Mortality by country of birth in England
and Wales, 2001-2003
Clare Griffiths & Anita Brock: Office for National Statistics
Sarah Wild & Colin Fischbacher: University of Edinburgh
Introduction
• Previous analysis based on data from 1971, 1981,
1991 Censuses found mortality in England and
Wales varied by country of birth.
• Our analysis looked at patterns around the 2001
Census.
– Additional countries.
– Additional causes of death.
– Age-specific rates as well as overall rate.
Methods
• Death registrations from 2001 to 2003 in England &
Wales by cause (ICD-10)
–
–
–
–
–
All causes
Ischaemic heart disease (IHD)
Cerebrovascular disease (CVD)
All cancer
Injury & poisoning
• 2001 Census population data for England & Wales
by country of birth
• Directly age-standardised rates per 100,000
(European standard population), people aged 20
and over (with 95% confidence intervals)
Country groupings
• Countries analysed using 2001 Census data
– England & Wales (90.6%)
– Scotland (2.0%)
– Ireland (N Ireland and the Republic of Ireland) (1.8%)
– Eastern Europe (0.5%)
– Africa (East (0.6%), North (0.2%) and West (0.5%))
– Middle East (0.5%)
– South Asia (Bangladesh (0.3%), India (1.1%) and
Pakistan (0.7%))
– West Indies (0.6%)
– China & Hong Kong (0.3%)
– All residents of Scotland and Ireland
Country of birth by ethnicity, England &
Wales, 2001 Census
ALL PEOPLE
England & Wales
Scotland
Ireland
Eastern Europe
South and Eastern Africa
(x S Africa)
North Africa
Central and Western
Africa
Middle East
Bangladesh
India
Pakistan
China
Caribbean & West Indies
White
Black
Asian
Mixed
91.3
95.2
98.6
99.2
96.7
17.7
2.2
1.2
0.2
0.1
0.1
30.3
4.4
2.3
0.6
0.2
0.6
46.0
1.3
1.1
0.4
0.3
1.9
4.4
Chinese
or other
0.9
0.2
0.2
0.1
0.6
1.4
50.9
6.7
16.5
86.5
2.1
3.8
13.4
2.9
17.1
0.1
60.1
0.9
11.6
2.5
7.2
6.0
1.1
0.0
0.1
0.0
0.1
88.0
21.1
98.4
85.9
96.6
0.5
1.5
6.9
0.5
2.1
0.6
1.0
4.4
10.9
0.2
0.3
0.2
91.3
0.3
Ethnicity by country of birth, England &
Wales, 2001 Census
England &
Wales
White
Black
Asian
Mixed
Chinese or
other
92.8
49.3
46.8
78.6
21.6
Scotland Ireland Eastern South and
Europe
Eastern
Africa
1.7
0.1
0.2
0.5
0.3
Middle East Bangladesh
White
Black
Asian
Mixed
Chinese or
other
0.3
0.2
2
2.3
5.3
0
0
6.6
0.1
0.1
1.5
0.1
0.1
0.3
0.2
0.5
0
0.1
0.7
0.3
India Pakistan
0.1
0
17.2
1.5
0.3
0
0
13.1
0.3
0.2
0.2
10.9
8.3
2.8
1.3
China
0
0
0
0.1
9.9
North
Africa
0.1
1
0.1
1.4
2.6
Central
and
Western
Africa
0
15
0.3
0.9
0.1
Caribbean &
West Indies
0
19.5
0.2
1.7
0.1
0
China & Hong Kong
West Indies
Pakistan
1400
India
1600
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England & Wales
Age-standardised rate per 100,000
All cause mortality by country of birth in
men aged 20 and over
Men
Total deaths in E&W
1200
1000
800
600
400
200
100
0
China & Hong
Kong
West Indies
Pakistan
900
India
1000
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
All cause mortality by country of birth in
women aged 20 and over
Women
Total deaths in E&W
800
700
600
500
400
300
200
0
China & Hong
Kong
West Indies
Pakistan
India
300
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
All cause mortality by country of birth in
men aged 20-44
Men aged 20-44
Total deaths in E&W
250
200
150
100
50
0
China & Hong
Kong
West Indies
Pakistan
India
140
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
All cause mortality by country of birth in
women aged 20-44
Women aged 20-44
Total deaths in E&W
120
100
80
60
40
20
0
China & Hong
Kong
West Indies
Pakistan
400
India
450
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
IHD mortality by country of birth in men
aged 20 and over
Men
Total deaths in E&W
350
300
250
200
150
100
50
0
China & Hong Kong
West Indies
Pakistan
250
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England & Wales
Age-standardised rate per 100,000
IHD mortality by country of birth in women
aged 20 and over
Women
Total deaths in E&W
200
150
100
50
0
China & Hong
Kong
West Indies
Pakistan
India
250
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
CVD mortality by country of birth in men
aged 20 and over
Men
Total deaths in E&W
200
150
100
50
0
China & Hong
Kong
160
West Indies
180
Pakistan
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
CVD mortality by country of birth in
women aged 20 and over
Women
Total deaths in E&W
140
120
100
80
60
40
20
0
China & Hong
Kong
400
West Indies
450
Pakistan
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
All cancer mortality by country of birth in
men aged 20 and over
Men
Total deaths in E&W
350
300
250
200
150
100
50
0
China & Hong Kong
West Indies
300
Pakistan
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England & Wales
Age-standardised rate per 100,000
All cancer mortality by country of birth in
women aged 20 and over
Women
Total deaths in E&W
250
200
150
100
50
0
China & Hong Kong
West Indies
120
Pakistan
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England & Wales
Age-standardised rate per 100,000
Injury and poisoning mortality by country
of birth in men aged 20 and over
Men
Total deaths in E&W
100
80
60
40
20
0
China & Hong
Kong
West Indies
40
Pakistan
India
Bangladesh
Middle East
W Africa
N Africa
E Africa
Eastern Europe
Ireland
Scotland
England &
Wales
Age-standardised rate per 100,000
Injury and poisoning mortality by country
of birth in women aged 20 and over
Women
Total deaths in E&W
35
30
25
20
15
10
5
Age-standardised rate per 100,000
Age standardised mortality rate per 100,000 by cause for men aged
20 and over for residents of Scotland and Scotland born residents of
E&W, 2001-2003
1400
Scotland residents
1200
Scotland born/E&W
resident
1000
800
600
400
200
0
All causes
IHD
CVD
All cancer
Injury&poisoning
Age standardised mortality rate per 100,000 by cause for women
aged 20 and over for residents of Scotland and Scotland born
residents of E&W, 2001-2003
Scotland residents
1000
Age-standardised rate per 100,000
900
Scotland born/E&W
resident
800
700
600
500
400
300
200
100
0
All causes
IHD
CVD
All cancer
Injury&poisoning
Age standardised mortality rate per 100,000 by cause for men aged
20 and over for residents of Ireland and Ireland born residents of
E&W, 2001-2003
Ireland residents
1600
Ireland born/E&W
resident
Age-standardised rate per 100,000
1400
1200
1000
800
600
400
200
0
All causes
IHD
Injury&poisoning
Age standardised mortality rate per 100,000 by cause for women
aged 20 and over for residents of Ireland and Ireland born residents
of E&W, 2001-2003
Ireland residents
1000
900
Ireland born/E&W
resident
Age-standardised rate per 100,000
800
700
600
500
400
300
200
100
0
All causes
IHD
Injury&poisoning
Key findings
• Mortality varied by country of birth around the 2001
Census.
• Some similar findings to previous analysis.
• Interesting new findings include
– High mortality in young adult men born in Eastern Europe
and the West Indies and young adult women born in West
Africa, East Africa and the West Indies.
– Low rates seen young adults of both sexes born in South
Asia.
– CVD rates very high but IHD rates very low in West African
men.
– Injury and poisoning mortality very high in people born in
Eastern Europe
Discussion
Any comments/questions?