School of GeographyFACULTY OF ENVIRONMENT

ESRC Research Award RES-165-25-0032, 01.10.2007- 30.09.2009What happens when international migrants settle? Ethnic group population trends and projections for UK local areas

EstimatingEthnic Mortality

Pia Wohland

Survival probability for ethnic groups in 432 local areas of the UK, by SYA age and 2 gender

UK:England 16 ethnic groups 352 LAWales 16ethnic groups 22 LAScotland 5 ethnic groups 32 LANorthern Ireland 12 ethnic groups 26 LA

Ethnic projection model by local areas (LA) of the UK

Mortality input data for

We have.....

Ethnic population estimates and projections in the UK

BUT

No ethnic specific mortality

Except:•Longitudinal Study•ONS ethnic group infant mortality (2008)

• United States

New Zealand

Is ethnic group mortality of importance?

Ajwani S, Blakely T, Robson B, Tobias M, Bonne M. 2003. Decades ofDisparity: Ethnic mortality trends in New Zealand 1980-1999. Wellington: Ministryof Health and University of Otago.

Arias E. United States life tables, 2004. National vital statistics reports; vol56 no 9. Hyattsville, MD: National Center for Health Statistics. 2007.

Surrogate data?Self-reported health - a strong predictor of subsequent mortality.

(Burström and Friedlund 2001, McGee et al. (1999) Heistaro et al. (2001) Helwig-Larson et al. (2003) Franks et al. (2003) , Singh and Siahpush (2001)

•The relationship for men is different from that for women.

•Socioeconomic factors are important in explaining mortality variation across groups but self-reported health status still has a significant influence after controlling for them.

•There is variation between racial/ethnic groups in the self-reported health-mortality link but it is not huge.

•There is an important influence of immigrant generation with the first generation having better self-reported health and mortality than subsequent generations.

Census 2001 Question

Available for local areas, ethnic groups and age groups

School of GeographyFACULTY OF ENVIRONMENT

ALL PERSONDEATHS DATA

2001 Vital statistics

Countries & Local Authorities

POPULATION DATA

2001 Mid year Estimates

Countries & Local Authorities

ALL PERSON STANDARDISED MORTALITY RATIOS (SMR)

2001, UK Standard

Countries & Local Authorities

STANDARDISED MORTALITY RATIOS BY ETHNICITY

2001, UK Standard

Countries & Local Authorities

LIFE TABLES & SURVIVORSHIP PROBABILITIES BY ETHNICITY

2001 (Calendar Year)

Countries & Local Authorities

ALL PERSON RESIDENTS DATA

2001 Census Tables S16,S65

Countries & Local Authorities

ALL PERSON LIMITING LONG TERM ILLNESS DATA

2001 Census Tables S16,S65Countries & Local

Authorities

ALL PERSON STANDARDISED ILLNESS RATIOS

(SIR)

2001 , UK Standard

Countries & Local Authorities

RESIDENTS DATA BY ETHNICITY

2001 Census Tables ST 101, 107, 207, 318

Countries & Local Authorities

LIMITING LONG TERM ILLNESS BY ETHNICITY

2001 Census Tables ST 101, 107, 207, 318

Countries & Local Authorities

STANDARDISED ILLNESS RATIOS BY ETHNICITY

(SIR)

2001, UK Standard

Countries & Local Authorities

Method 1Using illness data from the census

Step 1 compute life tables for all UK LAs: mortality rates

Wales

120 to 135 (0)

110 to 120 (6)

100 to 110 (31)

90 to 100 (20)

80 to 90 (2)

70 to 80 (0)

Female SMR UKEngland

120 to 135 (5)

110 to 120 (40)

100 to 110 (93)

90 to 100 (151)

80 to 90 (88)

70 to 80 (13)

Northern Ireland

120 to 135 (0)

110 to 120 (8)

100 to 110 (6)

90 to 100 (11)

80 to 90 (2)

70 to 80 (0)

Scotland

120 to 135 (11)

110 to 120 (35)

100 to 110 (76)

90 to 100 (26)

80 to 90 (0)

70 to 80 (0)

Wales

120 to 135 (0)

110 to 120 (6)

100 to 110 (31)

90 to 100 (20)

80 to 90 (2)

70 to 80 (0)

Female SMR UKEngland

120 to 135 (5)

110 to 120 (40)

100 to 110 (93)

90 to 100 (151)

80 to 90 (88)

70 to 80 (13)

Northern Ireland

120 to 135 (0)

110 to 120 (8)

100 to 110 (6)

90 to 100 (11)

80 to 90 (2)

70 to 80 (0)

Scotland

120 to 135 (11)

110 to 120 (35)

100 to 110 (76)

90 to 100 (26)

80 to 90 (0)

70 to 80 (0)

Standardised mortality ratio (SMR)

Standardisation = Observed data / Excepted data

Standard populationUK

UK population mortality ratesillness rates

All group SMR as a function of SIRDifferences between home countries?

Nation Gender r2 Intercept SlopeEngland   0.51 52.1 0.48Wales Females 0.78 43.9 0.37Scotland   0.69 60.5 0.64Northern Ireland   0.16 71.2 0.26

Gender r2 Intercept Slope  0.63 47.3 0.52

Males 0.56 54.9 0.39  0.75 28.3 0.82  0.40 59.9 0.36

♀ ♂

Female SIR175.00150.00125.00100.0075.0050.00

Fem

ale

SM

R

150.00

125.00

100.00

75.00

50.00

Fit line for TotalEthnic minorty <= 8.2%Ethnic minorty > 8.2%Fit line for TotalEthnic minorty <= 8.2%Ethnic minorty > 8.2%

ETH_Min

R Sq Linear = 0.484

Male SIR175.00150.00125.00100.0075.0050.00

Mal

e S

MR

150.00

125.00

100.00

75.00

50.00

Fit line for TotalFit line for TotalEthnic minority <= 8.2%Ethinc minorty > 8.2%Ethnic minority <= 8.2%Ethinc minorty > 8.2%

ETH_Min

R Sq Linear = 0.583

Female SIR175.00150.00125.00100.0075.0050.00

Fem

ale

SM

R

150.00

125.00

100.00

75.00

50.00

Fit line for TotalEthnic minorty <= 8.2%Ethnic minorty > 8.2%Fit line for TotalEthnic minorty <= 8.2%Ethnic minorty > 8.2%

ETH_Min

♀ ♂

England all group SMR as a function of SIR:High ethnic minority versus low ethnic minority LAs

Female SIR17515012510075

Fem

ale

SM

R

140

120

100

80

60

SouthNorthFit line for TotalSouthNorth

Female SIR17515012510075

Fem

ale

SM

R

140

120

100

80

60

SouthNorthFit line for TotalSouthNorth

Male SIR1751501251007550

Mal

e S

MR

140

120

100

80

60

SouthNorthFit line for TotalSouthNorth

http://img.dailymail.co.uk/i/pix/2007/10_04/england2410_468x816.jpg

England all group SMR as a function of SIR:North versus South

♂

Standardized Illness Ratios for ethnic groups in England

0 50 150 2500

5010

015

0 White British

Num

ber

of L

As

0 50 150 2500

5010

015

0

97 (m)96 (f)

0 50 150 250

050

100

150 White Irish

0 50 150 250

050

100

150

109 (m)100 (f)

0 50 150 250

050

100

150 Other White

0 50 150 250

050

100

150

79 (m)83 (f)

0 50 150 250

050

100

150 White & Black Caribbean

0 50 150 250

050

100

150

135 (m)133 (f)

0 50 150 250

050

100

150 White & Black African

Num

ber

of L

As

0 50 150 250

050

100

150

121 (m)117 (f)

0 50 150 2500

5010

015

0 White & Asian

0 50 150 2500

5010

015

0

108 (m)107 (f)

0 50 150 250

050

100

150 Other Mixed

0 50 150 250

050

100

150

115 (m)110 (f)

0 50 150 250

050

100

150 Indian

0 50 150 250

050

100

150

99 (m)122 (f)

0 50 150 250

050

100

150 Pakistani

Num

ber

of L

As

0 50 150 250

050

100

150

133 (m)159 (f)

0 50 150 250

050

100

150 Bangladeshi

0 50 150 250

050

100

150

138 (m)152 (f)

0 50 150 2500

5010

015

0 Other Asian

0 50 150 2500

5010

015

0

105 (m)119 (f)

0 50 150 250

050

100

150 Black Caribbean

0 50 150 250

050

100

150

110 (m)122 (f)

0 50 150 250

050

100

150 Black African

SIR

Num

ber

of L

As

0 50 150 250

050

100

150

83 (m)98 (f)

0 50 150 250

050

100

150 Other Black

SIR

0 50 150 250

050

100

150

129 (m)135 (f)

0 50 150 250

050

100

150 Chinese

SIR

0 50 150 250

050

100

150

60 (m)67 (f)

0 50 150 2500

5010

015

0 Other Ethnic Group

SIR

0 50 150 2500

5010

015

0

87 (m)80 (f)

Small number issue

♀♀ = above threshold

= below threshold = need model replacementthreshold = 10 ill, 100 population

SMR Bangladeshi Males

150 to < 175 (4)

130 to < 150 (41)

115 to < 130 (98)

101 to < 115 (146)

99 to < 101 (22)

85 to < 99 (43)

62 to < 85 (0)

SMR White British Males

150 + (0)

130 to < 150 (1)

115 to < 130 (18)

101 to < 115 (75)

99 to < 101 (25)

85 to < 99 (202)

62 to <85 (33)

SMR Indian Males

150 + (0)

130 to <150 (1)

115 to <130 (19)

101 to <115 (79)

99 to <101 (17)

85 to <99 (187)

62 to <85 (51)

SMR Chinese Males

150 + (0)

130 to < 150 (0)

115 to < 130 (0)

101 to < 115 (1)

99 to < 101 (0)

85 to < 99 (58)

55 to < 85 (295)

SMRs for White British Males

SMRs for Indian Males

SMRs for Bangladeshi Males

SMRs for Chinese males

Results: SMRs

SMRS for all groups

Estimate mortality rates by age and sex for ethnic groups from estimated SMRs:

Miexg = Mi

xg × SMRi eg / 100

We assume each ethnic group has the same mortality pattern by age

Adjust the estimated mortality rates so that they agree with the all group mortality rates.

From SMR to mortality rates

The ranking of mean life expectancy for ethnic groups, men and women, England, 2001

Rank Ethnic groupMean e0

Rank Ethnic groupMean e0  

Ethnic groupYears Rank

Women Men   ♀ - ♂ ♀ - ♂

1 Chinese 82.1 1 Chinese 78.1 Indian 3.8 5

2 Other Ethnic 81.5 2 Other White 76.9 Chinese 4 0

3 Other White 81.3 3 Other Ethnic 76.2 Pakistani 4.2 1

4 White British 80.5 4 Black African 76.1 Other Asian 4.3 2

  All groups 80.5   All group 76 Black African 4.3 1

5 Black African 80.4 5 White British 75.9 Other White 4.4 1

6 White-Irish 80.3 6 Indian 75.5 All group 4.5 0

7 White-Asian 80 7 Other Asian 75.2 White British 4.6 -1

8 Other Mixed 79.9 8 White-Asian 75.1 Black Caribbean 4.7 1

9 Other Asian 79.5 9 White-Irish 74.9 White-Asian 4.9 -1

10 White-Black African 79.5 10 Other Mixed 74.6 Bangladeshi 5 -1

11 Indian 79.3 11 Black Caribbean 74.4 Other Black 5.1 1

12 Black Caribbean 79.1 12 White-Black African 74.2 Other Ethnic 5.3 -1

13 White-Black Caribbean 78.7 13 Other Black 73.4 White-Black African 5.3 -2

14 Other Black 78.5 14 White-Black Caribbean 73.4 White-Black Caribbean 5.3 -1

15 Bangladeshi 77.7 15 Pakistani 73.1 Other Mixed 5.3 -2

16 Pakistani 77.3 16 Bangladeshi 72.7  White-Irish 5.4 -3

Spatial distribution of life expectancies at birth 2001(1)

White Other

Black African

Black Caribbean Pakistani

≥81.2 to <85.9

≥78.9 to <81.2

≥73.8 to <78.9

♀♀

Chinese ♀♀

≥81.2 to <85.9

≥78.9 to <81.2

≥73.8 to <78.9

Spatial distribution of life expectancies at birth 2001(2)

Pakistani

Spatial distribution of life expectancies at birth 2001 (3)

♂♂

Pakistani and other South Asian

≥77.2 to <84.6

≥74.5 to < 77.2

≥68.7 to < 74.5

1995 2000 2005

75

80

85

Townsend deprivation quintiles

Life

exp

ect

an

cy a

t bir

th, U

KT 1 (least deprived)T 2T 3T 4T 5 (most deprived)

Outlook- Projection Scenarios

7075

8085

Life

exp

acta

ncy

at b

irth

M SIR

WBRWIR

OWHWBC

WBAWAS

OMIIND

PAKBAN

OASBCA

BAFOBL

CHIOET

7075

8085

Life

exp

acta

ncy

at b

irth

M GWM

WBRWIR

OWHWBC

WBAWAS

OMIIND

PAKBAN

OASBCA

BAFOBL

CHIOET

7075

8085

Life

exp

acta

ncy

at b

irth

F SIR

WBR

WIR

OWH

WBC

WBA

WAS

OMI

IND

PAK

BAN

OAS

BCA

BAF

OBL

CHI

OET

7075

8085

Life

exp

acta

ncy

at b

irth

F GWM

WBR

WIR

OWH

WBC

WBA

WAS

OMI

IND

PAK

BAN

OAS

BCA

BAF

OBL

CHI

OET

Comparison with an alternative method

7075

8085

Life

exp

acta

ncy

at b

irth

M SIR

WBRWIR

OWHWBC

WBAWAS

OMIIND

PAKBAN

OASBCA

BAFOBL

CHIOET

7075

8085

Life

exp

acta

ncy

at b

irth

M GWM

WBRWIR

OWHWBC

WBAWAS

OMIIND

PAKBAN

OASBCA

BAFOBL

CHIOET

7075

8085

Life

exp

acta

ncy

at b

irth

F SIR

WBR

WIR

OWH

WBC

WBA

WAS

OMI

IND

PAK

BAN

OAS

BCA

BAF

OBL

CHI

OET

7075

8085

Life

exp

acta

ncy

at b

irth

F GWM

WBR

WIR

OWH

WBC

WBA

WAS

OMI

IND

PAK

BAN

OAS

BCA

BAF

OBL

CHI

OET

England

♂♂

England

♀♀

Alternative:geographically weighted

Alternative:geographically weighted

Method of choice

Method of choice