Morbidity and mortality among foreign-born Swedes

Abstract: Aims: The general aim of this thesis was to describe and compare the group of foreign-born persons living in Sweden and native Swedes with regard to health development over time, thus studying the influence of migration on health. Methods: All four studies are based on data from Statistics Sweden (SCB) and the National Board of Health and Welfare, Centre for Epidemiology covering the period 1970?1999. The database used included all foreign-born persons aged 16 years and upwards who were registered as living in Sweden in 1970. For each foreign-born person a Swedish matched control was chosen. The control was matched and was similar in age, sex, occupation, type of employment and county of residence in 1970. In total 906,564 people were included, 50 percent foreign-born persons. Information from the National Board of Health and Welfare, Centre for Epidemiology on date of death and death diagnosis was added to the database. Exclusion criteria were if no information was available or if a person had emigrated or migrated back (?re-migrated?). Persons were then also excluded if the information from the control subject was missing due to migration. The database used for analysis finally consisted of 723,948 persons, 361,974 foreign-born and 361,974 Swedish controls. All statistical analyses were carried out using the SPSS (Statistical Package for Social Sciences) program, version 11.5, and both descriptive and analytic statistic methods were used. Results: The results of the four studies show that foreign-born persons living in Sweden 1970?1999 have higher mortality, lower mean age at time of death and a different pattern of causes of death. The studies also found a tendency to less utilization of health care and that county of residence influences mortality among foreign-born persons. The most important finding was that migration has an influence on health. Conclusion: To explain the differences found in health among foreign-born persons, several different factors have to be taken into account. Health is influenced by economic situation, housing, working conditions, unemployment, social network and background before migration. Social and physical environment or inequalities in resources and utilization of health care are important. Migration is shown to have a negative influence on health and is an important factor to consider when studying mortality and health in a population.