Abstract
BackgroundHigh rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers.MethodsGender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort.ResultsThe risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population.ConclusionThe risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.
Highlights
High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse
This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers
The data is maintained at the Centre for Health Equity Studies (CHESS), SE-106 91 Stockholm, Phone: +46 8 16 20 00
Summary
Studies of young refugees in Scandinavia have demonstrated a high risk of mental health problems shortly after resettlement, such as anxiety, PTSD, sleeping disturbance, etc.; which result from their psychosocial life context associated with their status as refugees. Socioeconomic vulnerability in the destination country has been identified as a major pathway to drug related crime and hospital care due to substance misuse among immigrants in Scandinavia and in refugees in particular This issue have been associated with factors such as long-term unemployment and living in low status neighborhoods, characterized by high levels of criminality, poor housing quality and deficient public services[6, 8,9,10,11]. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers
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