Socio-economic inequalities in mortality for Asian people: New Zealand census-mortality study, 1996–2004

This study examines the association of socio-economic factors with mortality for the Asian population, and compares with those of the European/Other group. Conversely, it examines differences in mortality rates between the European/Other and Asian groups by levels of these socio-economic factors. Asian and European/Other 25–74 year olds on census night 1996 and 2001 were followed up for 3 years by record linkage with mortality data. Socio-economic position was measured using household income, highest educational qualification and a measure of neighbourhood deprivation. Poisson regression modelling was used to estimate the effect socio-economic variables and ethnicity on mortality rates. Asians with no qualifications had mortality rates 72% higher than those Asians with post-school qualifications whereas the corresponding figure for European/Others was 29%. Asian people living in areas of high deprivation had mortality rates 56% higher than those living in areas of low deprivation, with a similar result for the European/Other group. However, while there was no income-mortality gradient among Asian people, there was a significant effect of household income for the European/Other group where mortality rates decreased by 6% for each unit increase in income decile. Consequently, the protective effect on mortality from being Asian compared to European/Other) is more marked at higher levels of education or lower levels of income. Education is an important determinant of mortality among Asian people, but not income, perhaps reflecting the importance of education as a predictor of health status following migration, and sacrifices in income that migrants are prepared to make.