School of Geography FACULTY OF ENVIRONMENT ESRC Research Award RES , What happens when international migrants settle? Ethnic group population trends and projections for UK local areas Estimating Ethnic Mortality Pia Wohland

Survival probability for ethnic groups in 432 local areas of the UK, by SYA age and 2 gender UK: England16 ethnic groups352 LA Wales16ethnic groups22 LA Scotland5 ethnic groups32 LA Northern Ireland12 ethnic groups26 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 Decades of Disparity: Ethnic mortality trends in New Zealand Wellington: Ministry of Health and University of Otago. Arias E. United States life tables, National vital statistics reports; vol 56 no 9. Hyattsville, MD: National Center for Health Statistics

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 Geography FACULTY 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,S65 Countries & 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 1 Using illness data from the census Step 1 compute life tables for all UK LAs: mortality rates

Standardised mortality ratio (SMR) Standardisation = Observed data / Excepted data Standard population UK UK population mortality rates illness rates

All group SMR as a function of SIR Differences between home countries? NationGenderr2r2 InterceptSlope England WalesFemales Scotland Northern Ireland Genderr2r2 InterceptSlope Males ♀♂

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

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

Standardized Illness Ratios for ethnic groups in England

Small number issue♀ = above threshold = below threshold = need model replacement threshold = 10 ill, 100 population

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: M i exg = M i xg × SMR i 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 RankEthnic group Mean e 0 RankEthnic group Mean e 0 Ethnic group YearsRank WomenMen ♀ - ♂ 1Chinese82.11Chinese78.1Indian3.85 2Other Ethnic81.52Other White76.9Chinese40 3Other White81.33Other Ethnic76.2Pakistani4.21 4White British80.54Black African76.1Other Asian4.32 All groups80.5 All group76Black African4.31 5Black African80.45White British75.9Other White4.41 6White-Irish80.36Indian75.5All group4.50 7White-Asian807Other Asian75.2White British4.6 8Other Mixed79.98White-Asian75.1Black Caribbean4.71 9Other Asian79.59White-Irish74.9White-Asian4.9 10White-Black African79.510Other Mixed74.6Bangladeshi5 11Indian79.311Black Caribbean74.4Other Black Black Caribbean79.112White-Black African74.2Other Ethnic5.3 13White-Black Caribbean78.713Other Black73.4White-Black African Other Black78.514White-Black Caribbean73.4White-Black Caribbean5.3 15Bangladeshi77.715Pakistani73.1Other Mixed Pakistani77.316Bangladeshi72.7 White-Irish5.4-3

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

Outlook- Projection Scenarios

Comparison with an alternative method England ♂ ♀ Alternative: geographically weighted Alternative: geographically weighted Method of choice