Background and Purpose— Low socioeconomic status has been linked to high incidence of stroke in industrialized countries; therefore, reducing socioeconomic disparities is an important goal of health policy. The evidence on migrant groups is, however, limited and inconsistent. We assessed socioeconomic inequalities in relation to stroke incidence among major ethnic groups in the Netherlands. Methods— A nationwide register-based cohort study was conducted (n=2 397 446) between January 1, 1998, and December 31, 2010, among ethnic Dutch and ethnic minority groups. Standardized disposable household income was used as a measure of socioeconomic position. Results— Among ethnic Dutch, the incidence of stroke was higher in the low-income group than in the high-income group (adjusted hazard ratio, 1.18; 95% confidence interval, 1.16–1.20). Similar socioeconomic inequalities in stroke incidence were found among Surinamese (1.36; 1.17–1.58), Indonesians (1.15; 1.03–1.28), Moroccans (1.54; 0.97–2.43), Turkish (1.19; 0.97–1.46), and to a lesser extent among Antilleans (1.24; 0.84–1.84). When compared with ethnic Dutch, the incidence of stroke was lower in Moroccans, similar in Turkish, but higher in Surinamese among all income groups. The incidence of stroke was higher in Indonesian low- and high-income groups than in their ethnic Dutch counterparts. Among Antilleans, the risk of stroke was higher than ethnic Dutch but only in the low-income group. Conclusions— Our findings reveal socioeconomic inequalities in stroke incidence among all ethnic groups. Reduction of socioeconomic inequalities in stroke incidence among all ethnic groups may lead to a major public health improvement for all. Policy measures tackling socioeconomic inequalities should take into account the increased risk of stroke among ethnic minority populations.

Background Differences in acute myocardial infarction (AMI) incidence between migrants and the host population have been reported. Incidence may converge towards the host population over generations. We assessed whether AMI incidence differences between migrants and ethnic Dutch exist, and whether they converge towards ethnic Dutch over generations. Methods A nationwide register-based cohort study was conducted (n=7,601,785) from 1997 to 2007. Using Cox Proportional Hazard Models, AMI incidence differences between migrant groups and ethnic Dutch were estimated. If possible, analyses were stratified by generation. Results AMI incidence differences between migrants and ethnic Dutch depended on the migrant’s country of origin, and often varied between migrant groups originating from the same geographical region. For example, among North African and Mediterranean migrants, incidence was higher in Turkish (Hazard Ratio (HR):1·34;1·28-1·41), but lower in Moroccan migrants (HR:0·46;0·40-0·52) compared with ethnic Dutch. Most migrant groups had a similar or lower incidence than ethnic Dutch, which converged towards or exceeded the incidence in ethnic Dutch over generations. This was most profound in Polish and Chinese migrants (first generation Chinese: HR:0·51;0·42-0·62, second generation Chinese: HR:1·36;0·90-2·04). Conclusions Health care professionals and policy makers should be aware of substantial AMI incidence differences between migrant groups and the host population, and the often unbeneficial change over generations, most striking in some of Europe’s most expanding migrant groups (Polish, Chinese). Future research should be cautious when clustering migrant groups based on geographical region of the country of origin.