Socio-economic status inequality and major causes of death in adults: a 5-year follow-up study in rural Vietnam

OBJECTIVES: This study aimed to analyse the associations between cause-specific mortality in adults (aged 20 years and above) and socio-economic status (SES) in a rural setting of Vietnam during a time of economic transition. STUDY DESIGN: The study was carried out as part of the FilaBavi demographic surveillance system, with a dynamic cohort of 50,000 inhabitants from January 1999 to December 2003. METHODS: Causes of death in the adult population were derived using verbal autopsy. A Cox regression model was employed to check the association of SES with three major causes of death: communicable diseases; non-communicable diseases; and injuries. RESULTS: The crude mortality rates were 9.2 and 6.6 per 1000 person-years in adult males and females, respectively. Men had higher mortality rates than women for all mortality categories and for all levels of education and household economic situation (HES). Mortality rates increased substantially with age, and showed similar age effects for all mortality categories with the strongest association for non-communicable diseases. Education was an important factor for survival in general, and high HES seemed to benefit men more than women. CONCLUSIONS: Interventions and policies to reduce exposure to risk factors for non-communicable diseases are needed in low-education groups. However, further study is needed to analyse the mortality inequity across all age groups.