Ethnic and Immigrant Ill-health and Mortality and their Predictors in Northern Ireland
Dr Stefanie Doebler
Queen's University Belfast
The ethnic composition of the UK is changing and diversity is increasing. By 2011, 14% of the population in England and Wales defined themselves as Non-White. However, due to a scarcity of data, information on mortality for ethnic groups, an important population health indicator, is still not routinely collected. Numerous UK health studies found varying health outcomes by ethnic group and research into immigrant mortality also unearthed significant differences between groups.
The first aim of this project is to estimate mortality by ethnic group and immigrant status on a national level in Northern Ireland.
These estimates will be (1) compared to those of an estimation method which combines information on the spatial distribution of ethnic groups and mortality in the total population-Geographical Distribution Method (GDM).
This comparison will also inform how reliable the estimation method is for other countries (for example England and Wales) where ethnic mortality data are also not collected on the deaths certificate.
(2) We will also aim at analyzing predictors of ill health and mortality of ethnic minorities and immigrants and look at common main causes of death. So, one aim of the project is to predict ethnic and immigrant ill health and mortality, the risk of ethnic minorities of dying prematurely and of dying of certain causes of death compared to the white majority population. One hypothesis is that this is related to socio-economic deprivation, as ethnic minorities and immigrants have often been found to live in more deprived circumstances than the native majority.
This project will be using the Northern Ireland Mortality Study. Even though Northern Ireland has traditionally only a small population of ethnic minorities compared to England and Wales, the proportion of ethnic minorities doubled between 2001 and 2011 and the number reached about 32400 by 2011. Nationally large ethnic groups were: Chinese (6300), Indian (6200), Mixed (6000), Other Asian (5000) and slightly smaller Irish Travelers (1300). With Census returns for the whole of the enumerated population linked to subsequently registered mortality data, the NIMS is an excellent source to calculate mortality for these larger ethnic groups on a national level. This in turn will allow us for the first time to compare the GDM method with real data and we will demonstrate the effectiveness of this method in this presentation.
Based on the 2011 Census population, how does mortality in NI differ by ethnic group? Do the minority ethnic groups Chinese, Indian, Mixed, Other Asian and Irish Travellers have a better, worse or the same mortality compared to the White majority group?
How do ethnic mortality rates from the NILS compare to synthetic estimates using the geographical distribution of the population or information on health?
To answer these questions we would need on a national level the number of deaths by gender and age: 0, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29,……85+ by ethnic group (Chinese, Indian, Mixed, Other Asian and Irish Travellers) between the census day and 1 year later, 2 years later, 3 years later, to 4 years later.
These data will hopefully allow us to calculate in the first instance mortality rates, by age, gender and ethnic group:
Mortality rates = number of deaths/population at risk.
These in turn can be used to calculate summary measures such as standardised mortality rates or life expectancy from life table calculations. The resulting mortality estimates will inform input to a model to project the future ethnic group population composition. In addition it also will inform on the population health of ethnic minorities in Northern Ireland and is thus relevant to policy makers.
Secondly: Are ethnic minorities and immigrants at a higher risk of ill health and mortality than the white majority? Is this higher risk (if found) due to higher socio-economic deprivation?
Are members of ethnic minorities and immigrants at a higher risk of common causes of death than the white majority?
The set of second set of research questions will apply longitudinal models to the data and try to estimate the risk of ill-health and of death of ethnic minorities/immigrants compared to the (white), ‘native ‘majority population. This will give more depth of information not just on mortality itself, but also the risk of general ill health and its possible relation to ethnicity and immigrant deprivation.
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