Socioeconomic disparity in mortality risks widened across generations during rapid economic development in Hong Kong: an age-period-cohort analysis from 1976 to 2010

Abstract

Purpose: Hong Kong has been one of the fastest growing postwar economies with substantial decline in mortality risks during the past decades. Nevertheless, it is unclear whether there is a socioeconomic disparity in the trends of mortality risks across generations. Methods: We conducted a series of sex-specific age-period-cohort analyses by neighborhood-level socioeconomic status (SES) using mortality data from 1976 to 2010 to examine the socioeconomic disparity of cohort effects. Outcomes included all-cause mortality and mortality from ischemic heart disease, other cardiovascular diseases (CVD), lung cancer, other cancers, respiratory diseases (RD), other medical causes, and external causes. Results: Age-standardized mortality rates declined in both sexes, with generally higher rates observed in those of lower SES. Socioeconomic disparity in the risks of all mortality outcomes emerged and widened starting from cohorts born around the 1930s-1940s. These results suggested that mortality risks associated with lower SES did not decline across generations as much as those associated with higher SES. Conclusions: The share of health benefits brought by economic growth was notably unequal by SES with greater benefits for those of higher SES. More attention should be paid to postwar baby boomers of lower SES.