Socio-economic status and long-term mortality differentials among Mozambican self-settled refugees and the host population in rural South Africa: insights from population-based surveillance, 1994-2018

Abstract

OP 30: Refugees and Asylum Seekers 5, B308 (FCSH), September 4, 2025, 16:00 - 17:12

Mortality differentials reflect significant variations in health outcomes across populations and are essential for understanding public health dynamics. Understanding how mortality affects diverse groups including refugees over time is important for population health interventions. Our study examined mortality differentials and causes of death among self-settled refugees and the host population in Agincourt and how socio-economic status influences these patterns. We used data from the Agincourt (1994-2018) and Manica (1998-2018) Health and Demographic Surveillance System. We used discrete-time event history analysis to estimate the probability of dying between different sub-groups and assessed how these mortality differentials varied over time and by cause of death. Mozambican non-migrants in Manica had the highest probability of dying across all ages when compared to Mozambican migrants and self-settled refugees in Agincourt. However, the probability of dying for Mozambican self-settled refugees was higher across all ages than their counterparts in Agincourt. Overall, self-settled refugees had the highest risk of dying from every major cause of death group. Also, socio-economic status has a strong influence on mortality. It is therefore prudent that interventions to reduce mortality differentials for disadvantaged groups are specifically targeted towards refugees and individuals from lower socio-economic strata while focusing on access to antiretroviral treatment.