{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:57:22Z","timestamp":1787169442452,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The number of deaths occurring in private homes in England and Wales had been rising for years, increasingly rapidly from 2020. Media stories and research linked decomposing bodies found in private homes with pandemic-related social isolation. We aim to explore whether these incidents are one-offs or part of a wider trend.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Descriptive analysis of publicly available Office for National Statistics (ONS) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>England and Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All residents of England and Wales, 1979 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Using data from the Office for National Statistics, we calculate European Age Standardised Rates for deaths coded as R98 (\u2018unattended death\u2019) and R99 (\u2018other ill-defined and unknown causes of mortality\u2019) in the 10th version of the International Classification of Diseases (ICD-10), and the corresponding codes in ICD-9, by sex and age group from 1979 (when ICD-9 began) to 2020. These are proxy markers for deaths where decomposition precludes attribution of a specific cause at postmortem.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>While mortality from all other causes decreased from 1979 to 2020, the opposite was seen for deaths from R98 and R99 (or \u2018undefined deaths\u2019), with men more affected than women. There was a sharp rise in these deaths in both sexes but in men particularly in the 1990s and 2000s, coinciding with a time when overall mortality was rapidly improving.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increase in people found dead from unknown causes suggests wider societal breakdowns of both formal and informal social support networks. They are concerning and warrant urgent further investigation. We call on national and international authorities to consider measures that would make it possible to identify these deaths more easily in routine data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01410768231209001","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T19:10:10Z","timestamp":1700593810000},"page":"172-181","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["A deathly silence: why has the number of people found decomposed in England and Wales been rising?"],"prefix":"10.1177","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-0978","authenticated-orcid":false,"given":"Lucinda","family":"Hiam","sequence":"first","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Estrin-Serlui","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Dorling","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-9683","authenticated-orcid":false,"given":"Martin","family":"McKee","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Minton","sequence":"additional","affiliation":[{"name":"Public Health Scotland, Gyle Square, 1 S Gyle Cres, Edinburgh EH12 9EB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Simmons M. The mystery of Britain\u2019s surging at-home deaths. The Spectator. See www.spectator.co.uk\/article\/why-are-thousands-of-people-dying-at-home\/ (last checked 30 October 2023)."},{"key":"e_1_3_4_3_2","unstructured":"Office for National Statistics. Deaths registered in private homes England and Wales \u2013 Office for National Statistics. See https:\/\/cy.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/articles\/deathsinprivatehomesenglandandwales\/latest#deaths-in-private-homes-2001-to-2021 (last checked 30 October 2023)."},{"key":"e_1_3_4_4_2","unstructured":"Office for National Statistics. Excess deaths in England and Wales \u2013 Office for National Statistics. See www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/articles\/excessdeathsinenglandandwalesmarch2020todecember2022\/2023-03-09#excess-deaths-by-place-of-occurrence (last checked 30 October 2023)."},{"key":"e_1_3_4_5_2","unstructured":"Peabody Trust. The Sheila Seleoane Report \u2013 Lessons Learned. See: www.peabody.org.uk\/media\/16102\/altair-the-sheila-seleoane-report-lessons-learned-2022.pdf (last checked 30 October 2023)."},{"key":"e_1_3_4_6_2","article-title":"What we can learn from a lonely death in social housing","author":"Farley H.","unstructured":"Farley H. What we can learn from a lonely death in social housing. BBC News. See www.bbc.com\/news\/uk-65187603 (last checked 30 October 2023).","journal-title":"BBC News"},{"key":"e_1_3_4_7_2","article-title":"Vulnerable woman lay dead in Surrey flat for more than three years","author":"Butler P.","year":"2023","unstructured":"Butler P. Vulnerable woman lay dead in Surrey flat for more than three years. The Guardian, 27 January 2023 2023.","journal-title":"The Guardian"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2021-207675"},{"key":"e_1_3_4_9_2","first-page":"3","article-title":"Characteristics of coronial autopsy cases in the London area of the United Kingdom, pre and post COVID-19 lockdown","author":"Bates AWH.","unstructured":"Bates AWH. Characteristics of coronial autopsy cases in the London area of the United Kingdom, pre and post COVID-19 lockdown. Acad Forensic Pathol 2023; 13: 3\u20138.","journal-title":"Acad Forensic Pathol"},{"key":"e_1_3_4_10_2","unstructured":"Office for National Statistics. Deaths registered in England and Wales \u2013 Office for National Statistics. 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Glasgow; Glasgow Centre for Population Health\/University of Glasgow: 2022."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115397"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00205-X"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00110-9"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2020-216220"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-022-02251-9"},{"key":"e_1_3_4_29_2","first-page":"1","article-title":"A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality","author":"Wang F","year":"2023","unstructured":"Wang F, Gao Y, Han Z, Yu Y, Long Z, Jiang X, et\u00a0al. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. 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