Transcript Slide 1

School of Geography
FACULTY OF ENVIRONMENT
Estimating
Ethnic Mortality
Pia Wohland
ESRC Research Award RES-165-25-0032, 01.10.2007- 30.09.2009
What happens when international migrants settle? Ethnic group population trends and projections for UK local areas
Mortality input data for
Ethnic projection model by local areas (LA) of the UK
UK:
England
Wales
Scotland
Northern Ireland
16 ethnic groups
16ethnic groups
5 ethnic groups
12 ethnic groups
Survival probability for ethnic groups in 432
local areas of the UK, by SYA age and 2 gender
352 LA
22 LA
32 LA
26 LA
We have.....
Ethnic population estimates and projections in the UK
BUT
No ethnic specific mortality
Except:
•Longitudinal Study
•ONS ethnic group infant mortality (2008)
Is ethnic group mortality of importance?
• United States
Arias E. United States life tables, 2004.
National vital statistics reports; vol
56 no 9. Hyattsville, MD: National
Center
for Health Statistics. 2007.
New Zealand
Ajwani S, Blakely T, Robson B, Tobias M, Bonne M. 2003. Decades of
Disparity: Ethnic mortality trends in New Zealand 1980-1999. Wellington: Ministry
of Health and University of Otago.
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
ALL PERSON LIMITING LONG
TERM ILLNESS DATA
2001 Census Tables S16,S65
Countries & Local
Authorities
School of Geography
FACULTY OF ENVIRONMENT
ALL PERSON STANDARDISED
ILLNESS RATIOS
(SIR)
ALL PERSON
STANDARDISED MORTALITY
RATIOS (SMR)
2001 , UK Standard
2001, UK Standard
Countries & Local
Authorities
Countries & Local
Authorities
ALL PERSON RESIDENTS
DATA
POPULATION DATA
2001 Mid year Estimates
Countries & Local
Authorities
ALL PERSONDEATHS DATA
2001 Census Tables S16,S65
2001 Vital statistics
Countries & Local
Authorities
Countries & Local
Authorities
RESIDENTS DATA BY ETHNICITY
STANDARDISED MORTALITY RATIOS BY
ETHNICITY
2001 Census Tables ST 101, 107,
207, 318
2001, UK Standard
Countries & Local Authorities
STANDARDISED ILLNESS RATIOS BY
ETHNICITY
Countries & Local Authorities
(SIR)
LIFE TABLES & SURVIVORSHIP PROBABILITIES BY
ETHNICITY
2001 (Calendar Year)
2001, UK Standard
Countries & Local
Authorities
LIMITING LONG TERM ILLNESS BY
ETHNICITY
2001 Census Tables ST 101, 107,
207, 318
Countries & Local Authorities
Countries & Local Authorities
Method 1
Using illness data from the census
Step 1 compute life tables for all UK LAs: mortality rates
Female SMR UK
England
Standardisation = Observed data / Excepted data
120 to 135
(5)
110 to 120 (40)
100 to 110 (93)
90 to 100 (151)
80 to 90 (88)
70 to 80 (13)
Standardised
mortality
ratio (SMR)
Female SMR UK
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)
England
Standard population
UK
120 to 135Scotland
(5)
110 to 120 120
(40)to 135
100 to 110 110
(93)to 120
100 to 110
90 to 100 (151)
90 to 100
80 to 90 (88)
80 to 90
70 to 80
70 to 80 (13)
Wales
Northern Ireland
120 to 135
120 to 135 110
(0)to 120
110 to 120 100
(6)to 110
90 to 100
100 to 110 (31)
80 to 90
90 to 100 (20)
70 to 80
80 to 90 (2)
70 to 80 (0)
Scotland
UK population
mortality rates
illness rates
(11)
(35)
(76)
(26)
(0)
(0)
120 to 135
110 to 120
100 to 110
90 to 100
80 to 90
70 to 80
(11)
(35)
(76)
(26)
(0)
(0)
Northern Ireland
120 to 135 (0)
110 to 120 (8)
100 to 110 (6)
90 to 100 (11)
80 to 90 (2)
(0)
(8)
(6)
(11)
(2)
(0)
All group SMR as a function of SIR
Differences between home countries?
♀
♂
Nation
England
Wales
Scotland
Northern Ireland
r2 Intercept
0.51
52.1
Females 0.78
43.9
0.69
60.5
0.16
71.2
Gender
Slope
0.48
0.37
0.64
0.26
Gender
Males
r2
0.63
0.56
0.75
0.40
Intercept
47.3
54.9
28.3
59.9
Slope
0.52
0.39
0.82
0.36
England all group SMR as a function of SIR:
High ethnic minority versus low ethnic minority LAs
150.00
ETH_Min
♀
♂
Ethnic minorty > 8.2%
Ethnic minorty <= 8.2%
Fit150.00
line for Total
Ethnic minorty > 8.2%
Ethnic minorty <= 8.2%
Fit line for Total
125.00
Male SMR
Female SMR
125.00
100.00
75.00
100.00
75.00
R Sq Linear = 0.484
50.00
50.00
50.00
75.00
100.00
125.00
Female SIR
150.00
175.00
50.00
75.00
ETH_Min
Ethnic minorty > 8.2%
Ethnic minorty <= 8.2%
Fit line for Total
100.00
125.00
Male SIR
150.00
175.00
England all group SMR as a function of SIR:
North versus South
140
No
So
Fi
No
So
120
Male SMR
120
Female SMR
♂
140
North
South
Fit line for Total
North
South
100
80
100
80
60
60
75
100
125
150
175
50
75
Female SIR
100
125
Male SIR
0
0
North
South
Fit line for Total
North
South
http://img.dailymail.co.uk/i/pix/2007/10_04/england2410_468x816.jpg
150
175
SIR
150
250
Other Black
129 (m)
135 (f)
250
150
100
50
0
150
100
50
100
150
250
Black Caribbean
110 (m)
122 (f)
0
0 50
150
250
Chinese
60 (m)
67 (f)
0 50
150
250
Other Ethnic Group
87 (m)
80 (f)
0
50
SIR
150
99 (m)
122 (f)
50
Other Asian
105 (m)
119 (f)
0
0 50
Indian
0 50
150
250
150
250
250
50
150
150
0
0
100
150
0
0 50
White & Black Caribbean
135 (m)
133 (f)
0 50
100
150
100
50
0
150
100
250
50
Bangladeshi
138 (m)
152 (f)
50
0 50
150
Other Mixed
115 (m)
110 (f)
0 50
150
250
0
0
50
Black African
83 (m)
98 (f)
0 50
150
150
100
150
50
250
79 (m)
83 (f)
50
White & Asian
108 (m)
107 (f)
0 50
150
150
Other White
100
150
100
50
0
150
250
50
100
150
0
50
0
150
0 50
250
133 (m)
159 (f)
100
150
150
Pakistani
0 50
100
109 (m)
100 (f)
0
50
100
250
White & Black African
121 (m)
117 (f)
0 50
Number of LAs
150
0
Number of LAs
150
0 50
Number of LAs
White Irish
100
100
50
White British
97 (m)
96 (f)
0
Number of LAs
150
Standardized Illness Ratios for ethnic groups in England
0 50
SIR
150
250
0 50
SIR
150
250
Small number issue
threshold = 10 ill, 100 population
♀
= above threshold
= below threshold = need model replacement
SMRs for
White British
Males
Results: SMRs
SMRs for
Indian
Males
SMRS for all groups
SMR Indian Males
SMR White British Males
150 +
150 +
130 to < 150
130 to <150
(1)
115 to <130
(19)
101 to <115
(79)
(1)
115 to < 130
(18)
101 to < 115
(75)
99 to < 101
99 to <101
(17)
85 to <99
(187)
62 to <85
(51)
(25)
85 to < 99
62 to
(0)
(0)
(202)
<85
SMRs for
Bangladeshi
Males
(33)
SMRs for
Chinese
males
SMR Chinese Males
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)
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)
From SMR to mortality rates
Estimate mortality rates by age and sex for ethnic groups from estimated SMRs:
Miexg = Mixg × 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.
The ranking of mean life expectancy for ethnic
groups, men and women, England, 2001
Mean e0
Rank
Ethnic group
Mean e0
Rank Ethnic group
Women
Years
Rank
♀-♂
♀-♂
Ethnic group
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
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
All group
76
Spatial distribution of life expectancies at birth 2001(1)
White Other
♀
Black African
≥81.2 to <85.9
≥78.9 to <81.2
≥73.8 to <78.9
Black Caribbean
Pakistani
Spatial distribution of life expectancies at birth 2001(2)
Chinese ♀
≥81.2 to <85.9
≥78.9 to <81.2
≥73.8 to <78.9
Spatial distribution of life expectancies at birth 2001 (3)
Pakistani
♂
≥77.2 to <84.6
≥74.5 to < 77.2
≥68.7 to < 74.5
Pakistani and
other South Asian
Outlook- Projection Scenarios
80
T 1 (least deprived)
T2
T3
T4
T 5 (most deprived)
75
Life expectancy at birth, UK
85
Townsend deprivation quintiles
1995
2000
2005
85 85
80 80
75 75
England
♂
F SIR
F SIR
F GWM
F GWM
80 80
75 75
70 70
Method of choice
LifeLife
expactancy
expactancy
at birth
at birth
75 75
80 80
85 85
WBR OWH WBA OMI PAK OAS BAF CHI
WIR WBC WAS IND BAN BCA OBL OET
WBR OWH WBA OMI PAK OAS BAF CHI
WIR WBC WAS IND BAN BCA OBL OET
85 85
WBR OWH WBA OMI PAK OAS BAF CHI
WIR WBC WAS IND BAN BCA OBL OET
WBR OWH WBA OMI PAK OAS BAF CHI
WIR WBC WAS IND BAN BCA OBL OET
70 70
LifeLife
expactancy
expactancy
at birth
at birth
Alternative:
geographically weighted
70 70
LifeLife
expactancy
expactancy
at birth
at birth
85 85
75 75
80 80
Method of choice
70 70
LifeLife
expactancy
expactancy
at birth
at birth
M SIR
M GWM
Comparison
with
an
alternative
method
M SIR
M GWM
WBR OWH WBA OMI PAK OAS BAF CHI
WIR
WBC
WAS
BAN
BCA
OBLCHIOET
WBR
OWH
WBA
OMIINDPAK
OAS
BAF
England
Alternative:
geographically weighted
WBR OWH WBA OMI PAK OAS BAF CHI
WIR
WBC WAS
BAN
BCA
OBLCHIOET
WBR
OWHWBA
OMIINDPAK
OAS
BAF
♀