Abstract
BackgroundPrevious research has generally found lower rates of injury incidence in immigrant populations than in native-born populations. Most of this literature relies on mortality statistics or hospital data, and we know less about injuries treated in primary health care. The aim of the present study was to assess use of primary and secondary care for treatment of injuries among immigrants in Norway according to geographic origin and type of injury.MethodsWe conducted a nationwide register-based cohort study of all individuals aged 25–64 years who resided in Norway as of January 1st 2008. This cohort was followed through 2014 by linking sociodemographic information and injury data from primary and secondary care. We grouped immigrants into six world regions of origin and identified immigrants from the ten most frequently represented countries of origin. Six categories of injury were defined: fractures, superficial injuries, open wounds, dislocations/sprains/strains, burns and poisoning. Poisson regression models were fitted to estimate incidence rate ratios separately for injuries treated in primary and secondary care according to immigrant status, geographic origin and type of injury, with adjustment for sex, age, county of residence, marital status and socioeconomic status.ResultsImmigrants had a 16% lower incidence of injury in primary care than non-immigrants (adjusted IRR = 0.84, 95% CI 0.83–0.84), and a 10% lower incidence of injury in secondary care (adjusted IRR = 0.90, 95% CI 0.90–0.91). Immigrants from Asia, Africa and European countries outside EU/EEA had lower rates than non-immigrants for injuries treated in both primary and secondary care. Rates were lower in immigrants for most injury types, and in particular for fractures and poisoning. For a subset of injuries treated in secondary care, we found that immigrants had lower rates than non-immigrants for treatment of self-harm, falls, sports injuries and home injuries, but higher rates for treatment of assault, traffic injuries and occupational injuries.ConclusionsHealth care utilisation for treatment of injuries in primary and secondary care in Norway was lower for immigrants compared to non-immigrants. Incidence rates were especially low for immigrants originating from Asia, Africa and European countries outside EU/EEA, and for treatment of fractures, poisoning, self-harm and sports injuries.
Highlights
Previous research has generally found lower rates of injury incidence in immigrant populations than in native-born populations
The immigrant population was generally younger, in particular for those originating from Africa and Asia, and more likely to be married compared with non-immigrants
Compared to non-immigrants, immigrants from all regions were more likely to reside in the capital of Oslo, especially for those originating from Africa and Asia
Summary
Previous research has generally found lower rates of injury incidence in immigrant populations than in native-born populations. Research in developed countries comparing injury risk between immigrants and their native-born counterparts has generally found lower incidence rates in immigrant populations (Schwebel et al 2005; Xiang et al 2007; Laursen and Moller 2009; Sandvik et al 2012; Norredam et al 2013; Karimi et al 2015; Saunders et al 2017; Chang and Miller 2018; Andersen and Lauritsen 2020; Aamodt et al 2020) This advantage occurs despite the presence of various risk factors that ordinarily correlate with worse health outcomes, like lower socioeconomic position (Mackenbach et al 2008). This general finding disguises considerable variation, as injury incidence in immigrant groups differs substantially according to factors such as region/country of origin, reason for migration, length of stay in the host country and type of injury (Laursen and Moller 2009; Sandvik et al 2012; Norredam et al 2013; Karimi et al 2015; Saunders et al 2017; Aamodt et al 2020; Saunders et al 2018)
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