Mortality and ethnicity: minorities fare better than the White Scottish majority in the Scottish Health and Ethnicity Linkage Study (SHELS)
Cezard, G., Bhopal, R., Douglas, A., Steiner, M., Buchanan, D., Katikireddi, S.V., Clark, E., Millard, A., Sheikh, A. & Gruer, L. (2017) UK Administrative Data Research Network Annual Research Conference, Royal College of Surgeons, Edinburgh, UK, 1 - 2 June 2017
Background: Ethnic minority groups are often perceived to have worse health than the majority population but some research focusing on the minority mortality advantage in the US and in Europe suggests a more complex picture.
Methods: In Scotland, the 2001 census, giving self-reported ethnicity, was linked to 12 years of deaths (2001-2013), providing a retrospective cohort of 4.62 million people. We used Poisson regression to calculate mortality rate ratios (RRs) and their 95% confidence interval (CI) for 13 ethnic groups by sex and adjusted for age, socio-economic status (SES) (area deprivation, household tenure, educational status) and country of birth (CoB). White Scottish were the reference population (RR=100). Life expectancy at birth (LE) estimates were produced from the linked Census 2001 population and 3 years of deaths from 2001 using the revised Chiang method.
Results: In men, all minority groups had lower mortality RRs apart from the Any Mixed Background group (111.3). In women, all ethnic minority groups had lower RRs than the reference. Adjusting for CoB and SES attenuated but did not remove the differences in RRs (95% CI excluded 100) e.g. Other White British (89.4), Indian (82.6), Pakistani (75.5), Chinese (59.3) in men and Other White British (91.1), White Irish (89.2), Indian (78.1), Pakistani (87.3), and Chinese (80.3) in women. LE was 74.7 years in White Scottish men similar to Mixed Background (73.0) and Irish (75.0) men but shorter than in other ethnic groups, Indian men having the longest LE (80.9). LE in White Scottish women was 79.4 years, similar to Mixed Background women (79.3) but shorter than in any other ethnic groups.
Conclusions: Even when accounting for CoB and SES, most ethnic minority groups had lower all-cause mortality than the majority White Scottish population, findings reflected by longer life expectancies compared to the majority population.
For the presentation below we draw your attention to the fact that some of the data presented are unpublished and therefore not yet peer-reviewed. Anyone who wishes to cite or re-utilise the mortality data should make a request and contact Prof. Raj Bhopal (firstname.lastname@example.org)