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Open Access Research article

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

Bo Johansson1*, Magnus Helgesson1, Ingvar Lundberg12, Tobias Nordquist2, Ola Leijon34, Per Lindberg5 and Eva Vingård12

Author Affiliations

1 Department of Medical Sciences, Occupational and Environmental Medicine, Ulleråkersvägen 38-40, Uppsala, SE-751 85, Sweden

2 Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala University, Ulleråkersvägen 38-40, Uppsala, SE-751 85, Sweden

3 Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Norrbacka, Stockholm, SE-171 76, Sweden

4 The Swedish Social Insurance Inspectorate, Fleminggatan 7, Box 202, Stockholm, SE-101 24, Sweden

5 Department of Occupational and Public Health Science, Centre for Musculoskeletal Research, University of Gävle, Kungsbäcksvägen 47, Gävle, SE-80176, Sweden

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BMC Public Health 2012, 12:845  doi:10.1186/1471-2458-12-845

Published: 5 October 2012

Abstract

Background

There 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.

Methods

This 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.

Results

Nordic 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.

Conclusions

Employment 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.

Keywords:
Immigrant; Migration; Health; Hospitalization; Disability pension; Mortality; Labor market; Employment; Unemployment; Sweden