Dead and undiscovered: the rise of bodies isolated and decomposing in England and Wales raises concerns

A study has raised concerns about the increasing number of people in England and Wales who have died but are discovered so late their bodies have already decomposed.

Published in the Journal of the Royal Society of Medicine, the study highlighted potential links between growing isolation and these types of deaths - even before the Covid pandemic. It was conducted by a team led by Dr Lucinda Hiam of the University of Oxford and including histopathology registrar Dr Theodore Estrin-Serlui of Imperial College NHS Healthcare Trust who analysed data from the Office for National Statistics (ONS), identifying deaths where bodies were found in a state of decomposition.

They used a new proxy: deaths coded as R98 ("unattended death") and R99 ("other ill-defined and unknown causes of mortality") according to the International Classification of Diseases (ICD-10) and previous versions, referred to as “undefined deaths”.

The study revealed a steady increase in “undefined deaths” - deaths of people found decomposed - between 1979 and 2020 for both sexes. However, the proportion of total male deaths exceeded female deaths, with the deaths increasing significantly among men during the 1990s and 2000s, when overall mortality was rapidly improving.

The research team described the acceleration in deaths where people are found decomposed, particularly for men, as a "concerning" trend. Dr Estrin-Serlui said: “Many people would be shocked that someone can lie dead at home for days, weeks or even longer, without anyone raising an alarm among the community they live in.

“The increase in people found dead and decomposed suggests wider societal breakdowns of both formal and informal social support networks even before the pandemic. They are concerning and warrant urgent further investigation.”

The research team are calling on national and international authorities to consider measures that would make it possible to identify deaths where people are found decomposed more easily in routine data.