Mortality among the 10 largest groups of immigrants and their offspring in Sweden

Background: Sweden has experienced a rapid increase in immigration and has an immigrant population of roughly the same order as the United States with a growing number of native-born children of immigrants. As migrants have been singled out as a social category with troublesome living conditions, the study of migrant's health deserves further attention. We studied mortality differentials between specific groups of foreign-born immigrants in Sweden. Mortality risks among children of foreign-born parents were also examined. Data and methods: We conducted a follow-up study based on data from a multiple-linked database of national Swedish total-population registers. We examined mortality risks in the 10 largest immigrant groups between 1998 and 2006 using Cox regressions. Deaths from all causes, natural causes, and unnatural causes were examined. Results: We found increased mortality risks (natural, unnatural and all-cause deaths) among men and women born in the Nordic countries, Poland and former Yugoslavia when compared to native Swedes while immigrants born in Chile and Iran had lower mortality. Very high mortality risks from unnatural causes were found among men with parents born in Finland, former Yugoslavia, Chile, Turkey, Iran and Iraq (e.g. second-generation immigrants). Overall socioeconomic conditions (income, education and SES) explained much of these mortality differentials. Conclusion: Policies that aim to improve socioeconomic conditions may improve immigrant health. The increased mortality from unnatural causes (primarily accidents and suicides) among second-generation immigrants indicates that mechanisms related to risk-taking and unhealthy behaviours (drug abuse, alcohol consumption, violence etc.) may underlie such an association.