Groups In Sweden Research Articles

Cardiorespiratory Fitness in Occupational Groups—Trends over 20 Years and Future Forecasts

Background: Reports have indicated a negative trend in cardiorespiratory fitness (CRF) in the general population. However, trends in relation to different occupational groups are missing. Therefore, the aim of our study was to examine the trends in CRF during the last 20 years, and to provide a prognosis of future trends in CRF, in different occupational groups of Swedish workers. Methods: Data from 516,122 health profile assessments performed between 2001 to 2020 were included. CRF was assessed as maximal oxygen consumption and was estimated from a submaximal cycling test. Analyses include CRF as a weighted average, standardized proportions with low CRF (<32 mL/min/kg), adjusted annual change in CRF, and forecasting of future trends in CRF. Results: There was a decrease in CRF over the study period, with the largest decrease in both absolute and relative CRF seen for individuals working in administrative and customer service (−10.1% and −9.4%) and mechanical manufacturing (−6.5% and −7.8%) occupations. The greatest annual decrease was seen in transport occupations (−1.62 mL/min/kg, 95% CI −0.190 to −0.134). Men and younger individuals had in generally a more pronounced decrease in CRF. The proportion with a low CRF increased, with the greatest increase noted for blue-collar and low-skilled occupations (range: +19% to +27% relative change). The forecast analyses predicted a continuing downward trend of CRF. Conclusion: CRF has declined in most occupational groups in Sweden over the last two decades, with a more pronounced decline in blue-collar and low-skilled occupational groups.

Drinking and acquisition of unrecorded alcohol across educational groups in Sweden.

It is estimated that 18.5% of total alcohol consumption in Sweden in 2018 was unrecorded. However, little is known about the socio-economic profile of consumers of unrecorded alcohol. The aim of this study was to elucidate this issue by analysing data from a unique Swedish national repeated cross-sectional alcohol use survey. Individual-level information on alcohol consumption and socio-economic status (SES) for the years 2013-2018 was retrieved from the Monitoring Project; a nationally representative monthly alcohol use survey. The analytical sample comprised 64 375 respondents aged 25-74 years. SES was measured by educational level. We used three educational groups: (i) low (<10 years); (ii) intermediate (10-12 years); and (iii) high (13+ years). We included indicators of the following sources of unrecorded alcohol consumption: travellers' import, smuggled alcohol, home production, internet and illicit home-distilling. We estimated adjusted SES-specific means of the various forms of unrecorded consumption. The means were adjusted for the effects of age, sex and region. There were no significant educational differences in the total of unrecorded alcohol consumption; the same holds true for home-production and internet. However, with respect to smuggled and home-distilling, a statistically significant educational gradient was observed with the lowest educational group scoring approximately four times higher than the highest. Our findings suggest that there are no differences across educational groups in the consumption of unrecorded alcohol as a whole. However, consumption of smuggled alcohol and illicitly distilled spirits is elevated in the low educational group.

Sharing is daring, but is it sustainable? An assessment of sharing cars, electric tools and offices in Sweden

The sharing economy has emerged as a potential way to reduce the environmental impact and costs of using products, whilst increasing their accessibility. However, there is a paucity of literature on its sustainability implications. To help fill this void we provide a first indicative assessment of the potential sustainability implications for the sharing of three product groups in Sweden, namely cars, small electrical tools and offices. A quantitative assessment of Greenhouse Gas (GHG) emissions, resource use and waste based on case studies, is used as a basis to develop scenarios of upscaling sharing at national level. This is combined with a qualitative scoring framework to assess the socio-economic impacts. Office sharing was found to have a significant potential to reduce GHG emissions by 164–243 KtCO2e/yr. Car sharing has a larger potential but has a wide range of uncertainty with potential reductions of 0.5–3.7 MtCO2e (if 80% of cars in Sweden were sharing cars), depending on how many owned cars are replaced by a shared vehicle. However, 80% ownership of battery electric vehicles offer a greater potential benefit with a saving of up to 8.2 MtCO2e. In terms of the reduction in material use, there are potential savings of 232,000 t/yr and 24.4-34.4Mt/yr for cars and offices, respectively. However, the tool sharing case does not demonstrate such large potential for national reductions. The qualitative analysis on socio-economic implications showed largely positive results across the indicators. However, further research is needed to assess the impacts on jobs and the local economy for the shared product groups, and to more fully understand how shared offices effect health and well-being of users. Finally, to avoid potential rebound effects additional support is needed to promote electric cars to avoid fleets of fossil fuel cars with high emissions, a flexible stock of desks without large empty office spaces, and proximity of tool sharing to minimise transport.

Clinical Priority Setting and Decision-Making in Sweden: A Cross-sectional Survey Among Physicians.

Priority setting in healthcare that aims to achieve a fair and efficient allocation of limited resources is a worldwide challenge. Sweden has developed a sophisticated approach. Still, there is a need for a more detailed insight on how measures permeate clinical life. This study aimed to assess physicians' views regarding (1) impact of scarce resources on patient care, (2) clinical decision-making, and (3) the ethical platform and national guidelines for healthcare by the National Board of Health and Welfare (NBHW). An online cross-sectional questionnaire was sent to two groups in Sweden, 2016 and 2017. Group 1 represented 331 physicians from different departments at one University hospital and group 2 consisted of 923 members of the Society of Cardiology. Overall, a 26% (328/1254) response rate was achieved, 49% in group 1 (162/331), 18% in group 2 (166/923). Scarcity of resources was perceived by 59% more often than 'at least once per month,' whilst 60% felt less than 'well-prepared' to address this issue. Guidelines in general had a lot of influence and 19% perceived them as limiting decision-making. 86% professed to be mostly independent in decision-making. 36% knew the ethical platform 'well' and 'very well' and 64% NBHW's national guidelines. 57% expressed a wish for further knowledge and training regarding the ethical platform and 51% for support in applying NBHW's national guidelines. There was a need for more support to deal with scarcity of resources and for increased knowledge about the ethical platform and NBHW's national guidelines. Independence in clinical decision-making was perceived as high and guidelines in general as important. Priority setting as one potential pathway to fair and transparent decision-making should be highlighted more in Swedish clinical settings, with special emphasis on the ethical platform.

How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography.

In an increasingly interconnected world, the demographic effects of wars are not confined only to war zones and neighbouring areas; wars and conflicts may also change populations far away. Without the war in Syria under President Assad and the associated mass exodus of Syrian refugees, the population trends in distant countries like Sweden and Norway over the last few years would have been different. We create hypothetical scenarios of the population developments in Sweden and Norway without a war in Syria from 2011 onwards, where excess immigration due to the war and associated excess births are removed. The results indicate that population growth in 2016 would have been roughly 36% lower in Sweden and 26% lower in Norway without the Syrian war. The number of births in 2017 would have been about 3% lower in Sweden and 1% lower in Norway. One in ten municipalities would have had a population decline in 2016 instead of a population increase, and the largest immigrant group in Sweden by January 2019 would still be of Finnish origin.

Socio-economic disparities in the dispensation of antibiotics in Sweden 2016-2017: An intersectional analysis of individual heterogeneity and discriminatory accuracy.

Aims: Antimicrobial resistance presents an increasingly serious threat to global public health, which is directly related to how antibiotic medication is used in society. Actions aimed towards the optimised use of antibiotics should be implemented on equal terms and according to the needs of the population. Previous research results on differences in antibiotic use between socio-economic and demographic groups in Sweden are not entirely coherent, and have typically focused on the effects of singular socio-economic variables. Using an intersectional approach, this study provides a more precise analysis of how the dispensation of antibiotic medication was distributed across socio-economic and demographic groups in Sweden in 2016–2017. Methods: Using register data from a nationwide cohort and adopting an intersectional analysis of individual heterogeneity and discriminatory accuracy, we map the dispensation of antibiotics according to age, sex, country of birth and income. Results: While women and high-income earners had the highest antibiotic dispensation prevalence, no large differences in the dispensation of antibiotics were identified between socio-economic groups. Conclusions: Public-health interventions aiming to support the reduced and optimised use of antibiotics should be directed towards the whole Swedish population rather than towards specific groups. Correspondingly, an increased focus on socio-economic or demographic factors is not warranted in interventions aimed at improving antibiotic prescription patterns among medical practitioners.

Appearance of IgG to SARS-CoV-2 in Saliva Effectively Indicates Seroconversion in mRNA Vaccinated Immunocompromised Individuals

Background: mmunocompromised individuals are highly susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Whether vaccine-induced immunity in these individuals involves the oral cavity, a primary site of infection, is presently unknown.Methods: Immunocompromised individuals (n=404) and healthy controls (n=82) participated in a prospective clinical trial encompassing two doses of the mRNA BNT162b2 vaccine. Immunocompromised individuals included primary immunodeficiencies (PID) and secondary immunodeficiencies caused by human immunodeficiency virus (HIV) infection, allogeneic hematopoietic stem cell transplantation (HSCT)/chimeric antigen receptor T cell therapy (CAR-T), solid organ transplantation (SOT), and chronic lymphocytic leukemia (CLL). Saliva and serum samples were collected at four time points from the first vaccine dose until 2 weeks after second dose. SARS-CoV-2 spike specific immunoglobulin G (IgG) responses were quantified by a multiplex bead-based assay in saliva and correlated to paired serum IgG titers determined by Elecsys Anti-SARS-CoV-2 S assay.Results: IgG responses to the SARS-CoV-2 spike full-length tr­imeric glycoprotein (Spike-f) and S1 subunit in saliva in the HIV and HSCT/CAR-T groups were comparable to healthy controls. In contrast, PID, SOT, and CLL patients all displayed weaker responses which were mainly influenced by disease parameters or immunosuppressants. Salivary IgG levels strongly correlated with serum IgG titers on days 21 and 35 (rho=0.8079 and 0.7768, p=Conclusions: Saliva conveys humoral responses induced by BNT162b2 vaccination. The predictive power makes it highly suitable for screening low responding/vulnerable groups for revaccination.Funding: Knut and Alice Wallenberg Foundation, Erling Perssons family foundation, Region Stockholm, Swedish Research Council, Karolinska Institutet, The Swedish Blood Cancer Foundation and the organization for PID patient group in Sweden, and Nordstjernan AB. Center for Medical Innovation (CIMED), the Swedish Medical Research Council and the Stockholm County Council (ALF).Declaration of Interests: The authors have declared that no conflict of interest exists.Ethics Approval Statement: The study was approved by the Swedish Medical Product Agency (ID 5.1-2021-5881) and the Swedish Ethical Review Authority (ID 2021-00451 and 2020-06381). All participants provided written informed consent. Trial Registration: This trial was registered at EudraCT (no. 2021-000175-37), and clinicaltrials.gov (no. 2021-000175-37).

The Wallenberg financial and industrial group in Sweden’s foreign policyduring the World War II

The Wallenberg financial and industrial group in Sweden’s foreign policyduring the World War II

Profissionais de Educação Infantil na Suécia: limites e possibilidades de compartilhamento de tarefas entre homens e mulheres

Este artigo tem como objetivo principal problematizar a divisão do trabalho pedagógico entre homens e mulheres que atuam em pré-escolas na Suécia. Nesse sentido, busca-se refletir sobre como as responsabilidades e tarefas são divididas a partir do gênero dos profissionais no cotidiano das pré-escolas. Dessa forma, utiliza-se como principal referencial teórico a categoria de “gênero”, a partir dos estudos de Judith Butler. Para tanto, parte-se de uma investigação mais ampla, realizada em duas instituições educacionais e cujo escopo da investigação se constituiu de nove profissionais, sendo sete mulheres e dois homens. Por meio da observação sistemática do cotidiano laboral desses profissionais, e apoiados nos estudos de gênero, os resultados apontaram que não há uma paridade no que diz respeito à na divisão de tarefas e práticas realizadas pelos profissionais investigados, visto que as mulheres trazem mais para si a responsabilidade de estabelecer normas e regras com as crianças.

Impacted family equality, self-confidence and loneliness: a cross-sectional study of first-time and multi-time fathers' satisfaction with prenatal and postnatal father groups in Sweden.

Fathers often feel secondary or invisible in traditional parent groups. Gender-specific parent groups, referred to as father groups, may be inclusive spaces for fathers to discuss their transition into parenthood. To quantitatively assess fathers' perceptions and satisfaction of father groups in Sweden during the prenatal and postnatal periods. A cross-sectional quantitative study design was used to report fathers' satisfaction of father groups, including how the groups impacted their personal outcomes, as well as their relationship with their partner and child. Further analyses were completed on if their depressive symptoms, via EPDS, and/or parity affected their satisfaction and personal outcomes. Fathers were recruited through father group leaders, who then provided the researchers with their contact information. In total, 87 fathers were contacted via email and 67 fathers from two geographical areas, including urban and suburban settings, completed the survey. Most fathers had a university education, a good household economy and were married/cohabiting, while almost 60% were first-time fathers and almost 25% had depressive symptoms. Overall, fathers were generally satisfied with both the prenatal and postnatal father groups, although fathers attended prenatal father groups to a lesser extent. The participants rated the father groups as moderately impacting their equality in the family, self-confidence, feelings of loneliness, social network and being able to express their own opinions, as well as positively affected their relationship with their partner and child, respectively. While there were no differences based on fathers' parity, those who self-estimated depressive symptoms were less satisfied and rated the father groups less impactfully. Father groups may help encourage fathers to meet policy goals, such as childrearing equality, and can be an important arena for screening fathers for depression.

Moving Evidence: Patients’ Groups, Biomedical Research, and Affects

Research in science and technology studies has analyzed how patients’ groups engage in practices that connect biomedicine and patient experience in order to become involved in the shaping of biomedical research. However, there has been limited attention to the affective dimensions of such practices. Based on ethnographic fieldwork with a gynecological cancer patients’ group in Sweden, this article focuses on practices that aim to influence researchers and research institutions to prioritize biomedical gynecological cancer research. It analyzes how “affects” are woven through these practices and pays attention to the entanglements of affects, biomedical research, and lay experience they involve. The article explores the relation between the gynecological cancer patients’ group and biomedical research as a set of material-semiotic practices of “moving evidence.” These practices of moving evidence (1) enact gynecological cancer as under-researched; (2) collect and produce new “evidence”; (3) “mobilize” the evidence at public events, in interactions with biomedical researchers, and in different online settings; and (4) entangle affects with biomedical and experiential evidence to enact (a lack of) gynecological cancer biomedical research as a matter of concern.

Multiple sclerosis among first‐ and second‐generation immigrant groups in Sweden

Risk of multiple sclerosis (MS) is low among first-generation immigrants in Sweden. We aimed to study incident MS in first- and second-generation immigrant groups. We included adults aged 18years and older in Sweden in first-generation (n=6042891) and second-generation (n=4860469) sub-studies. MS was defined via two diagnoses in the Swedish National Patient Register. MS risk was estimated by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI), in different immigrant groups, using Swedish-born as referents in first-generation sub-study, and individuals with Swedish-born parents in the second-generation. Full models were adjusted for age, geographic residence in Sweden, educational level, marital status, neighborhood socioeconomic status, and co-morbidity. MS was diagnosed among 10746 individuals in the first-generation sub-study, (men 3055 and women 7691), and 11737 in the second-generation sub-study (men 3549 and women 8188) in the period 1998-2015. The annual incidence rate was higher in Swedish-born compared to foreign-born, 11.5 vs 6.3 per 100000 person-years (age-standardized to the European standard population). Fully adjusted HRs were lower in first-generation immigrant men (HR 0.72, 0.64-0.82) and women (HR 0.67, 0.62-0.73), and in second-generation immigrant men (HR 0.88, 0.79-0.97) and women (HR 0.79; 0.73-0.84). Among first-generation immigrants, lower HRs were found in most groups. The MS risk was lower in first- and second-generation immigrants compared to Swedish-born or individuals with Swedish-born parents.

Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial

ABSTRACT Arabic-speaking immigrants and refugees constitute one of the largest immigrant groups in Sweden. Previous research on Arabic-speaking immigrants indicates elevated levels of psychological disorders, including depression and anxiety. The aim of the present pilot study was to examine the efficacy of an internet-delivered cognitive behavioural treatment (ICBT) in an Arabic-speaking immigrant population. The intervention was individually tailored based on self-described problems and consisted of nine modules targeting areas such as depression, anxiety and insomnia. In total, 59 individuals were included and randomized to either an 8-week treatment or wait-list control. Self-reported symptoms of depression on the PHQ-9 were used as primary outcome measure. Secondary outcome measures of anxiety, stress, insomnia, quality of life and post-traumatic stress were also used. In the intention-to-treat analysis, depressive symptoms were significantly reduced compared to the wait-list control group with a between-group effect at post-treatment of Cohen’s d = 0.85 [0.29, 1.41]. We also found significant between-group effects for symptoms of insomnia and stress, but not for anxiety, post-traumatic stress or quality of life measures. The results indicate that ICBT is a promising treatment approach for treating symptoms of depression, insomnia and stress, in an Arabic-speaking immigrant population. Further studies with larger samples are warranted.

‘The Swedish Strategy’ to COVID-19 Pandemic:Impact on Vulnerable and Marginalised Communities

All around the world the COVID-19 pandemic is having an enormous impact on people’s lives. Contrary to many other countries, Sweden has opted against lockdown. The Swedish Government has put trust in its people and has advised them to be responsible and follow the recommendations and guidelines of the Public Health Agency of Sweden. Using the Interest Theory of Rights, this article discusses the impact of the Swedish response to COVID-19 on three different Swedish communities, and considers the implications of such a strategy on social development. Data was collected from different national and international media sources as well as from Swedish authorities’ websites. A qualitative content analysis was used to analyse the data with the help of ATLAS-ti.8.4. The findings section discusses how three community groups in Sweden—the elderly, immigrants from marginalised areas and prisoners—are having their rights altered during this pandemic period. It also outlines different social development approaches being used in Sweden for tackling the challenges relating to the COVID-19 pandemic. This article concludes that a strong democratic state is vital in managing a pandemic such as COVID-19. It also argues that the strength of a state largely depends on its citizens’ willpower to take ownership of responsibilities—both individually and collectively.

Who Are ‘We’ in a Nuclear Disaster?

This article explores a major but largely forgotten event at the intersection of the environmental movement and the movement of independent theatre groups in Sweden. Eko-positivet, a ritualistic mass-performance about nuclear power, was performed in Stockholm in May 1977 by 300-400 participants in front of around 4 000 spectators. In contrast to the discourse on class that dominated the political theatre of the time, the mass-spectacle enacted other kinds of collective, political identities, e.g. populist and biological ones. The established independent theatre groups did not participate in the event. In the article, it is argued that this reluctance can be explained by conflicting views on the political ‘we’.

“…of immediate use to society”. On Folklorists, Archives and the Definition of “Others”

This article focuses on archival collections relating to so-called “tattare” and “zigenare” (roughly translated as “tinkers” and “gypsies”) created by Swedish folklore scholars during the twentieth century, and how these scholars influenced politics and interventions regarding these categories. It addresses questions regarding the production of knowledge about these categories and the contexts, structures and actors that have created the basis for these kinds of collections. Special focus has been placed on works by the folklore scholars Carl-Martin Bergstrand and Carl-Herman Tillhagen, and collections at the Institute for Language and Folklore, Department of Dialectology, Onomastics and Folklore Research and the Nordic Museum. By unfolding the networks of Bergstrand and Tillhagen and following the traces of their work to other archives, the article highlights some of the political and monitoring dimensions of archival practices in relation to minority groups in Sweden.

Moving Spaces: Mapping the Drama Room as Heterotopia

This article is aimed at exploring the political characteristics of the drama space, which reflects, juxtaposes, and opposes particular sites in a participant’s everyday life, such as the school. By putting spatial theories to work, this article investigates the drama space belonging to an all-girls community group in Sweden, participation in which is voluntary and where the artistic work produced relies on a democratic process, with the girls’ input being vital. I conceptualise the drama room as a heterotopia that functions as an exclusive and excluding space as a well as a space of resistance. Based on interviews with the girls, this ethnographic study challenges the conventional notion that applied drama is only an interrelational matter between the drama participants. By examining the drama room’s role as the ‘other place’ in the girls’ everyday lives while being connected to ‘everyday’ places, this article demonstrates the drama room as an important space for the girls to have agency, there and elsewhere. When placing space and place in the foreground, a ‘dramaspaceknowledge’ emerges, the influence of which stretches beyond the drama room. This article argues that the girls’ dramaspaceknowledge is utilised when creating a performance and while challenging structures and norms elsewhere, such as in their schools and communities.

The national implementation of VAT Grouping in Sweden

This chapter deals with VAT groups in Sweden. Sweden introduced rules on VAT groups in 1998. The first groups were founded in 1999. In Sweden, only certain categories of entities may form VAT groups. VAT groups are mainly to be found in the financial and insurance sectors. Also, entities which are commission agents and principals, and which have a commission link such as that referred to in Chapter 36 of the law on income tax may form VAT groups. The reason not to extend the possibility to form VAT groups to all groups of companies was that the state otherwise would lose too much revenue. This limitation to only certain categories of entities is a feature that really stands out regarding Swedish VAT groups from a comparative perspective.

Improved Wellbeing for Both Caretakers and Users from A Zoo-Related Nature Based Intervention-A Study at Nordens Ark Zoo, Sweden.

Nature-based interventions have been proposed to promote physical and mental health and give stress reduction. Little attention has been given to the potential of zoos for human health and wellbeing. A disadvantaged group in Sweden regarding access to nature are individuals with disabilities who consequently do not have the same access to these health benefits as other groups. To increase awareness and knowledge regarding spending time in nature and with animals, courses directed at caretakers for persons with disabilities and their users were held at Nordens Ark, a zoo in Sweden. To explore if the courses had led to increased nature activities, and if participating in the courses had affected caretakers’ and their users’ health and wellbeing, questionnaires and interviews for evaluating the courses were used. The results showed improved quality in nature visits because of course participation as well as positive effects for the wellbeing, sustainability for the caregivers and users in their working lives, and relationships were positively affected. The conclusion from this study is that nature and animal-based education should be more frequent to provide opportunities for a disadvantaged group to have the positive effects of nature of which most other groups have obvious access to.

Substance use disorders in refugee and migrant groups in Sweden: Anationwide cohort study of 1.2 million people.

Refugees are at higher risk of some psychiatric disorders, including post-traumatic stress disorder (PTSD) and psychosis, compared with other non-refugee migrants and the majority population. However, it is unclear whether this also applies to substance use disorders, which we investigated in a national register cohort study in Sweden. We also investigated whether risk varied by region of origin, age at migration, time in Sweden, and diagnosis of PTSD. Using linked Swedish register data, we followed a cohort born between 1984 and 1997 from their 14th birthday or arrival in Sweden, if later, until an International Classification of Diseases, 10th revision (ICD-10), diagnosis of substance use disorder (codes F10.X-19.X), emigration, death, or end of follow-up (31 December 2016). Refugee and non-refugee migrants were restricted to those from regions with at least 1,000 refugees in the Swedish registers. We used Cox proportional hazards regression to estimate unadjusted and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) in refugee and non-refugee migrants, compared with Swedish-born individuals, for all substance use disorders (F10.X-19.X), alcohol use disorders (F10.X), cannabis use disorders (F12.X), and polydrug use disorders (F19.X). In adjusted analyses, we controlled for age, sex, birth year, family income, family employment status, population density, and PTSD diagnosis. Our sample of 1,241,901 participants included 17,783 (1.4%) refugee and 104,250 (8.4%) non-refugee migrants. Refugees' regions of origin were represented in proportions ranging from 6.0% (Eastern Europe and Russia) to 41.4% (Middle East and North Africa); proportions of non-refugee migrants' regions of origin ranged from 11.8% (sub-Saharan Africa) to 33.7% (Middle East and North Africa). These groups were more economically disadvantaged at cohort entry (p < 0.001) than the Swedish-born population. Refugee (aHR: 0.52; 95% CI 0.46-0.60) and non-refugee (aHR: 0.46; 95% CI 0.43-0.49) migrants had similarly lower rates of all substance use disorders compared with Swedish-born individuals (crude incidence: 290.2 cases per 100,000 person-years; 95% CI 287.3-293.1). Rates of substance use disorders in migrants converged to the Swedish-born rate over time, indicated by both earlier age at migration and longer time in Sweden. We observed similar patterns for alcohol and polydrug use disorders, separately, although differences in cannabis use were less marked; findings did not differ substantially by migrants' region of origin. Finally, while a PTSD diagnosis was over 5 times more common in refugees than the Swedish-born population, it was more strongly associated with increased rates of substance use disorders in the Swedish-born population (aHR: 7.36; 95% CI 6.79-7.96) than non-refugee migrants (HR: 4.88; 95% CI 3.71-6.41; likelihood ratio test [LRT]: p = 0.01). The main limitations of our study were possible non-differential or differential under-ascertainment (by migrant status) of those only seen via primary care and that our findings may not generalize to undocumented migrants, who were not part of this study. Our findings suggest that lower rates of substance use disorders in migrants and refugees may reflect prevalent behaviors with respect to substance use in migrants' countries of origin, although this effect appeared to diminish over time in Sweden, with rates converging towards the substantial burden of substance use morbidity we observed in the Swedish-born population.