Abstract
Migrants suffer from worse psychological health than natives in many countries, yet the extent to which this varies by age at migration and duration of residence in the receiving context remains unexplored in Sweden. Drawing on a life course approach, we investigate differences in psychological distress by age at migration and duration of residence in working-age migrants to Sweden, and examine the role of various social determinants of health in explaining these differences relative to Swedish-born.Using pooled cross-sectional data from the 2011/2015 Health on Equal Terms survey in Västra Götaland Region, Sweden (n = 58,428), we applied logistic regression analysis to calculate predicted probabilities and average marginal effects (AME) of migrant status, by age at migration and duration of residence, on psychological distress. Analyses were stratified by sex and region of origin and controlled for indicators of socioeconomic status (SES), social cohesion, and discrimination to assess their potential contribution to differences in migrants' and natives' psychological distress.All migrants except men from OECD-predominant regions had a greater probability of psychological distress than Swedish-born (ranging from AME 0.031 [95% Confidence Interval or CI 0.000–0.062] for OECD women to AME 0.115 [95% CI 0.074–0.156] for non-OECD men). Marginal effects of migration status on psychological distress probabilities generally increased with age at migration and duration of residence. Differences between migrants and natives were largely attenuated after controlling for social determinants, the greatest contribution coming from inequalities in social cohesion, followed by inequalities in discrimination and SES.Our results suggest a relative health advantage of early-life compared to later-life migration, albeit with worse outcomes with longer residence in Sweden. The predominance of integration opportunities in childhood strengthens calls for supportive policies to assist older migrants' integration directly upon arrival, which may ultimately improve their psychological wellbeing.
Highlights
The healthy migrant paradox stipulates that international migrants experience better physical health than natives (Abraido-Lanza et al, 1999; Aldridge et al, 2018; Kennedy et al, 2015), yet findings for psychological health largely suggest a migrant disadvantage (Close et al, 2016)
We found a positive marginal effect of migrant status on the probability of psychological distress among men from Organization for Economic Cooperation and Development (OECD) regions (AME 0.030 [95% confidence intervals (CI) -0.003–0.063]; Table 2i, Model 1a)
This study examined differences in psychological distress by migrants' age at migration and duration of residence in Sweden, and whether such differences could be explained by various social determinants of health
Summary
The healthy migrant paradox stipulates that international migrants experience better physical health than natives (Abraido-Lanza et al, 1999; Aldridge et al, 2018; Kennedy et al, 2015), yet findings for psychological health largely suggest a migrant disadvantage (Close et al, 2016). In order to better understand these outcomes, migrant populations should be considered in relation to the timing of their migration, including their age at migration and duration of residence in the receiving country, as well as their experiences across sending, transit, and receiving contexts (Acevedo-Garcia et al, 2012) Together, these measures can help capture the health-modifying role of age- and duration-specific exposures to new contexts. Psychological distress is a useful measure to capture affective symptomologies of varying severity, from the sub-clinical to cases manifesting as psychiatric disorders (Mirowsky and Ross, 2003; Payton, 2009). It is effective for assessing population-wide patterns of poor
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
