Work and health among immigrants and native Swedes 1990–2008: a register-based study on hospitalization for common potentially work-related disorders, disability pension and mortality

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.

Association of Socio-Demographic Factors, Sick-Leave and Health Care Patterns with the Risk of Being Granted a Disability Pension among Psychiatric Outpatients with Depression

“…The inverse association of educational level and disability pension risk in depressed patients is in line with a previous study [13]. The finding that first generation immigrants have a higher risk for disability pension was earlier reported in studies based on the general population [25] and individuals on long term sick-leave [26], but to our best knowledge not on patients with depression. Differences in diagnostics and treatment in the native population compared to immigrants with a different cultural background have previously been noted and suggested to contribute to the higher risk of immigrants to become disability pensioners [27].…”

Suicide among first-generation and second-generation immigrants in Sweden: association with labour market marginalisation and morbidity

“…Individuals were categorised in the group of second-generation immigrants, when born in Sweden with both parents born outside Sweden. As a reference population, we used the native population, individuals born in Sweden with both parents born in Sweden 12 14…”

“…Immigrants are often depicted as a vulnerable group in terms of exclusion from the labour market. In Sweden, immigrants were found to have a considerably higher risk for disability pension than the native population 12. To the best of our knowledge, there are to date no studies investigating if and to what extent differences in socioeconomic status, marginalisation at the labour market and morbidity can explain the association of migration status with subsequent suicide risk.…”

Physical and mental health inequalities between native and immigrant Swedes

“…Explanatory models for the observed differences in health between native and immigrant Swedes include pre‐migration, peri‐migration, and post‐migration factors (Hjern, ). Although many suggest an association between foreign origin and health, this association decreases significantly once socioeconomic differences are accounted for (Andersen et al., , Johansson et al., , Tinghög et al., ). Other factors associated with poorer health and often more common in immigrants are unemployment, being in unqualified work, lack of mental stimulation, lack of utilization of one's skills, poor socio‐cultural adaptation, financial difficulties, and low level of education (Fritzell et al., ; World Health Organization, ; Padyab et al., ; Rostila, ; Tinghög et al., ).…”