Language-group mortality differentials in Finland in 1988-2004: assessment of the contribution of cause of death, sex and age

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The higher mortality among Finnish-speaking than Swedish-speaking Finns is well established and has been shown to be very persistent. However, the most recent comprehensive documentation on the language-group differential extends only to the mid-1980s. We study recent trends in sex- and age-specific language-group mortality from 1988 to 2004, focusing on the relative contribution of the main causes of death and differences in sociodemographic structure. The register data are based on an 11% sample of Finns aged > or =30 years at the end of 1987--which further includes an oversample of deaths covering 80% of all deaths in the period 1988-2004. Finnish-speaking men had 19% and women 11% higher age-adjusted mortality rates than the Swedish speakers. Further adjustments for sociodemographic composition explained 47% and 36%, respectively, of these differences. Age group-specific analyses showed the steepest differences in the young and middle-aged groups (30-49 years) in both men and women. The cause-specific differences were most pronounced in alcohol-related diseases, suicide and other external causes, for which a slight increase in differentials was also observed. The relative difference in mortality between the two main language groups in Finland persists, with a slight narrowing of the gap among women. Moreover, the largest differences and indications of diverging trends were found among the youngest age groups. The causes of death in which the difference is greatest highlight the importance of health-related behaviour and cultural differences in lifestyle.