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Does country of res...
Does country of resettlement influence the risk of suicide in refugees? : A case-control study in Sweden and Norway
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- Amin, R. (author)
- Karolinska Institutet
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- Mittendorfer-Rutz, E. (author)
- Karolinska Institutet
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- Mehlum, L. (author)
- University of Oslo, Norway,Univ Oslo, Natl Ctr Suicide Res & Prevent, Inst Clin Med, Sognsvannsveien 21, N-0374 Oslo, Norway.
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- Runeson, B. (author)
- Karolinska Institutet
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- Helgesson, M. (author)
- Karolinska Institutet
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- Tinghög, Petter (author)
- Röda Korsets Högskola,Hälsovetenskapliga institutionen,Karolinska Institutet, Sweden,Swedish Red Cross Univ Coll, Halsovagen 11, S-14157 Huddinge, Sweden.;Karolinska Inst, Dept Clin Neurosci, Div Psychol, SE-17177 Stockholm, Sweden.
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- Björkenstam, E. (author)
- Karolinska Institutet
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- Holmes, Emily A. (author)
- Karolinska Institutet,Uppsala universitet,Institutionen för psykologi,Karolinska Inst, Dept Clin Neurosci, Div Psychol, SE-17177 Stockholm, Sweden
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- Qin, P. (author)
- University of Oslo, Norway,Univ Oslo, Natl Ctr Suicide Res & Prevent, Inst Clin Med, Sognsvannsveien 21, N-0374 Oslo, Norway.
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(creator_code:org_t)
- Cambridge University Press, 2021
- 2021
- English.
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In: Epidemiology and Psychiatric Sciences. - : Cambridge University Press. - 2045-7960 .- 2045-7979. ; 30
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Abstract
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- Aims Little is known regarding how the risk of suicide in refugees relates to their host country. Specifically, to what extent inter-country differences in structural factors between the host countries may explain the association between refugee status and subsequent suicide is lacking in previous literature. We aimed to investigate (1) the risk of suicide in refugees resident in Sweden and Norway, in general, and according to their sex, age, region/country of birth and duration of residence, compared with the risk of suicide in the respective majority host population; (2) if factors related to socio-demographics, labour market marginalisation (LMM) and healthcare use might explain the risk of suicide in refugees differently in host countries. Methods Using a nested case-control design, each case who died by suicide between the age of 18 and 64 years during 1998 and 2018 (17 572 and 9443 cases in Sweden and Norway, respectively) was matched with up to 20 controls from the general population, by sex and age. Multivariate-adjusted conditional logistic regression models yielding adjusted odds ratios (aORs) with 95% confidence intervals (95% CI) were used to test the association between refugee status and suicide. Separate models were controlled for factors related to socio-demographics, previous LMM and healthcare use. Analyses were also stratified by sex and age groups, by refugees' region/country of birth and duration of residence in the host country. Results The aORs for suicide in refugees in Sweden and Norway were 0.5 (95% CI 0.5-0.6) and 0.3 (95% CI 0.3-0.4), compared with the Swedish-born and Norwegian-born individuals, respectively. Stratification by region/country of birth showed similar statistically significant lower odds for most refugee groups in both host countries except for refugees from Eritrea (aOR 1.0, 95% CI 0.7-1.6) in Sweden. The risk of suicide did not vary much across refugee groups by their duration of residence, sex and age except for younger refugees aged 18-24 who did not have a statistically significant relative difference in suicide risk than their respective host country peers. Factors related to socio-demographics, LMM and healthcare use had only a marginal influence on the studied associations in both countries. Conclusions Refugees in Sweden and Norway had almost similar suicide mortality advantages compared with the Swedish-born and Norwegian-born population, respectively. These findings may suggest that resiliency and culture/religion-bound attitudes towards suicidal behaviour in refugees could be more influential for their suicide risk after resettlement than other post-migration environmental and structural factors in the host country.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Case-control studies
- Country of birth
- Duration of residence
- Labour market marginalisation
- Migration
- Refugees
- Suicide
Publication and Content Type
- ref (subject category)
- art (subject category)
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