Mortality and the Wealth Gradient in Western Africa

Julia Callaway , Interdisciplinary Centre On Population Dynamics, University Of Southern Denmark
Carlos Ruimallo-Herl, Erasmus University Rotterdam
Angela Chang, Danish Institute for Advanced Study

Background: In high-income countries, there is a 10+ year gap in life expectancy between the richest and poorest percentiles. In low- and middle-income countries, little is known about the rates and trends in socioeconomic inequalities in mortality. The aim of this study is to estimate age-specific mortality rates by wealth quintile in Western Africa, over time. Methods: We used sibling survival data from the DHS and MICS from 2000 onwards for 15 Western African countries. Wealth quintiles were assumed to be the same as the survey participant. We estimated mortality rates for siblings aged 15-49 by calculating number of deaths in each age group and wealth quintile divided by the number of person years of exposure. Preliminary results: Preliminary analyses were conducted using 2019 DHS for Sierra Leone to analyze mortality from 2012-2019. Among those aged 15-24 and women aged 25-34, the second lowest wealth quintile had the highest mortality rates. For men aged 25-34, mortality rates two lowest wealth quintiles overlapped. Among those aged 35-44, mortality rates followed the wealth gradient for men, while for women mortality rates followed the wealth gradient, with the exception of the second lowest wealth quintile, which had the lowest mortality in this age group. Discussion: It was unexpected that those in the second lowest wealth quintile had the highest mortality for those aged 15-24, and for women aged 25-34. These results show that the association between wealth and mortality is not always clear in LMICs, and further research is needed in this area.

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 Presented in Session P2. Health, Mortality, Ageing - Aperitivo