| 1. |
- Aradhya, Siddartha
(författare)
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Diversity of Legacy : The Experience of Immigrants and their Descendants in Sweden
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation examines the integration of immigrants from an intergenerational and multidimensional perspective. During the post-World War Two period, Sweden has been characterized by a large and increasing degree of heterogeneity in terms of immigrant background and reason for migration. This diversity has led to considerable challenges in terms of integration. While the economic challenges of immigrants are well documented, much less is known about other aspects of integration. In particular, little is known about the extent to which an individual’s home country characteristics and experiences carry over into the long-term integration prospects of immigrants and their descendants. This thesis examines integration as an intergenerational process, and examines aspects such as residential choice, education, gender differences, and health. Specific focus is placed on understanding the varying extent to which country of origin differences persist.The thesis exploits longitudinal administrative data found in Swedish registers to link families across generations. Using this linkage, it is possible to move away from standard mono-generational studies of integration and identify mechanisms through which parental experiences and background manifest themselves in the outcomes of their descendants. This not only allows us to understand integration in the past, but it also allows us to make informed assumptions of how integration may evolve over time.General results of this thesis suggest that there is considerable heterogeneity in the extent to which immigrant background carries over into the integration process in the new country. In an examination of residential choice, it becomes clear that country of origin may not be an adequate unit of aggregation to understand residential clustering of migrants. For countries with high degrees of ethnic heterogeneity, nationality is not the salient characteristic. When examining educational outcomes, the migration histories of parents are important in determining the educational disadvantage of the children. Additionally, the gender norms in the home country also affect the degree to which daughters perform relative to their brothers - origin countries with high degrees of gender inequality seem to penalize girls’ educational achievement. Finally, the thesis identifies a puzzling development where some migrant groups display increasing birthweight disparities relative to the native population, with differences growing even in the third generation.In sum, this thesis points to the broad diversity of legacy in terms of immigrant integration over generations. These results underline the fact that no single aspect of integration is adequate to assess the overall integration process. The identification of these processes highlights a potential development towards persistent socioeconomic stratification based on immigrant background.
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| 2. |
- Aradhya, Siddartha, et al.
(författare)
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Father’s Repeat Migration and Children’s Educational Performance
- 2019
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Ingår i: International Migration Review. - : SAGE Publications. - 0197-9183 .- 1747-7379. ; 53:1, s. 154-182
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Tidskriftsartikel (refereegranskat)abstract
- Repeat migration is a common, but unstudied, pattern of migration. This study examines the potential intergenerational consequences of this behavior. To investigate this, we estimate the effect of fathers’ repeat migration on their children’s grade point averages using population-level register data from Sweden. We find that the children of fathers who repeat migrate have a significantly lower grade point average, even after controlling for individual and family characteristics, than children of permanent migrants. Results suggest selection and delayed integration may exert negative pressure on the GPA of children of repeat migrants.
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| 3. |
- Aradhya, Siddartha, et al.
(författare)
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Immigrant ancestry and birthweight across two generations born in Sweden : an intergenerational cohort study
- 2022
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Ingår i: BMJ Global Health. - : BMJ. - 2059-7908. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Differences in birthweight are often seen between migrants and natives. However, whether migrant-native birthweight inequalities widen, narrow or remain persistent across generations when comparing the descendants of immigrants and natives remains understudied. We examined inequalities in birthweight of mothers (G2) and daughters (G3) of foreign-born grandmothers (G1) compared with those of Swedish-born grandmothers.Methods We used population registers with multigenerational linkages to identify 314 415 daughters born in Sweden during the period 1989–2012 (G3), linked to 246 642 mothers (G2) born in Sweden during 1973–1996, and to their grandmothers (G1) who were Swedish or foreign-born. We classified migrants into non-western, Eastern European, the rest of Nordic and Western. We used multivariable methods to examine mean birthweight and low birthweight (<2500 g; LBW).Results Birthweight between individuals with Swedish background (G1) and non-western groups increased from -80 g to -147 g between G2 (mothers) and G3 (daughters), respectively. Furthermore, the odds of LBW increased among the G3 non-western immigrants compared with those with Swedish grandmothers (OR: 1.38, 95% CI 1.12 to 1.69). Birthweight increased in both descendants of Swedes and non-western immigrants, but less so in the latter (83 g vs 16 g).Conclusion We observed an increase in birthweight inequalities across generations between descendants of non-western immigrants and descendants of Swedes. This finding is puzzling considering Sweden has been lauded for its humanitarian approach to migration, for being one of the most egalitarian countries in the world and providing universal access to healthcare and education.
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| 4. |
- Aradhya, Siddartha, et al.
(författare)
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Intermarriage and COVID-19 mortality among immigrants. A population-based cohort study from Sweden
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the role of language proficiency and institutional awareness in explaining excess COVID-19 mortality among immigrants. Design Cohort study with follow-up between 12 March 2020 and 23 February 2021. Setting Swedish register-based study on all residents in Sweden. Participants 3 963 356 Swedish residents in co-residential unions who were 30 years of age or older and alive on 12 March 2020 and living in Sweden in December 2019. Outcome measures Cox regression models were conducted to assess the association between different constellations of immigrant-native couples (proxy for language proficiency and institutional awareness) and COVID-19 mortality and all other causes of deaths (2019 and 2020). Models were adjusted for relevant confounders. Results Compared with Swedish-Swedish couples (1.18 deaths per thousand person-years), both immigrants partnered with another immigrant and a native showed excess mortality for COVID-19 (HR 1.43; 95% CI 1.29 to 1.58 and HR 1.24; 95% CI 1.10 to 1.40, respectively), which translates to 1.37 and 1.28 deaths per thousand person-years. Moreover, similar results are found for natives partnered with an immigrant (HR 1.15; 95% CI 1.02 to 1.29), which translates to 1.29 deaths per thousand person-years. Further analysis shows that immigrants from both high-income and low-income and middle-income countries (LMIC) experience excess mortality also when partnered with a Swede. However, having a Swedish-born partner is only partially protective against COVID-19 mortality among immigrants from LMIC origins. Conclusions Language barriers and/or poor institutional awareness are not major drivers for the excess mortality from COVID-19 among immigrants. Rather, our study provides suggestive evidence that excess mortality among immigrants is explained by differential exposure to the virus.
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| 5. |
- Aradhya, Siddartha, et al.
(författare)
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Maternal age and the risk of low birthweight and pre-term delivery : a pan-Nordic comparison
- 2022
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 52:1, s. 156-164
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Tidskriftsartikel (refereegranskat)abstract
- Background: Advanced maternal age at birth is considered a risk factor for adverse birth outcomes. A recent study applying a sibling design has shown, however, that the association might be confounded by unobserved maternal characteristics.Methods: Using total population register data on all live singleton births during the period 1999–2012 in Denmark (N = 580 133; 90% population coverage), Norway (N = 540 890) and Sweden (N = 941 403) and from 2001–2014 in Finland (N = 568 026), we test whether advanced maternal age at birth independently increases the risk of low birthweight (LBW) (<2500 g) and pre-term birth (<37 weeks gestation). We estimated within-family models to reduce confounding by unobserved maternal characteristics shared by siblings using three model specifications: Model 0 examines the bivariate association; Model 1 adjusts for parity and sex; Model 2 for parity, sex and birth year.Results: The main results (Model 1) show an increased risk in LBW and pre-term delivery with increasing maternal ages. For example, compared with maternal ages of 26–27 years, maternal ages of 38–39 years display a 2.2, 0.9, 2.1 and 2.4 percentage point increase in the risk of LBW in Denmark, Finland, Norway and Sweden, respectively. The same patterns hold for pre-term delivery.Conclusions: Advanced maternal age is independently associated with higher risk of poor perinatal health outcomes even after adjusting for all observed and unobserved factors shared between siblings.
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| 6. |
- Aradhya, Siddartha, et al.
(författare)
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Pushing and Pulling : A population based approach to analysing the historical determinants of internal migration
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper contributes to the literature on internal migration by estimating parameters for push and pull factors by modelling the complete migration decision. Using data based on individuals linked between the complete Swedish censuses of 1880 and 1890, we consider both the push factors which determined whether an individual choose to leave their origin and the pulls factors which attracted migrants to specific destinations. The analysis includes both male and female migrants and takes into account the effect of individual, family, and location specific characteristics . Moreover, we consider all possible origins and destinations for internal migrants.
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| 7. |
- Aradhya, Siddartha, et al.
(författare)
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Region of Origin: Settlement Decisions of Turkish and Iranian Immigrants in Sweden, 1968-2001
- 2017
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Ingår i: Population Space and Place. - : Wiley. - 1544-8452 .- 1544-8444. ; 23:4
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Tidskriftsartikel (refereegranskat)abstract
- This paper focuses on the residential resettlement decisions of a sample of immigrants from Iran and Turkey living in Sweden between 1968 and 2001. Using the Swedish Longitudinal Immigrant database, we are able to link unique pre- and post-migration data to understand whether region of origin is a better predictor of internal migration decisions than is country of origin, the more often used measure in existing research. More specifically, we test whether living in municipalities with a high number of individuals from the same country of origin is a similar phenomenon as a high number of individuals from the same region of origin. This is relevant, as large immigrant groups come from ethnically, religiously, and linguistically heterogeneous countries of origin where regional characteristics differ according to aforementioned aspects from that of the mainstream population. We indeed find that individuals are less likely to relocate from municipalities in which there is a large presence of other immigrants from the same region of origin. Instead, individuals residing in areas with a large number of individuals from their country of origin are observed with an elevated probability of resettlement. Copyright © 2016 John Wiley & Sons, Ltd.
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| 8. |
- Aradhya, Siddartha, et al.
(författare)
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Unemployment persistence among second-generation immigrants
- 2023
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Ingår i: European Sociological Review. - : Oxford University Press (OUP). - 0266-7215 .- 1468-2672. ; 39:3, s. 433-448
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Tidskriftsartikel (refereegranskat)abstract
- Many immigrant groups disproportionately experience unemployment and this disadvantage often extends to their children—the second generation. This paper contributes to this stream of research by studying unemployment dynamics of the ancestral population and second-generation immigrants in Sweden. In particular, we ask: does unemployment persistence differ between ancestral Swedes and 10 second-generation immigrant groups? We answer this question using correlated dynamic random-effects logit models to study the effect of past on current unemployment—also known as genuine state dependence. We use Swedish register data to follow individuals over their early working careers. The results indicate that although past unemployment has a similar relative effect on current unemployment across the ancestry groups, past unemployment increases the probability of current unemployment (absolute effect) more among second-generation Middle-Eastern, Turkish, and Southern European immigrants. Because of higher baseline levels of unemployment, the labour market consequences of similar relative effects are more pronounced among the second generation as compared to ancestral Swedes. The paper concludes by elaborating on the reasons behind these contrasting results while highlighting the importance of examining heterogeneous effects on both the relative and absolute scales.
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| 9. |
- Billingsley, Sunnee, 1976-, et al.
(författare)
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COVID-19 mortality across occupations and secondary risks for elderly individuals in the household : A population register-based study
- 2022
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 48:1, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This is the first population-level study to examine inequalities in COVID-19 mortality according to working-age individuals' occupations and the indirect occupational effects on COVID-19 mortality of older individuals who live with them.Methods We used early-release data for the entire population of Sweden of all recorded COVID-19 deaths from 12 March 2020 to 23 February 2021, which we linked to administrative registers and occupational measures. Cox proportional hazard models assessed relative risks of COVID-19 mortality for the working-aged population registered in an occupation in December 2018 and the older population who lived with them.Results Among working aged-adults, taxi/bus drivers had the highest relative risk of COVID-19 mortality: over four times that of skilled workers in IT, economics, or administration when adjusted only for basic demographic characteristics. After adjusting for socioeconomic factors (education, income and country of birth), there are no occupational groups with clearly elevated (statistically significant) COVID-19 mortality. Neither a measure of exposure within occupations nor the share that generally can work from home were related to working-aged adults' risk of COVID-19 mortality. Instead of occupational factors, traditional socioeconomic risk factors best explained variation in COVID-19 mortality. Elderly individuals, however, faced higher COVID-19 mortality risk both when living with a delivery or postal worker or worker(s) in occupations that generally work from home less, even when their socioeconomic factors are taken into account.Conclusions Inequalities in COVID-19 mortality of working-aged adults were mostly based on traditional risk factors and not on occupational divisions or characteristics in Sweden. However, older individuals living with those who likely cannot work from home or work in delivery or postal services were a vulnerable group.
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| 10. |
- Brandén, Maria, et al.
(författare)
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Residential context and COVID-19 mortality among adults aged 70 years and older in Stockholm : a population-based, observational study using individual-level data
- 2020
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Ingår i: The Lancet Healthy Longevity. - : Elsevier. - 2666-7568. ; 1:2, s. e80-e88
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Tidskriftsartikel (refereegranskat)abstract
- Background Housing characteristics and neighbourhood context are considered risk factors for COVID-19 mortality among older adults. The aim of this study was to investigate how individual-level housing and neighbourhood characteristics are associated with COVID-19 mortality in older adults.Methods For this population-based, observational study, we used data from the cause-of-death register held by the Swedish National Board of Health and Welfare to identify recorded COVID-19 mortality and mortality from other causes among individuals (aged ≥70 years) in Stockholm county, Sweden, between March 12 and May 8, 2020. This information was linked to population-register data from December, 2019, including socioeconomic, demographic, and residential characteristics. We ran Cox proportional hazards regressions for the risk of dying from COVID-19 and from all other causes. The independent variables were area (m2) per individual in the household, the age structure of the household, type of housing, confirmed cases of COVID-19 in the borough, and neighbourhood population density. All models were adjusted for individual age, sex, country of birth, income, and education.Findings Of 279 961 individuals identified to be aged 70 years or older on March 12, 2020, and residing in Stockholm in December, 2019, 274 712 met the eligibility criteria and were included in the study population. Between March 12 and May 8, 2020, 3386 deaths occurred, of which 1301 were reported as COVID-19 deaths. In fully adjusted models, household and neighbourhood characteristics were independently associated with COVID-19 mortality among older adults. Compared with living in a household with individuals aged 66 years or older, living with someone of working age (<66 years) was associated with increased COVID-19 mortality (hazard ratio 1·6; 95% CI 1·3–2·0). Living in a care home was associated with an increased risk of COVID-19 mortality (4·1; 3·5–4·9) compared with living in independent housing. Living in neighbourhoods with the highest population density (≥5000 individuals per km2) was associated with higher COVID-19 mortality (1·7; 1·1–2·4) compared with living in the least densely populated neighbourhoods (0 to <150 individuals per km2).Interpretation Close exposure to working-age household members and neighbours is associated with increased COVID-19 mortality among older adults. Similarly, living in a care home is associated with increased mortality, potentially through exposure to visitors and care workers, but also due to poor underlying health among care-home residents. These factors should be considered when developing strategies to protect this group.
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| 11. |
- Cozzani, Marco, et al.
(författare)
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The cognitive development from childhood to adolescence of low birthweight children born after medically assisted reproduction-a UK longitudinal cohort study
- 2021
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 50:5, s. 1514-1523
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous research has documented that children conceived through medically assisted reproduction (MAR) are at increased risk of poor birth outcomes, such as low birthweight (LBW), which are risk factors for stunted longer-term cognitive development. However, parents who undergo MAR to conceive have, on average, advantaged socioeconomic backgrounds which could compensate for the negative effects of being born LBW. Previous studies have not analysed whether the negative effects of LBW are attenuated among MAR conceived children.Methods: We draw on the UK Millennium Cohort Study (sweeps 1–6) which contains a sub-sample of (N = 396) MAR-conceived children. The dependent variable measures cognitive ability at around ages 3, 5, 7, 11 and 14. We examine the cognitive development of four groups of children: MAR-conceived low birthweight (MAR LBW); MAR-conceived non-low birthweight (MAR NLBW); naturally conceived low birthweight (NC LBW); naturally conceived non-low birthweight (NC NLBW). We estimate the two following linear regression models for each sweep: (i) a baseline model to examine the unadjusted association between cognitive development and low birthweight by mode of conception; and (ii) a model adjusted by socio-demographic family characteristics.Results: In baseline models, MAR LBW children [age 3: β = 0.021, 95% confidence interval (CI): -0.198, 0.241; age 5: β = 0.21, 95% CI: 0.009, 0.418; age 7: β = 0.163, 95% CI: -0.148, 0.474; age 11: β = 0.003, 95% CI: -0.318, 0.325; age 14: β = 0.156, 95% CI: -0.205, 0.517], on average perform similarly in cognitive ability relative to NC NLBW at all ages, and display higher cognitive scores than NC LBW children until age 7. When we account for family characteristics, differences are largely attenuated and become close to zero at age 14.Conclusions: Despite the higher incidence of LBW among MAR compared with NC children, they do not seem to experience any disadvantage in their cognitive development compared with naturally conceived children. This finding is likely explained by the fact that, on average, MAR children are born to socioeconomically advantaged parents.
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| 12. |
- Debiasi, Enrico, 1989-, et al.
(författare)
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Unintended Perinatal Health Consequences Associated With a Swedish Family Policy
- 2024
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 178:6, s. 608-615
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Tidskriftsartikel (refereegranskat)abstract
- Importance The 1980 and 1986 Swedish so-called speed premium policies aimed at protecting parents’ income-based parental leave benefits for birth intervals shorter than 24 and 30 months, respectively, but indirectly encouraged shorter birth spacing and childbearing at older ages, both risk factors for several perinatal health outcomes. Whether those policy changes are associated with perinatal health remains unknown.Objective To evaluate the association between the 1980 and 1986 speed premium policies and perinatal health outcomes.Design, Setting, and Participants This cross-sectional study investigated data from 1 762 784 singleton births in the Swedish Medical Birth Register from January 1, 1974, through December 31, 1991. Data were analyzed from October 11, 2022, to December 12, 2023.Interventions Speed premium policy introduction (January 1, 1980) and extension (January 1, 1986).Main Outcomes and Measures Total population register data were used in an interrupted time series analysis with segmented logistic regression to calculate the odds of preterm birth, low birth weight, small for gestational age (SGA) at preterm, and stillbirth measured before and after the speed premium policy reforms. Subgroup analyses by maternal origin were conducted to evaluate changes by different policy responses.Results Among 1 762 784 births analyzed, 4.8% were preterm (of which 12.0% were SGA), 3.2% had low birth weight, and 0.3% were stillbirths. The 1980 speed premium policy was associated with a 0.3% monthly increase in the odds of preterm birth compared with the period before the reform (odds ratio [OR], 1.0029 [95% CI, 1.002-1.004]), equivalent to a 26.4% increase from January 1, 1980, to December 31, 1985. After the 1986 relaxation of the policy, preterm birth odds decreased 0.5% per month (OR, 0.9951 [95% CI, 0.994-0.996]), equivalent to an 11.1% decrease across the next 6 years. Low birth weight displayed a similar pattern for both reform periods, that is, increased 0.2% (OR, 1.0021; 95% CI, 1.001-1.003) per month in 1980 through 1985 compared with baseline, and decreased 0.3% (OR, 0.9975; 95% CI, 0.996-0.998) per month in the following period, but was attenuated when considering low birth weight at term. Odds of SGA at preterm were decreased after 1980 (OR, 0.9965; 95% CI, 0.994-0.999) but not in 1986 (OR, 1.0009; 95% CI, 0.998-1.003), whereas stillbirths did not change following either reform (1980: OR, 1.0020 [95% CI, 0.999-1.005]; 1986: OR, 1.0002 [95% CI, 0.997-1.003]). Subgroup analyses suggested that perinatal health changes were restricted to births to Swedish- and Nordic-born mothers, the primary groups to adjust their fertility behaviors to the reforms.Conclusions and Relevance Despite its economic advantages for couples, especially for mothers, the introduction of the speed premium policy was associated with adverse perinatal health consequences, particularly for preterm births. Family policies should be carefully designed with a “Health in All Policies” lens to avoid possible unintended repercussions for fertility behaviors and, in turn, perinatal health.
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| 13. |
- Drefahl, Sven, et al.
(författare)
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A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden
- 2020
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- As global deaths from COVID-19 continue to rise, the world's governments, institutions, and agencies are still working toward an understanding of who is most at risk of death. In this study, data on all recorded COVID-19 deaths in Sweden up to May 7, 2020 are linked to high-quality and accurate individual-level background data from administrative registers of the total population. By means of individual-level survival analysis we demonstrate that being male, having less individual income, lower education, not being married all independently predict a higher risk of death from COVID-19 and from all other causes of death. Being an immigrant from a low- or middle-income country predicts higher risk of death from COVID-19 but not for all other causes of death. The main message of this work is that the interaction of the virus causing COVID-19 and its social environment exerts an unequal burden on the most disadvantaged members of society. Better understanding of who is at highest risk of death from COVID-19 is important for public health planning. Here, the authors demonstrate an unequal mortality burden associated with socially disadvantaged groups in Sweden.
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| 14. |
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| 15. |
- Juárez, Sol Pia, 1982-, et al.
(författare)
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COVID-19 mortality among immigrants by duration of residence in Sweden : a population-based cohort study
- 2024
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Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 52:3, s. 370-378
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Tidskriftsartikel (refereegranskat)abstract
- Background: Explanations for the disproportional COVID-19 burden among immigrants relative to host-country natives include differential exposure to the virus and susceptibility due to poor health conditions. Prior to the pandemic, immigrants displayed deteriorating health with duration of residence that may be associated with increased susceptibility over time. The aim of this study was to compare immigrant–native COVID-19 mortality by immigrants’ duration of residence to examine the role of differential susceptibility. Methods: A population-based cohort study was conducted with individuals between 18 and 100 years old registered in Sweden between 1 January 2015 and 15 June 2022. Cox regression models were run to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Inequalities in COVID-19 mortality between immigrants and the Swedish-born population in the working-age group were concentrated among those of non-Western origins and from Finland with more than 15 years in Sweden, while for those of retirement age, these groups showed higher COVID-19 mortality HRs regardless of duration of residence. Both age groups of immigrants from Africa and the Middle East showed consistently higher COVID-19 mortality HRs. For the working-age population: Africa: HR<15: 2.46, 95%CI: 1.78, 3.38; HR≥15: 1.49, 95%CI: 1.01, 2.19; and from the Middle East: HR<15: 1.20, 95%CI: 0.90, 1.60; HR≥15: 1.65, 95%CI: 1.32, 2.05. For the retirement-age population: Africa: HR<15: 3.94, 95%CI: 2.85, 5.44; HR≥15: 1.66, 95%CI: 1.32, 2.09; Middle East: HR<15: 3.27, 95%CI: 2.70, 3.97; HR≥15: 2.12, 95%CI: 1.91, 2.34. Conclusions: Differential exposure, as opposed to differential susceptibility, likely accounted for the higher COVID-19 mortality observed among those origins who were disproportionately affected by the pandemic in Sweden.
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| 16. |
- Juárez, Sol Pia, et al.
(författare)
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Differences in hospitalizations associated with severe COVID-19 disease among foreign- and Swedish-born
- 2023
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 33:3, s. 522-527
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Tidskriftsartikel (refereegranskat)abstract
- 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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| 17. |
- Juárez, Sol Pia, et al.
(författare)
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Explaining COVID-19 mortality among immigrants in Sweden from a social determinants of health perspective (COVIS) : protocol for a national register-based observational study
- 2023
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Ingår i: BMJ Open. - 2044-6055. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Adopting a social determinants of health perspective, this project aims to study how disproportionate COVID-19 mortality among immigrants in Sweden is associated with social factors operating through differential exposure to the virus (eg, by being more likely to work in high-exposure occupations) and differential effects of infection arising from socially patterned, pre-existing health conditions, differential healthcare seeking and inequitable healthcare provision. Methods and analysis This observational study will use health (eg, hospitalisations, deaths) and sociodemographic information (eg, occupation, income, social benefits) from Swedish national registers linked using unique identity numbers. The study population includes all adults registered in Sweden in the year before the start of the pandemic (2019), as well as individuals who immigrated to Sweden or turned 18 years of age after the start of the pandemic (2020). Our analyses will primarily cover the period from 31 January 2020 to 31 December 2022, with updates depending on the progression of the pandemic. We will evaluate COVID-19 mortality differences between foreign-born and Swedish-born individuals by examining each mechanism (differential exposure and effects) separately, while considering potential effect modification by country of birth and socioeconomic factors. Planned statistical modelling techniques include mediation analyses, multilevel models, Poisson regression and event history analyses. Ethics and dissemination This project has been granted all necessary ethical permissions from the Swedish Ethical Review Authority (Dnr 2022-0048- 01) for accessing and analysing deidentified data. The final outputs will primarily be disseminated as scientific articles published in open-access peer-reviewed international journals, as well as press releases and policy briefs.
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| 18. |
- Kjøllesdal, M. K. R., et al.
(författare)
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Understanding the excess COVID-19 burden among immigrants in Norway
- 2022
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Ingår i: Journal of Public Health. - : Oxford University Press (OUP). - 1741-3842 .- 1741-3850. ; 45:2, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- Background We aim to use intermarriage as a measure to disentangle the role of exposure to virus, susceptibility and care in differences in burden of COVID-19, by comparing rates of COVID-19 infections between immigrants married to a native and to another immigrant.Methods Using data from the Norwegian emergency preparedness, register participants (N=2 312 836) were linked with their registered partner and categorized based on own and partner's country of birth. From logistic regressions, odds ratios (OR) of COVID-19 infection (15 June 2020-01 June 2021) and related hospitalization were calculated adjusted for age, sex, municipality, medical risk, occupation, household income, education and crowded housing.Results Immigrants were at increased risk of COVID-19 and related hospitalization regardless of their partners being immigrant or not, but immigrants married to a Norwegian-born had lower risk than other immigrants. Compared with intramarried Norwegian-born, odds of COVID-19 infection was higher among persons in couples with one Norwegian-born and one immigrant from Europe/USA/Canada/Oceania (OR 1.42-1.46) or Africa/Asia/Latin-America (OR 1.91-2.01). Odds of infection among intramarried immigrants from Africa/Asia/Latin-America was 4.92. For hospitalization, the corresponding odds were slightly higher.Conclusion Our study suggests that the excess burden of COVID-19 among immigrants is explained by differences in exposure and care rather than susceptibility.
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| 19. |
- Mussino, Eleonora, 1981-, et al.
(författare)
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Lives saved, lives lost, and under-reported COVID-19 deaths : Excess and non-excess mortality in relation to cause-specific mortality during the first year of the COVID-19 pandemic in Sweden
- 2024
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Ingår i: Demographic Research. - 1435-9871. ; 50
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Tidskriftsartikel (refereegranskat)abstract
- Background: The number of confirmed COVID-19 deaths differed across countries and across waves of the pandemic. Patterns also differed between groups within a country.Objective: We combine data on excess mortality with data on cause-of-death-specific mortality in the case of Sweden to identify which groups had excess mortality beyond what can be captured by analyses of COVID-19-specific deaths. We also explore the possibility that some groups may have benefited in terms of reduced all-cause mortality, potentially due to home-centered living conditions during the pandemic.Methods: We produced and compared three sets of group-specific incidence rates: deaths from (1) any cause in 2020, (2) any cause in 2019, (3) any cause excluding COVID-19 in 2020. We compared rates across different socioeconomic profiles based on combinations of sex, age, marital status, education, and country of birth.Contribution: We show that many of those who died during 2020 would not have done so in the absence of the pandemic. We find some evidence of COVID-19 mortality underestimation, mainly among individuals with a migration background. We also found groups for which mortality decreased during the pandemic, even when including COVID-19 mortality. Progression across the first and second waves of the pandemic shows that more groups appeared to become protected over time and that there was less underestimation of COVID-19 mortality in the second part of 2020.
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| 20. |
- Oksuzyan, Anna, et al.
(författare)
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Is it Better to Intermarry? Immigration Background of Married Couples and Suicide Risk Among Native-Born and Migrant Persons in Sweden
- 2023
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Ingår i: European Journal of Population. - : Springer Science and Business Media LLC. - 0168-6577 .- 1572-9885. ; 39:1
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Tidskriftsartikel (refereegranskat)abstract
- Marriage is protective against suicide across most populations, including for persons of different ethnicities and immigrant backgrounds. However, the well-being benefits of marriage are contingent upon marital characteristics—such as conflict and quality—that may vary across spousal dyads with different immigration backgrounds. Leveraging Swedish register data, we compare suicide mortality among married persons on the basis of their and their spouse’s immigration backgrounds. We find that relative to those in a native Swede-Swede union, Swedish men married to female immigrants and immigrant women married to native men are at higher risk of death by suicide, while immigrants of both genders who are married to someone from their birth country have a lower risk of suicide mortality. The findings support hypotheses about the strains that may be encountered by those who intermarry, as well as the potential selection of individuals into inter- and intra-ethnic marriages.
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| 21. |
- Rostila, Mikael, 1977-, et al.
(författare)
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Inequalities in COVID-19 severe morbidity and mortality by country of birth in Sweden
- 2023
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Ingår i: Nature Communications. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Migrants have been more affected by the COVID-19 pandemic. Whether this has varied over the course of the pandemic remains unknown. We examined how inequalities in intensive care unit (ICU) admission and death related to COVID-19 by country of birth have evolved over the course of the pandemic, while considering the contribution of social conditions and vaccination uptake. A population-based cohort study was conducted including adults living in Sweden between March 1, 2020 and June 1, 2022 (n = 7,870,441). Poisson regressions found that migrants from Africa, Middle East, Asia and European countries without EU28/EEA, UK and Switzerland had higher risk of COVID-19 mortality and ICU admission than Swedish-born. High risks of COVID-19 ICU admission was also found in migrants from South America. Inequalities were generally reduced through subsequent waves of the pandemic. In many migrant groups socioeconomic status and living conditions contributed to the disparities while vaccination campaigns were decisive when such became available.
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| 22. |
- Scott, Kirk, et al.
(författare)
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Repeat Immigration: A Previously Unobserved Source of Heterogeneity?
- 2017
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 45:Suppl 17, s. 25-29
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Tidskriftsartikel (refereegranskat)abstract
- AIMS:Register data allow for nuanced analyses of heterogeneities between sub-groups which are not observable in other data sources. One heterogeneity for which register data is particularly useful is in identifying unique migration histories of immigrant populations, a group of interest across disciplines. Years since migration is a commonly used measure of integration in studies seeking to understand the outcomes of immigrants. This study constructs detailed migration histories to test whether misclassified migrations may mask important heterogeneities. In doing so, we identify a previously understudied group of migrants called repeat immigrants, and show that they differ systematically from permanent immigrants. In addition, we quantify the degree to which migration information is misreported in the registers.METHOD:The analysis is carried out in two steps. First, we estimate income trajectories for repeat immigrants and permanent immigrants to understand the degree to which they differ. Second, we test data validity by cross-referencing migration information with changes in income to determine whether there are inconsistencies indicating misreporting.RESULTS:From the first part of the analysis, the results indicate that repeat immigrants systematically differ from permanent immigrants in terms of income trajectories. Furthermore, income trajectories differ based on the way in which years since migration is calculated. The second part of the analysis suggests that misreported migration events, while present, are negligible.CONCLUSIONS:Repeat immigrants differ in terms of income trajectories, and may differ in terms of other outcomes as well. Furthermore, this study underlines that Swedish registers provide a reliable data source to analyze groups which are unidentifiable in other data sources.
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| 23. |
- Tønnessen, Marianne, et al.
(författare)
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How Assad changed population growth in Sweden and Norway : Syrian refugees' impact on Nordic national and municipal demography
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 24. |
- Uggla, Caroline, 1986-, et al.
(författare)
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Are women from man-older unions economically disadvantaged following separation? Sweden 1997–2015
- 2024
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Ingår i: Acta Sociologica. - : SAGE Publications. - 0001-6993 .- 1502-3869. ; 67:1, s. 98-116
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Tidskriftsartikel (refereegranskat)abstract
- Separation often leads to worse economic consequences for women than for men. However, little is known about how economic consequences of separation play out for different groups of women. Women who are younger than their male partner are generally assumed to have lesser agency, but evidence mostly comes from contexts with low gender equality. Here, we examine women's benefit recipiency as a function of the partner age gap of their dissolved union. Using register data from Sweden, we examine whether women from man-older unions suffer greater economic disadvantage after separation, and whether patterns differ for ancestral Swedes and women with migrant background. Results from logistic regression models suggest that, post-separation, the uptake of social and housing benefits increases for nearly all groups of women. However, these data do not show any consistent disadvantages of women from man-older unions. Among ancestral Swedes, patterns differed by benefit type, and among women of African/Middle Eastern origin, benefit recipiency increases were inversely U-shaped to the age gap. Social norms do not appear to explain economic costs of separation, but may explain why the risk of separation itself differed between ancestral Swedish women and women with migrant background.
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| 25. |
- Zarei, Kasra, et al.
(författare)
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Parent-Child Nativity, Race, Ethnicity, and Common Mental Health Conditions Among United States Children and Adolescents
- 2023
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Ingår i: The Journal of Pediatrics. - 0022-3476 .- 1097-6833. ; 263
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Tidskriftsartikel (refereegranskat)abstract
- Objective To examine associations between race, ethnicity, and parent-child nativity, and common mental health conditions among U.S. children and adolescents.Methods Data were from 2016 to 2019 National Survey of Children's Health, a US population-based, serial cross-sectional survey, and restricted to children who had access to health care. We used weighted multivariable logistic regression to examine the associations between race and ethnicity (Asian, Black, Hispanic, White, Other-race); mental health outcomes (depression, anxiety, and behavior/conduct problems) stratified by household generation; and between household generation and outcomes stratified by race and ethnicity, adjusting for demographics (age, sex, family income to poverty ratio, parental education), and an adverse childhood experience (ACE) score.Results When stratifying by household generation, racial and ethnic minority children generally had similar to lower odds of outcomes compared with White children, with the exception of higher odds of behavior/conduct problems among third + -generation Black children. When stratifying by race and ethnicity, third + generation children had increased odds of depression compared to their first-generation counterparts. Third + generation, racial and ethnic minority children had increased odds of anxiety and behavior/conduct problems compared with their first-generation counterparts. The associations generally remained significant after adjusting for the ACE score.Conclusions Lower odds of common mental health conditions in racial and ethnic minority children could be due to factors such as differential reporting, and higher estimates, including those in third + generation children, could be due to factors including discrimination; systemic racism; and other factors that vary by generation and need further investigation to advance health equity.
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