Learning From Lives and Deaths; Key Messages from the 2023 LeDeR Report.
Authors: Michael Yu and Lili Bokor
Continuing the Conversation
Part of the Estia Centre's Learning Together 2026 blog series, featuring articles from conference speakers and contributors.
Report
The Learning from Lives and Deaths (LeDeR) programme plays a vital role in improving our understanding of the health inequalities experienced by adults with a learning disability and autistic adults in England. By reviewing deaths and identifying recurring themes, LeDeR helps health and social care services learn from what has happened and identify opportunities to improve care and reduce avoidable deaths.
The 2023 LeDeR report highlights both progress and continuing inequalities in health outcomes for people with a learning disability and autistic people.
Continuing Inequalities in Life Expectancy
In 2023, LeDeR was notified of 3,556 deaths of adults with a learning disability. The median age at death was 62.5 years, almost 20 years younger than the median age at death in the general population (81.9 years).
Nearly 60% of adults with a learning disability died before the age of 65, compared with fewer than 15% of adults in the general population. These figures demonstrate the significant and persistent inequalities experienced by people with a learning disability and underline the need for continued action to improve health outcomes.
Avoidable Deaths Remain Too High
In 2023, 40.2% of reviewed deaths of adults with a learning disability were classified as avoidable. Although lower than in recent years, this remains substantially higher than in the general population.
Treatable deaths accounted for a greater proportion of avoidable deaths than preventable deaths, highlighting the importance of improving access to timely diagnosis, treatment and ongoing healthcare support. While progress is encouraging, avoidable mortality remains a major area of concern.
Leading Causes of Death
Diseases of the circulatory system were the most common grouped cause of death in 2023, followed by respiratory diseases and cancers. Among avoidable deaths, influenza and pneumonia remained the most common causes, while cardiovascular conditions such as ischaemic heart disease and cerebrovascular disease also featured prominently.
These findings reinforce the importance of regular health checks, proactive management of long-term conditions and equitable access to healthcare services.
Ethnicity and Health Inequalities
The report found that adults with a learning disability from several ethnic minority groups experienced higher levels of avoidable mortality than those from “White” ethnic groups.
Significant differences were also seen in age at death. Adults from ethnic minority groups had a median age at death of 47.7 years, compared with 63 years for adults from “White” ethnic groups. These findings highlight the need for culturally responsive services and a better understanding of how ethnicity, disability and wider social determinants of health influence outcomes.
Adults with a Severe or Profound Learning Disability
The report includes a dedicated analysis of adults with a severe or profound learning disability, a group whose experiences are often underrepresented in research. Mortality patterns differed from those seen in adults with a mild or moderate learning disabilit y , reflecting distinct health needs, communication requirements and support arrangements.
The findings emphasise the importance of personalised care and ensuring that services are equipped to meet the needs of people with more complex disabilities.
Autistic Adults
The report also examined deaths of autistic adults without a learning disability. The most common causes of death were diseases of the circulatory system, cancers, and mental, behavioural and neurodevelopmental conditions.
These findings highlight the importance of recognising the specific health needs of autistic people and ensuring that services are accessible, responsive and person-centred.
Looking Forward
The 2023 LeDeR report shows that important progress has been made, but substantial inequalities remain. Adults with a learning disability continue to die much younger than the general population and experience disproportionately high levels of avoidable mortality.
The findings reinforce the need to reduce health inequalities, improve access to healthcare, make reasonable adjustments routine, and ensure that people with a learning disability and autistic people receive high-quality, person-centred care. Every LeDeR review provides an opportunity to learn, and by acting on these lessons we can work towards better health outcomes and longer, healthier lives for all.
About the authors
Michael Kwan Leung Yu is a Postdoctoral Research Fellow, and Lili Bokor is a Research Assistant at the Institute of Psychiatry, Psychology & Neuroscience at King's College London. They both work on the Learning from Lives and Deaths ( LeDeR ) programme, which aims to reduce health inequalities and prevent avoidable early deaths among people with a learning disability and autistic people through the analysis of population-based, real-world data.