Abstract
BackgroundThere are many immigrants in the Swedish workforce, but knowledge of their general and work-related health is limited. The aim of this register-based study was to explore whether documented migrant residents in Sweden have a different health status regarding receipt of a disability pension, mortality and hospitalization for lung, heart, psychiatric, and musculoskeletal disorders compared with the native population, and if there were variations in relation to sex, geographical origin, position on the labor market, and time since first immigration.MethodsThis study included migrants to Sweden since 1960 who were 28–47 years old in 1990, and included 243 860 individuals. The comparison group comprised a random sample of 859 653 native Swedes. These cohorts were followed from 1991 to 2008 in national registers. The immigrants were divided into four groups based on geographic origin. Hazard ratios for men and women from different geographic origins and with different employment status were analyzed separately for the six outcomes, with adjustment for age, education level, and income. The influence of length of residence in Sweden was analyzed separately.ResultsNordic immigrants had increased risks for all investigated outcomes while most other groups had equal or lower risks for those outcomes than the Swedes. The lowest HRs were found in the EU 15+ group (from western Europe, North America, Australia and New Zealand). All groups, except Nordic immigrants, had lower risk of mortality, but all had higher risk of disability pension receipt compared with native Swedes. Unemployed non-Nordic men displayed equal or lower HRs for most outcomes, except disability pension receipt, compared with unemployed Swedish men. A longer time since first immigration improved the health status of men, while women showed opposite results.ConclusionsEmployment status and length of residence are important factors for health. The contradictory results of low mortality and high disability pension risks need more attention. There is great potential to increase the knowledge in this field in Sweden, because of the high quality registers.
Highlights
There are many immigrants in the Swedish workforce, but knowledge of their general and work-related health is limited
Far less has been studied on the health status and health transformations of these groups, and there is very fragmentary knowledge of health related to immigration and labor market participation in Sweden as well as internationally
Since the main aim of the study was to examine the impact of employment/unemployment on health, we excluded all individuals who had any of the examined disorders, disability pension or death in 1990
Summary
There are many immigrants in the Swedish workforce, but knowledge of their general and work-related health is limited. Several studies have presented in detail the historic immigration from the extensive post-World War II labor migration, predominantly from other Nordic countries and Southern and Eastern Europe, through the increasingly restrictive policy following the oil crisis in the early 1970s, to the mainly refugee and family reunification immigration in recent decades, dominated by migrants of non-European and former Yugoslavian origin. These studies described the changing regulative policies [1,2,3]. It may vary in relation to gender, the reason for migration, geographical origin, age at migration, and time in the new country of residence
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