Differences in overall and cause-specific mortality between various groups of older migrants and non-migrants in Belgium, 2001 to 2009

Background: European societies are rapidly ageing and becoming multicultural, and Belgium is one of the countries ahead in this transition. Differences in mortality between migrants and non-migrants in Europe have been shown to depend on sex, socio-economic status, migrant background and country of residence, but have not been studied much at older ages.
Objective: The aim of this study is to determine which overall and cause-specific mortality differences exist between different groups of older migrants and non-migrants in Belgium.
Methods: A mortality follow-up of the population aged 50 and over living in Flanders and the Brussels-Capital region in the 2001 census was performed until 2009, by linking the census with the Belgian register and death certificates. Migrants were classified as western and non-western, and some specific migrant origins were distinguished as well. Mortality differences were analysed via directly age-standardised mortality rates (overall mortality) and Poisson regression models (cause-specific mortality), separately for men and women.
Results: Older migrant men and women, especially from non-western origin, experienced lower mortality than Belgians. Although migrants experienced lower mortality from most causes of death, infectious diseases and diabetes mellitus mortality was higher among older non-western migrants, and lung cancer mortality was higher among western migrant women. The overall mortality advantage of migrants was mainly driven by their mortality advantage in cancers and cardiovascular diseases.
Conclusion: Older migrants experienced lower overall mortality than Belgians. However, cause-specific mortality differences showed the importance of preventing obesity among non-western migrants and reducing the smoking prevalence among western migrant women.