Mortality of migrants from the Caribbean to England and Wales: effect of duration of residence

Aim To investigate mortality of Caribbean migrants in England and Wales by duration of residence and age at migration. Method Study members in a national cohort, aged 25-54 years in 1971, were followed up from 1971 to 2000. There were 1540 migrant Caribbeans amongst whom there were 329 deaths during follow-up. Cox regression models were used to analyse mortality from cardiovascular disease and cancers. All results were adjusted for sex and socioeconomic position. Results All-cause mortality was not related to duration of residence or age at migration at ages 25-34 or 35-44 years in 1971. At ages 45-54 years a pattern of increasing mortality with each additional year of residence prior to 1971 (hazard ratio [HR] = 1.07, 95% CI: 0.95, 1.20, 144 deaths) and with each additional year of age at migration (HR = 1.09, 95% CI: 0.97, 1.22) was observed. Circulatory disease mortality, accounting for 40% of all deaths, contributed to this pattern. At ages 45-54 years, both duration of residence (HR = 1.21, 95% CI: 1.01, 1.44, 62) and age at migration (HR = 1.25, 95% CI: 1.06, 1.49) increased per year of each. Of these deaths, stroke mortality was positively associated with both predictors (HR = 1.38, 95% CI: 1.10, 1.74 for duration of residence and HR = 1.44, 95% CI: 1.15, 1.80 for age at migration), a pattern due to effects at ages 45-54 years. Deaths from coronary heart disease showed similar trends in the oldest age cohort. No significant trends were observed for deaths from cancers. Conclusion Circulatory disease mortality in Caribbean migrants increased with increasing duration of residence and age at migration in the oldest age cohort, primarily due to the effects from stroke mortality.