All cause and cardiovascular mortality in African migrants living in Portugal: evidence of large social inequalities

AIM: To examine cardiovascular mortality of African migrants in Portugal in relation to socio-economic status. METHOD: Data from death registrations, 1998-2002, and the 2001 Census were used to derive standardized death rates by country of birth and occupational class/marital status. RESULTS: Compared with native Portuguese, African migrants had higher mortality for all causes, circulatory disease, coronary heart disease and stroke. There was considerable heterogeneity among Africans with Cape Verdeans having higher mortality than Angolans or Mozambiquans. Class differences in mortality were generally greater for African than for Portuguese men. Although the coronary heart disease mortality rate among Africans in a manual class was twice that of those in a nonmanual class, there was no class difference for Portuguese men. Marital status was associated with 2-3-fold differences in mortality rates in both Africans and Portuguese. A larger proportion of Africans were not married which accounted for some of the excess mortality. CONCLUSION: Adverse cardiovascular mortality experience of African migrants is associated with socio-environmental factors. Investigating how best to achieve risk reduction in Africans should be a public health priority in Portugal.