Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 Apr;59(4):329–335. doi: 10.1136/jech.2004.019794

Socioeconomic inequalities in mortality within ethnic groups in the Netherlands, 1995–2000

V Bos 1, A Kunst 1, J Garssen 1, J Mackenbach 1
PMCID: PMC1733064  PMID: 15767388

Abstract

Study objective: To analyse socioeconomic inequalities in mortality in Dutch, Turkish, Moroccans, Surinamese, and Antillean/Aruban men and women living in the Netherlands and to assess the contribution of specific causes of death to these inequalities.

Design: Open cohort design using data from the Municipal Population Registers and cause of death registry.

Setting: the Netherlands from 1995 through 2000.

Participants: All inhabitants of the Netherlands.

Main outcome measures: This study calculated directly standardised mortality rates by mean neighbourhood income and estimated relative mortality ratios comparing the two lowest socioeconomic groups with the two highest socioeconomic groups for all and cause specific mortality by country of origin and sex.

Main results: Socioeconomic differences in total mortality were comparatively large in Dutch, (RR = 1.49, CI = 1.46 to 1.52), Surinamese (1.32, 1.19 to 1.46), and Antillean/Aruban men (1.56, 1.29 to 1.89) and in Dutch (1.39, 135 to 1.42) and Surinamese women (1.27, 1.11 to 1.46). They were comparatively small among Turkish (1.10, 0.99 to 1.23) and Moroccan men (1.10, 0.97 to 1.26) and among Turkish (1.13, 0.97 to 1.33), Moroccan (1.12, 0.93 to 1.35) and Antillean/Aruban women (1.03, 0.80 to 1.33). The mortality differences among the Dutch were partly attributable to inequalities in mortality from cardiovascular diseases, whereas among Antillean/Aruban men external causes strongly contributed to the mortality differences. The small differences among Turkish and Moroccan men were due to a lack of inequalities for cardiovascular diseases and small inequalities for the other causes.

Conclusions: The impact of socioeconomic status on mortality differed between ethnic groups living in the Netherlands. Maintaining small socioeconomic inequalities in mortality among Turkish and Moroccans men and women and among Antillean/Aruban women could prevent future increases in overall mortality in these groups.

Full Text

The Full Text of this article is available as a PDF (85.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bos Vivian, Kunst Anton E., Keij-Deerenberg Ingeborg M., Garssen Joop, Mackenbach Johan P. Ethnic inequalities in age- and cause-specific mortality in The Netherlands. Int J Epidemiol. 2004 May 27;33(5):1112–1119. doi: 10.1093/ije/dyh189. [DOI] [PubMed] [Google Scholar]
  2. Cavelaars A. E., Kunst A. E., Geurts J. J., Crialesi R., Grötvedt L., Helmert U., Lahelma E., Lundberg O., Matheson J., Mielck A. Educational differences in smoking: international comparison. BMJ. 2000 Apr 22;320(7242):1102–1107. doi: 10.1136/bmj.320.7242.1102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chandola T. Ethnic and class differences in health in relation to British South Asians: using the new National Statistics Socio-Economic Classification. Soc Sci Med. 2001 Apr;52(8):1285–1296. doi: 10.1016/s0277-9536(00)00231-8. [DOI] [PubMed] [Google Scholar]
  4. Davey Smith G., Neaton J. D., Wentworth D., Stamler R., Stamler J. Mortality differences between black and white men in the USA: contribution of income and other risk factors among men screened for the MRFIT. MRFIT Research Group. Multiple Risk Factor Intervention Trial. Lancet. 1998 Mar 28;351(9107):934–939. doi: 10.1016/s0140-6736(00)80010-0. [DOI] [PubMed] [Google Scholar]
  5. Keleş Ibrahim, Onat Altan, Toprak Sadik, Avci Günsel S., Sansoy Vedat. Family income a strong predictor of coronary heart disease events but not of overall deaths among Turkish adults: a 12-year prospective study. Prev Med. 2003 Aug;37(2):171–176. doi: 10.1016/s0091-7435(03)00112-9. [DOI] [PubMed] [Google Scholar]
  6. Koskinen S., Martelin T. Why are socioeconomic mortality differences smaller among women than among men? Soc Sci Med. 1994 May;38(10):1385–1396. doi: 10.1016/0277-9536(94)90276-3. [DOI] [PubMed] [Google Scholar]
  7. Kunst A. E., Looman C. W., Mackenbach J. P. Socio-economic mortality differences in The Netherlands in 1950-1984: a regional study of cause-specific mortality. Soc Sci Med. 1990;31(2):141–152. doi: 10.1016/0277-9536(90)90055-w. [DOI] [PubMed] [Google Scholar]
  8. Kunst A. E., del Rios M., Groenhof F., Mackenbach J. P. Socioeconomic inequalities in stroke mortality among middle-aged men: an international overview. European Union Working Group on Socioeconomic Inequalities in Health. Stroke. 1998 Nov;29(11):2285–2291. doi: 10.1161/01.str.29.11.2285. [DOI] [PubMed] [Google Scholar]
  9. Liang Jersey, Bennett Joan, Krause Neal, Kobayashi Erika, Kim Hyekyung, Brown J. Winchester, Akiyama Hiroko, Sugisawa Hidehiro, Jain Arvind. Old age mortality in Japan: does the socioeconomic gradient interact with gender and age? J Gerontol B Psychol Sci Soc Sci. 2002 Sep;57(5):S294–S307. doi: 10.1093/geronb/57.5.s294. [DOI] [PubMed] [Google Scholar]
  10. Mackenbach J. P., Cavelaars A. E., Kunst A. E., Groenhof F. Socioeconomic inequalities in cardiovascular disease mortality; an international study. Eur Heart J. 2000 Jul;21(14):1141–1151. doi: 10.1053/euhj.1999.1990. [DOI] [PubMed] [Google Scholar]
  11. Mackenbach J. P., Kunst A. E., Groenhof F., Borgan J. K., Costa G., Faggiano F., Józan P., Leinsalu M., Martikainen P., Rychtarikova J. Socioeconomic inequalities in mortality among women and among men: an international study. Am J Public Health. 1999 Dec;89(12):1800–1806. doi: 10.2105/ajph.89.12.1800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Nazroo James Y. The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. Am J Public Health. 2003 Feb;93(2):277–284. doi: 10.2105/ajph.93.2.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Smith G. D. Learning to live with complexity: ethnicity, socioeconomic position, and health in Britain and the United States. Am J Public Health. 2000 Nov;90(11):1694–1698. doi: 10.2105/ajph.90.11.1694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Smith G. D., Wentworth D., Neaton J. D., Stamler R., Stamler J. Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: II. Black men. Am J Public Health. 1996 Apr;86(4):497–504. doi: 10.2105/ajph.86.4.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sorlie P., Rogot E., Anderson R., Johnson N. J., Backlund E. Black-white mortality differences by family income. Lancet. 1992 Aug 8;340(8815):346–350. doi: 10.1016/0140-6736(92)91413-3. [DOI] [PubMed] [Google Scholar]
  16. Sporle Andrew, Pearce Neil, Davis Peter. Social class mortality differences in Maori and non-Maori men aged 15-64 during the last two decades. N Z Med J. 2002 Mar 22;115(1150):127–131. [PubMed] [Google Scholar]
  17. Wilkinson R. G. Health, hierarchy, and social anxiety. Ann N Y Acad Sci. 1999;896:48–63. doi: 10.1111/j.1749-6632.1999.tb08104.x. [DOI] [PubMed] [Google Scholar]
  18. Williams R. Health and length of residence among south Asians in Glasgow: a study controlling for age. J Public Health Med. 1993 Mar;15(1):52–60. doi: 10.1093/oxfordjournals.pubmed.a042820. [DOI] [PubMed] [Google Scholar]
  19. Williams R., Wright W., Hunt K. Social class and health: the puzzling counter-example of British South Asians. Soc Sci Med. 1998 Nov;47(9):1277–1288. doi: 10.1016/s0277-9536(98)00202-0. [DOI] [PubMed] [Google Scholar]
  20. Yost K., Perkins C., Cohen R., Morris C., Wright W. Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control. 2001 Oct;12(8):703–711. doi: 10.1023/a:1011240019516. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES