Ethnic differences in ischaemic heart disease and stroke mortality in Mauritius between 1989 and 1994

Abstract

Objective. To measure ethnic differences in overall, cardiovascular, ischaemic heart disease and stroke mortality in the Republic of Mauritius. Design. Analysis of vital registration mortality data from 1989 to 1994 among Hindus, Muslims, Chinese and Creoles, aged 30–64 years, presented as age‐standardized mortality rates, proportional mortality ratios and standardized mortality ratios. Results. During the six year period of analysis 10 657 deaths were recorded in men and 5008 in women. Mortality rates from ischaemic heart disease in Mauritian men are above the average of those found elsewhere. Ischaemic heart disease mortality in women and stroke mortality in both sexes are among the highest recorded in the world. Due to large ethnic differences in overall mortality, which could not be explained by the uncertainty about the exact population size by ethnic group, proportional mortality ratios are an inadequate measure of differential mortality between ethnic groups. ‘Best’ estimates of standardized mortality ratios indicate that in comparison to Hindus as the ‘standard’ population: (i) Creole women have lower ischaemic heart disease (by 34%) and stroke (by 22%) mortality; (ii) Creole women have lower ischaemic heart disease mortality (by 19%); (iii) Muslim men have lower stroke mortality (by 51%) and similar ischaemic heart disease mortality; (iv) Chinese men and women have markedly lower ischaemic heart disease (by 48% and 70%, respectively) and stroke mortality (by 54% and 48%, respectively). Conclusion. The mortality rates of ischaemic heart disease and stroke of all ethnic groups in Mauritius, with the exception of the small Chinese ethnic minority, are very high by international standards. This pleads against differential allocation of resources for prevention strategies despite considerable differences in mortality rates from cardiovascular diseases between ethnic groups.