Harding Seeromanie
MRC Unit, Social and Public Health Sciences Unit, University of Glasgow, Lilybank Gardens, Glasgow, G12 8RZ, UK.
Int J Epidemiol. 2004 Apr;33(2):382-6. doi: 10.1093/ije/dyh059.
Aim To investigate mortality of Caribbean migrants in England and Wales by duration of residence and age at migration.
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.
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.
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.
目的是按居住时长和移民时年龄调查在英格兰和威尔士的加勒比移民的死亡率。
全国队列研究中的成员，在1971年年龄为25 - 54岁，从1971年至2000年进行随访。有1540名加勒比移民，随访期间有329人死亡。采用Cox回归模型分析心血管疾病和癌症的死亡率。所有结果均根据性别和社会经济地位进行了调整。
1971年年龄在25 - 34岁或35 - 44岁时，全因死亡率与居住时长或移民时年龄无关。在45 - 54岁年龄段，1971年前每多居住一年死亡率呈上升趋势（风险比[HR]=1.07，95%置信区间：0.95，1.20，144例死亡），且移民时每增长一岁死亡率也呈上升趋势（HR = 1.09，95%置信区间：0.97，1.22）。占所有死亡人数40%的循环系统疾病死亡率导致了这种趋势。在45 - 54岁年龄段，居住时长（HR = 1.21，95%置信区间：1.01，1.44，62例）和移民时年龄（HR = 1.25，95%置信区间：1.06，1.49）每年均有所增加。在这些死亡病例中，中风死亡率与这两个预测因素均呈正相关（居住时长的HR = 1.38，95%置信区间：1.10，1.74；移民时年龄的HR = 1.44，95%置信区间：1.15，1.80），这种模式归因于45 - 54岁年龄段的影响。冠心病死亡在最年长队列中呈现类似趋势。癌症死亡未观察到显著趋势。
在最年长队列中，加勒比移民的循环系统疾病死亡率随居住时长和移民时年龄的增加而上升，主要是由于中风死亡率的影响。
