Inequalities in mortality rates by ethnicity

Mortality rates vary by ethnicity and migration status

Health varies across different populations within the UK. Understanding inequalities between ethnic groups is complex, because social and economic determinants of health, health-related behaviours and the impact of discrimination or racism all interact.  

One additional factor that may further complicate understanding of inequality is the difference in health between people who have migrated to the UK and people who are born in the UK. This is known as the ‘healthy migrant effect’ and refers to the better mortality rates that migrants often have compared with people of the same ethnicity already living in the home country, which could be due to a number of factors, including healthier people being more able and likely to migrate.  

This chart shows age-standardised mortality rates by ethnicity and migration status in England and Wales. 

• When considering all people whether born in or outside the UK together, male and female mortality rates are the highest for people who are white or from mixed/multiple ethnic groups. Mortality rates are 937 per 100,000 for white women and 918 per 100,000 for mixed/multiple ethnicity women, rates that are more than 15% higher than any other ethnic group.
• However, there are clear differences in mortality rates depending on whether someone was born in the UK or not. For almost every ethnic group (except Pakistani men), the mortality rate for people born outside the UK is lower than that of people born in the UK – on average, the mortality rate for people born outside the UK is four-fifths that of people born in the UK.
• Women from Bangladeshi backgrounds who were born in the UK have the highest mortality rates – twice as high as mortality rates for women from Black African backgrounds who were born in the UK.
• Men from mixed/multiple ethnicity backgrounds who were born in the UK have the highest mortality rates – twice as high as mortality rates for Pakistani men who were born in the UK.  
• There is less inequality in mortality rates for people born outside the UK. Of this group, Pakistani women have the highest mortality rates, which are 1.3 times higher than Black African women, who have the lowest mortality rates. White men have the highest mortality rates, 1.4 times higher than men in the ‘Asian other’ group, who have the lowest mortality rates. 

As the analysis does not include children under the age of 10, it will not reflect inequalities in infant mortality and some of the inequality in child mortality. Given that infant mortality varies significantly between ethnic groups – with the highest rates for Black Caribbean infants almost three times as high as the lowest rates for infants of other white backgrounds – this needs to be considered to fully understanding mortality inequalities. Also, as the analysis covers mortality between 2012 and 2014, it does not reflect the higher mortality rates observed during the pandemic for people belonging to minority ethnic groups.  

Some minority ethnic groups also fare worse than the white British population for many other health outcomes – including a number of chronic conditions, and mortality for specific causes of death. More research is needed to better understand the specific mechanisms linking ethnicity, migration and health, including how factors such as socio-economic status and social mobility may play a role.