Misclassified Maternal Deaths among East African Immigrants in Sweden

Elebro, Karin; Rööst, Mattias; Moussa, Kontie; Johnsdotter, Sara; Essén, Birgitta

doi:10.1016/s0968-8080(07)30322-4

Cited by 13 publications

(7 citation statements)

References 23 publications

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“…However, some earlier studies indicate a higher risk of misclassified causes of death among foreign-born individuals compared to native-born individuals [41]. This would only be of major concern if the aim was to focus on specific diagnostic causes of death, but of little consequence when focusing on all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Honkaniemi

Bacchus-hertzman

Fritzell³

et al. 2017

BMC Public Health

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BackgroundImmigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region’s population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries.MethodsThe methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian.ResultsOur findings from fully-adjusted models on Swedish data support claims of excess mortality risks in specific categories of foreign-born. Most notably, immigrants from other Nordic countries, especially Finland, experience increased risk of mortality from all causes, and specifically by suicide, breast and gynaecological cancers, and circulatory diseases. Increased risks in people from Central and Eastern Europe can also be found. On the contrary, decreased risks for people with Southern European and Middle Eastern origins are found for all-cause, suicide, and breast and gynaecological cancer mortality. The few Danish studies are more difficult to compare, with conflicting results arising in the analysis. Finally, results from the one Norwegian study suggest significantly decreased mortality risks among foreign-born, to be explored in further research.ConclusionsWith new studies being published on mortality differentials between native and foreign-born populations in the Nordic countries, specific risk patterns have begun to arise. Regardless, data from most Nordic countries remains limited, as does the information on specific causes of death. The literature should be expanded in upcoming years to capture associations between country of birth and mortality more clearly.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4447-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Honkaniemi

Bacchus-hertzman

Fritzell³

et al. 2017

BMC Public Health

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“…However, in HIC maternal mortality is rare, and it can take years to approach a clear understanding about risks and how to improve health care conditions in a single, particular setting [7,15]. Scrutinising the road to death may therefore clarify why the incidence is higher for different groups of women [4,16,17] and why women representing high risk groups face barriers to care-seeking or regular utilisation of available maternity care services [8,18,19]. Assessing both the quality of maternity care that a woman received and her own pregnancy care strategies may be essential [20].…”

Section: Introductionmentioning

confidence: 99%

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the ‘migration three delays’ model

Esscher

Binder-Finnema

Bødker³

et al. 2014

BMC Pregnancy Childbirth

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104

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BackgroundSeveral European countries report differences in risk of maternal mortality between immigrants from low- and middle-income countries and host country women. The present study identified suboptimal factors related to care-seeking, accessibility, and quality of care for maternal deaths that occurred in Sweden from 1988–2010.MethodsA subset of maternal death records (n = 75) among foreign-born women from low- and middle-income countries and Swedish-born women were audited using structured implicit review. One case of foreign-born maternal death was matched with two native born Swedish cases of maternal death. An assessment protocol was developed that applied both the ‘migration three delays’ framework and a modified version of the Confidential Enquiry from the United Kingdom. The main outcomes were major and minor suboptimal factors associated with maternal death in this high-income, low-maternal mortality context.ResultsMajor and minor suboptimal factors were associated with a majority of maternal deaths and significantly more often to foreign-born women (p = 0.01). The main delays to care-seeking were non-compliance among foreign-born women and communication barriers, such as incongruent language and suboptimal interpreter system or usage. Inadequate care occurred more often among the foreign-born (p = 0.04), whereas delays in consultation/referral and miscommunication between health care providers where equally common between the two groups.ConclusionsSuboptimal care factors, major and minor, were present in more than 2/3 of maternal deaths in this high-income setting. Those related to migration were associated to miscommunication, lack of professional interpreters, and limited knowledge about rare diseases and pregnancy complications. Increased insight into a migration perspective is advocated for maternity clinicians who provide care to foreign-born women.

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“…Greenfields (2009) found in her study of Romany Gypsies and Irish Travellers in the UK that respondents are more likely to respond to members of their own community. Other studies (e.g., Elebro, Rööst, Moussa, Johnsdotter, & Essén, 2007;Lavelle et al, 2009) also suggest that data collectors recruited from the target group can help overcome cultural barriers and alleviate issues of trust. They note their success at hiring first generation Korean Americans as interviewers and members of their research staff.…”

Section: Interviewer Recruitment and Trainingmentioning

confidence: 99%

Surveying cultural and linguistic minorities

Harkness¹,

Stange²,

Cibelli³

et al. 2014

Hard-to-Survey Populations

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Cultural and linguistic minorities can be hard to survey either as the target population of interest or as a subpopulation of a general population survey. The challenges associated with studying these minorities are important to understand in order to assess and address the survey error that can be introduced when designing and implementing studies that include these groups. This chapter begins with a description of what constitutes cultural and linguistic minorities, based on a systematic review of the literature (see Chapter 5 in this volume, for a complete description of the process). We note that the literature in this area is largely limited to research among cultural and linguistic minorities in the context of Western and industrialized countries. Therefore, we supplement this literature by drawing upon our own experience and discussions with colleagues who conduct research among cultural and linguistic minorities in other parts of the world. This review is followed by a discussion of the potential challenges faced by researchers interested in surveying cultural and linguistic minorities and approaches taken to address these challenges in the areas of sampling, questionnaire development, adaptation and translation, pretesting, and data collection. We then discuss additional approaches to studying these hard-to-survey populations including qualitative, mixed-methods, and community-based research methods and how these can complement survey methods. The concluding section addresses needed improvements in the documentation and development of research methods to expand solutions and increase the quality of hard-to-survey cultural and linguistic minority research. Defining cultural and linguistic minoritiesThis section sets out the key features of cultural and linguistic minorities. Three core concepts are defined and discussed. First, we define minority populations followed by a discussion of linguistic and cultural minorities. The distinct concept of hard-to-survey is also relevant and discussed in this context (also see Chapter 1 in this volume). On the one hand, it is a relatively straightforward task to define these concepts; however, as we discuss below, applying these definitions in a survey context is far more complicated. Formal definitions serve as a good starting point for this discussion, however. 245https:/www.cambridge.org/core/terms. https://doi.

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Misclassified Maternal Deaths among East African Immigrants in Sweden

Cited by 13 publications

References 23 publications

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Mortality by country of birth in the Nordic countries – a systematic review of the literature

Suboptimal care and maternal mortality among foreign-born women in Sweden: maternal death audit with application of the ‘migration three delays’ model

Surveying cultural and linguistic minorities

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