The Bishop of St Albans received the following written answers on 4th September 2023:
The Lord Bishop of St Albans asked His Majesty’s Government 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.
Baroness Neville-Rolfe (Con, Cabinet Office): 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).
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] .
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].
| Year | Due to malnutrition | Involving malnutrition |
| 2019 | 76 | 390 |
| 2020 | 78 | 383 |
| 2021 | 85 | 398 |
| 2022 | 67 | 386 |
Source: Office for National Statistics
The Lord Bishop of St Albans asked His Majesty’s Government how many recorded diagnoses of malnutrition occurred among children in England in (1) 2019, (2) 2020, (3) 2021, and (4) 2022.
Lord Markham (Con, Department of Health and Social Care): NHS England has provided a count of Finished Admission Episodes, for patients aged 0-17, by year of admission, with a “primary” or “primary or secondary” diagnosis of malnutrition for the years 2019 to 2022. The following table shows activity in English National Health Service Hospitals and English NHS-commissioned activity in the independent sector:
| Year | Primary Diagnosis | Primary or Secondary Diagnosis |
| 2019 | 38 | 406 |
| 2020 | 47 | 332 |
| 2021 | 39 | 320 |
| 2022 (provisional) | 52 | 303 |
Source: Hospital Episode Statistics (HES), NHS England
The Lord Bishop of St Albans asked His Majesty’s Government how many recorded diagnoses of malnutrition have occurred among child asylum seekers.
Lord Murray of Blidworth (Con, Home Office): The Home Office does not hold data on diagnoses of malnutrition in the asylum seeking population.
Asylum seekers in contingency accommodation are provided with breakfast, lunch, and evening meals, with a choice of at least one hot and one cold selection, at least one vegetarian option with each main meal and a food service for babies and small children with the appropriate foodstuffs. Food is provided in a location easily accessible to all.
Portion sizes will be in line with the NHS 5-a-day guidelines, available at: 5 A Day portion sizes – NHS (www.nhs.uk). If an asylum seeker would like to discuss their dietary requirements, they are advised and supported to contact Migrant Help.
We continuously look at ways to improve our procedures to ensure we address concerns quickly and effectively; one of the tools we use to achieve this is through our targeted surveys. These are 100% anonymous and available 24/7 in a variety of languages. The Initial Accommodation (IA) survey is aimed at all those who reside in all forms of contingency accommodation and seeks insight on the fundamental aspects of the provision. This includes questions on the accommodation standards and suitability, food offering, information provided.
The Home Office monitors our service providers closely to ensure the requirements we set out in our contracts are being delivered. This includes physically inspecting contingency sites and food provision. The food service at hotels meets appropriate nutritional standards for each menu and satisfies cultural, religious, health or other specific requirements.
The Lord Bishop of St Albans asked His Majesty’s Government how many recorded cases of rickets occurred in each of the past four years; and what evidence they have regarding what is causing the increase in cases.
Lord Markham: NHS England publishes data on hospital admissions in England for rickets. A count of finished admission episodes with a “primary” diagnosis and a “primary or secondary” diagnosis of rickets for the years 2018-19 to 2021-22 is shown in the table below:
| Financial year | Primary diagnosis | Primary or secondary diagnosis |
| 2018-19 | 68 | 477 |
| 2019-20 | 43 | 504 |
| 2020-21 | 50 | 391 |
| 2021-22 | 53 | 439 |
Rickets is a condition which mostly affects children and is usually caused by prolonged vitamin D or calcium deficiency. Evidence on the relationship between vitamin D status or vitamin D supplementation and risk of nutritional rickets in children was assessed by the government’s Scientific Advisory Committee on Nutrition in its report ‘Vitamin D and Health’ (2016).
The National Diet and Nutrition Survey reported evidence of low vitamin D status, as indicated by low plasma 25-hydroxy vitamin D concentrations in blood, in all age groups surveyed between 2016 and 2019. 16% of adults aged 19 to 64 years, 13% of adults aged 65 years and over, 19% of children aged 11 to 18 years and 2% of children 4 to 10 years had low vitamin D status (taking account of seasonal variation). A low vitamin D status does not necessarily indicate clinical deficiency.
Copies of these reports has previously been placed in the Library but are also attached here [on Hansard].
The Church of England in Parliament 
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