 | 8.4 |
Table 2: breakdown of the female life expectancy gap between the most and least deprived fifth of areas in England, by cause of death, 2020 to 2021 and 2022 to 2023 (provisional data)
| Cause of death | 2020 to 2021 | 2022 to 2023 |
|---|---|---|
| COVID-19 | 15.0% | 3.2% |
| Cardiovascular | 19.4% | 21.5% |
| Cancer | 19.4% | 19.6% |
| Respiratory | 14.2% | 18.6% |
| Digestive | 7.7% | 8.7% |
| External causes | 5.2% | 6.0% |
| Mental and behavioural | 6.4% | 7.3% |
| Other | 11.0% | 12.4% |
| Deaths under 28 days | 1.8% | 2.8% |
| Gap in life expectancy (years) | 7.1 | 6.6 |
Age at death
Across different age groups, the breakdown of the gap shows that higher mortality rates among those aged 60 to 79 in deprived areas continued to contribute the most to inequality in life expectancy in 2022 to 2023. This accounted for 44% of the male gap and 48% of the female gap. These percentages are very similar to those for previous periods, 2017 to 2019 and 2020 to 2021.
Local areas
Data for 2022 to 2023 is also provided in the tool for regions, upper tier local authorities and integrated care boards. In many areas, higher mortality from cardiovascular disease, cancer and respiratory disease are the main contributors to the life expectancy gap. However, there are variations at local level, and some areas where other causes of death make large contributions to the gap.
For the male life expectancy gap, the cause with the largest regional variation in 2022 to 2023 was deaths from external causes. This includes deaths from injury, poisoning and suicide. These made up 17% of the life expectancy gap in the North East but only 7% in London (see table 3).
For the female life expectancy gap, deaths from cardiovascular disease had the largest regional variation. These deaths made up 27% of the life expectancy gap in London compared with 17% in the North East (see table 4).
Table 3: breakdown of the male life expectancy gap between the most and least deprived fifth of areas within each region, and within England, by cause of death, 2022 to 2023 (provisional data)
| Cause of death | England | East Midlands | East of England | London | North East | North West | South East | South West | West Midlands | Yorkshire and The Humber |
|---|---|---|---|---|---|---|---|---|---|---|
| COVID-19 | 2.6% | 3.3% | 3.2% | 3.3% | 2.6% | 2.1% | 2.2% | 2.0% | 2.6% | 2.4% |
| Cardiovascular | 25.9% | 27.5% | 24.4% | 28.2% | 20.8% | 24.5% | 24.9% | 25.6% | 27.1% | 27.1% |
| Cancer | 17.2% | 16.1% | 17.8% | 20.9% | 17.7% | 17.4% | 21.1% | 18.3% | 17.0% | 15.2% |
| Respiratory | 14.7% | 13.4% | 14.2% | 13.8% | 12.4% | 15.6% | 15.6% | 13.9% | 15.8% | 15.0% |
| Digestive | 9.2% | 10.0% | 8.4% | 6.1% | 9.7% | 10.0% | 9.9% | 9.5% | 8.9% | 8.8% |
| External causes | 11.3% | 11.5% | 10.8% | 7.1% | 16.5% | 12.8% | 10.4% | 13.0% | 8.4% | 12.0% |
| Mental and behavioural | 4.8% | 5.5% | 5.5% | 4.1% | 6.5% | 4.4% | 4.0% | 3.9% | 4.3% | 5.3% |
| Other | 11.7% | 10.3% | 13.9% | 14.2% | 11.0% | 11.0% | 10.4% | 11.2% | 13.1% | 11.7% |
| Deaths under 28 days | 2.5% | 2.5% | 1.7% | 2.3% | 2.7% | 2.2% | 1.5% | 2.6% | 2.8% | 2.5% |
| Gap in life expectancy (years) | 8.4 | 8.0 | 6.9 | 6.5 | 11.0 | 9.8 | 6.8 | 6.7 | 7.9 | 9.3 |
Table 4: breakdown of the female life expectancy gap between the most and least deprived fifth of areas within each region, and within England, by cause of death, 2022 to 2023 (provisional)
| Cause of death | England | East Midlands | East of England | London | North East | North West | South East | South West | West Midlands | Yorkshire and The Humber | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVID-19 | 3.2% | 3.7% | 3.5% | 4.0% | 2.7% | 3.0% | 2.9% | 3.3% | 3.1% | 2.9% | ||
| Cardiovascular | 21.5% | 21.1% | 22.7% | 26.7% | 17.2% | 20.4% | 22.1% | 23.0% | 22.3% | 21.4% | ||
| Cancer | 19.6% | 19.6% | 21.6% | 20.2% | 20.3% | 19.5% | 21.9% | 20.6% | 18.7% | 20.3% | ||
| Respiratory | 18.6% | 16.8% | 15.6% | 17.9% | 18.6% | 21.1% | 18.0% | 16.1% | 19.0% | 19.2% | ||
| Digestive | 8.7% | 9.8% | 8.6% | 7.2% | 9.3% | 9.6% | 8.1% | 9.5% | 7.8% | 7.8% | ||
| External causes | 6.0% | 5.6% | 5.2% | 2.3% | 7.7% | 7.6% | 7.2% | 8.4% | 4.3% | 6.0% | ||
| Mental and behavioural | 7.3% | 9.5% | 7.0% | 5.7% | 9.7% | 6.2% | 5.6% | 6.0% | 6.6% | 7.4% | ||
| Other | 12.4% | 12.8% | 13.4% | 13.8% | 13.7% | 10.3% | 11.9% | 12.4% | 13.0% | 11.7% | ||
| Deaths under 28 days | 2.8% | 1.1% | 2.4% | 2.3% | 0.9% | 2.4% | 2.3% | 0.8% | 5.2% | 3.3% | ||
| Gap in life expectancy (years) | 6.6 | 6.0 | 5.3 | 4.2 | 8.5 | 7.7 | 5.3 | 4.9 | 6.3 | 7.6 |
Definitions
Life expectancy
The estimates reported are period life expectancies. Period life expectancy is a summary measure of mortality in a population. Life expectancy at birth represents the average number of years that would be lived by babies born in a time period if they experienced the mortality rates for that time period throughout their lives.
Deprivation
Index of Multiple Deprivation (IMD) 2019 scores were used to define deprivation quintiles for the time periods 2017 to 2019, 2020 to 2021, and 2022 to 2023. IMD 2015 scores were used to define deprivation quintiles for 2014 to 2016.
IMD 2025 scores, published on 30 October 2025, have not yet been incorporated into the Segment tool. This is planned for the next update.
Revisions
Data for all periods within the tool (including data for 2014 to 2016 in the downloadable data) has been revised since the last update in 2023. All results have now been produced with populations based on the 2021 Census. Mid-year populations for lower super output areas were not available for 2023 from the Office for National Statistics (ONS) when analysis was undertaken. Provisional estimates for 2023 were therefore produced by the Office for Health Improvement and Disparities (OHID). Estimates for 2022 have also been revised by ONS since analysis was undertaken. Data for 2022 to 2023 in the tool should therefore be regarded as provisional.
Methodology
Details of the methods and data sources used are given in the guidance tab of the Segment tool.
For queries about this publication email pha-ohid@dhsc.gov.uk.