Canadian census mortality follow-up study, 1991 through 2001

Abstract Background An important step in monitoring progress toward reducing or eliminating inequalities in health is to determine the distribution of mortality rates across various groups defined by education, occupation, income, language, ethnicity, and Aboriginal, visible minority and disability status. This article describes the methods used to link census data from the long-form questionnaire to mortality data, and reports simple findings for the major groups. Data and methods Mortality from June 4, 1991 to December 31, 2001 was tracked among a 15% sample of the adult population of Canada, who completed the 1991 census long-form questionnaire (about 2.7 million, including 260,000 deaths). Age-specific and age-standardized mortality rates were calculated across the various groups, as were hazard ratios and period life tables. Results Compared with people of higher socio-economic status, mortality rates were elevated among those of lower socio-economic status, regardless of whether status was determined by education, occupation or income. The findings reveal a stair-stepped gradient, with bigger steps near the bottom of the socio-economic hierarchy