298 Inequalities in all-cause mortality by ethnicity in the United Kingdom: a systematic review and meta-analysis

Abstract OP 35: Health Status 2, B210 (FCSH), September 5, 2025, 10:15 - 11:15 Aims To systematically review and meta analyse all-cause mortality by ethnicity in the United Kingdom (UK) and the contribution of socio-economic position (SEP) and country of birth to inequalities. Methods We searched Medline, Embase, Scopus and Web of Science from inception to 20/04/2024. We searched EThOs, Proquest and Google and contacted relevant investigators for unpublished data. We included studies conducted in the UK that measured all-cause mortality by ethnicity or its proxy such as country of birth. The White population provided the reference for comparison. Results We screened 7672 titles and abstracts and 211 full text articles and 32 were included. This included 10 unlinked Census and death registry studies, four Census-linked studies and 21 other cohort studies. We found lower relative age-adjusted all-cause mortality in females of Chinese, Indian, Pakistani, Bangladeshi, Black Caribbean ethnicity and mixed ethnicity (6-35% lower). There was also lower relative mortality in Chinese, Bangladeshi, Indian, Pakistani and Black Caribbean men (10-35% lower). There was 20% higher relative all-cause mortality in White Irish and White Scottish males and in White Scottish females There was weak evidence of mortality inequalities in Black African and Polish males and females, males of Mixed ethnicity and females of White Irish ethnicity. Evidence was equivocal about the role of SEP in these inequalities due to methodological concerns and heterogeneity between studies. There was equivocal evidence about mortality inequalities within ethnic groups by country of birth (UK-born vs overseas-born). The UK-born Black Caribbean population had higher relative mortality rate compared to the UK-born White British population (Relative Risk=1.49; 95% confidence interval – 0.98-2.28). Conclusions Inequalities in mortality by ethnic group demonstrated in this first, comprehensive meta-analysis were consistent and substantial but the contribution of SEP to observed inequalities and whether inequalities differed within ethnic groups by country of birth are unclear.