Understanding the excess COVID-19 burden among immigrants in Norway

Kjøllesdal, Marte Karoline Råberg; Juárez, Sol; Aradhya, Siddartha; Indseth, Thor

doi:10.1093/pubmed/fdac033

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…However, in our analyses, language spoken at home was not significantly related to reporting a vaccine offer among migrants. Similarly, there is growing evidence from Norway and Sweden showing higher rates of disease and death among non-migrants married to migrants compared to non-migrant only couples, supporting the suggestion that language alone is insufficient for explaining higher hospitalization and COVID-19 death rates among migrants [24,25]. However, our question did not directly assess Norwegian proficiency for the individual participant, which might have diluted any association if some of the participants who spoke both or only other languages at home were proficient in Norwegian.…”

Section: Discussionmentioning

confidence: 93%

Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study

Díaz

Dimka²,

Mamelund³

2022

BMC Public Health

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Background Vaccination is key to reducing the spread and impacts of COVID-19 and other infectious diseases. Migrants, compared to majority populations, tend to have lower vaccination rates, as well as higher infection disease burdens. Previous studies have tried to understand these disparities based on factors such as misinformation, vaccine hesitancy or medical mistrust. However, the necessary precondition of receiving, or recognizing receipt, of an offer to get a vaccine must also be considered. Methods We conducted a web-based survey in six parishes in Oslo that have a high proportion of migrant residents and were hard-hit during the COVID-19 pandemic. Logistic regression analyses were conducted to investigate differences in reporting being offered the COVID-19 vaccine based on migrant status. Different models controlling for vaccination prioritization variables (age, underlying health conditions, and health-related jobs), socioeconomic and demographic variables, and variables specific to migrant status (language spoken at home and years lived in Norway) were conducted. Results Responses from 5,442 participants (response rate of 9.1%) were included in analyses. The sample included 1,284 (23.6%) migrants. Fewer migrants than non-migrants reported receiving a vaccine offer (68.1% vs. 81.1%), and this difference was significant after controlling for prioritization variables (OR 0.65, 95% CI: 0.52–0.82). Subsequent models showed higher odds ratios for reporting having been offered the vaccine for females, and lower odds ratios for those with university education. There were few to no significant differences based on language spoken at home, or among birth countries compared to each other. Duration of residence emerged as an important explanatory variable, as migrants who had lived in Norway for fewer than 15 years were less likely to report offer of a vaccine. Conclusion Results were consistent with studies that show disparities between non-migrants and migrants in actual vaccine uptake. While differences in receiving an offer cannot fully explain disparities in vaccination rates, our analyses suggest that receiving, or recognizing and understanding, an offer does play a role. Issues related to duration of residence, such as inclusion in population and health registries and health and digital literacy, should be addressed by policymakers and health services organizers.

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Section: Discussionmentioning

confidence: 93%

Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study

Díaz

Dimka²,

Mamelund³

2022

BMC Public Health

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“…Although consistent evidence coming from large databases from European countries is available [15,[19][20][21], studies using primary data from primary care services are scarce [22,23]. To our knowledge, no study in Spain has jointly analyzed the importance of social deprivation and economic migration in the clinical course of SARS-CoV-2 infection.…”

Section: Introductionmentioning

confidence: 99%

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Martínez-Alfonso¹,

Mesas

Jimenez-Olivas³

et al. 2022

Int J Public Health

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Objective: To analyze whether social deprivation and economic migrant (EM) status influence the risk of being hospitalized with COVID-19.Methods: This was a retrospective follow-up study including all patients older than 18 years attending the Daroca Health Center in Madrid, Spain, diagnosed with COVID-19 during September 2020. Data on EM status and other sociodemographic, lifestyle and comorbidities that could affect the clinical course of the infection were obtained from electronic medical records.Results: Of the 796 patients positive for COVID-19, 44 (5.53%) were hospitalized. No significant differences were observed between those who were hospitalized and those who were not in the mean of social deprivation index or socioeconomic status, but EM status was associated with the risk of being hospitalized (p = 0.028). Logistic regression models showed that years of age (OR = 1.07; 95% CI: 1.04–1.10), EM status (OR = 5.72; 95% CI: 2.56–12.63) and hypertension (OR = 2.22; 95% CI: 1.01–4.85) were the only predictors of hospitalization.Conclusion: Our data support that EM status, rather than economic deprivation, is the socioeconomic factor associated with the probability of hospital admission for COVID-19 in Madrid, Spain.

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“…Those who are aware of being at higher risk might take actions to protect themselves against infection, as suggested by a Norwegian study. 37 …”

Section: Discussionmentioning

confidence: 99%

Differences in hospitalizations associated with severe COVID-19 disease among foreign- and Swedish-born

Juárez

Cederström

Aradhya

et al. 2023

European Journal of Public Health

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Background Differences in pre-existing health conditions are hypothesized to explain immigrants’ excess COVID-19 mortality compared to natives. In this study, we evaluate whether immigrants residing in Sweden before the outbreak were more likely to be hospitalized for conditions associated with severe COVID-19 disease. Methods A cohort study using population-register data was conducted with follow-up between 1 January 1997 and 31 December 2017. Poisson regression was fitted to estimate incidence rate ratio (RR) and 95% confident intervals (95% CI) for 10 causes of hospitalization. Results Compared to Swedish-born individuals, most immigrant groups showed a decreased risk of hospitalization for respiratory chronic conditions, CVD, cancer, chronic liver conditions and neurological problems. All immigrant groups had increased risk of hospitalization for tuberculosis [RR between 88.49 (95% CI 77.21; 101.40) for the Horn of Africa and 1.69 (95% CI 1.11; 2.58) for North America], HIV [RR between 33.23 (95% CI 25.17; 43.88) for the rest of Africa and 1.31 (95% CI 0.93; 1.83) for the Middle East] and, with a few exceptions, also for chronic kidney conditions, diabetes and thalassemia. Conclusions Foreign-born individuals—including origins with excess COVID-19 mortality in Sweden—did not show increased risk of hospitalizations for most causes associated with severe COVID-19 disease. However, all groups showed increased risks of hospitalization for tuberculosis and HIV and, with exceptions, for chronic kidney conditions, diabetes and thalassemia. Although studies should determine whether these health conditions explain the observed excess COVID-19 mortality, our study alerts to an increased risk of hospitalization that can be avoidable via treatment or preventive measures.

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Understanding the excess COVID-19 burden among immigrants in Norway

Cited by 8 publications

References 21 publications

Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study

Disparities in the offer of COVID-19 vaccination to migrants and non-migrants in Norway: a cross sectional survey study

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Differences in hospitalizations associated with severe COVID-19 disease among foreign- and Swedish-born

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