How does mortality compare between different countries/regions of birth for the population of England and Wales, 2007...

To examine all-cause mortality differences among migrants from different countries/regions compared with native-born populations in England and Wales from 2007 to 2021 and assess whether migrant mortality patterns converge with or diverge from native-born trends over the study period.

Descriptive, observational study analysing mortality trends over a 15-year period.

England and Wales, using national mortality records and Census data.

The study included all recorded deaths in England and Wales from 2007 to 2021, stratified by sex and country/region of birth.

European age-standardised rates (EASRs) and standardised mortality ratios (SMRs) for all-cause mortality, with and without COVID-19-related deaths. Linear regressions were used to assess mortality trends over time.

Mortality patterns varied significantly by country/region of birth. While most migrant groups had lower mortality rates than the native-born population at the beginning of the study period, this advantage declined for many in recent years. Migrants from Ireland, Scotland and Northern Ireland exhibited consistently worse mortality outcomes. Excluding COVID-19 deaths, 14 out of 19 migrant groups retained a mortality advantage, though trends indicate substantial heterogeneity. Some migrant groups, particularly from North and Central America and parts of Europe, showed improving mortality rates, whereas others, such as those from Bangladesh, converged towards native-born mortality levels.

Despite lacking data on individual-level factors (e.g. duration of residence, socio-economic status and co-morbidities), this national-level study demonstrates important trends in migrant mortality. The findings highlight the urgent need for improved data to capture migration-related variables and enable a deeper understanding of the drivers behind observed trends. The decline in migrant mortality advantage over time for some groups highlights the importance of monitoring structural health inequalities and can inform targeted public health policies and more granular future research.