Social and ethnic inequalities in all-cause and cause-specific mortality among adolescents and young adults living in the Brussels-Capital Region

Hannelore De Grande, Vrije Universiteit Brussel
Patrick Deboosere, Vrije Universiteit Brussel

This paper examines social and ethnic differences in adolescent and young adult mortality and if this varies between the period of 1991-1995 and 2001-2005 in the Brussels-Capital Region (BCR). Having a diverse population, who rejuvenated over the last decades and contains approximately 170 different nationalities, makes the BCR an interesting location to analyse these trends. The situation of the Brussels’ youth and young adults is alarming: early school dropout and unemployment is high, especially among ethnic minorities, and they are less healthy compared to their peers of other Belgian regions. The data consists of the censuses of 1991 and 2001 linked to the national registry of death and emigration records of 01/03/1991-01/01/1996 and 01/10/2001-01/01/2006 accordingly. The Belgian, Maghreb, Turkish and Southern European population aged 15-34 and living in BCR are included in the analysis. ASMRs are calculated through direct standardization, as well as Mortality Rate Ratios using Poisson regression. The Relative Index of Inequality (RII) is measured in order to compare educational inequality trends over time. All-cause mortality for men has almost been halved between 1991-1996 and 2001-2006: from 46.7 [43.7-49.8] (per 100,000 PY) to 26.2 [23.6-28.7]. Mortality rates dropped in all socio-economic groups, but the social gradient still exists among men. This pattern is less clear among women, and the RII confirms rather little inequalities (RII=1,29) for this group. Concerning cause-specific deaths, there are differences according to nationality of origin, e.g. lower suicide rates and higher other external mortality rates among Turkish and Maghrebin men than among native Belgians; and higher cancer mortality among South-European men. Although education and activity status are important contributors to these differences, other explanations have to be sought. Risk behavior more peculiar to some nationality groups and belonging to communities who are more group oriented may also be underlying causes of these differences.