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Healthy migrant effect in the Swedish context: a register-based, longitudinal cohort study
Magnus Helgesson1,2, Bo Johansson2,3, Tobias Nordquist2,3
1Division of Insurance Medicine, Department of Clinical Neuroscience, Stockholm SE-171 77, Karolinska Institutet.
BMJ Open
|March 18, 2019
Summary
The healthy-migrant effect (HME) was observed in Western migrants in Sweden, showing better health outcomes. Non-Western migrants did not consistently show this effect, highlighting the need to consider migrant categories and labor market attachment in health studies.
Area of Science:
- Public Health
- Sociology
- Epidemiology
Background:
- The healthy-migrant effect (HME) suggests migrants have better health than non-migrants.
- This effect's applicability varies across different migrant groups and host countries.
Purpose of the Study:
- To investigate the HME in Sweden comparing Western and non-Western migrants to native Swedes.
- To examine the correlation between labor market attachment (LMA) and health outcomes in migrant populations.
Main Methods:
- A register-based, longitudinal cohort study design was employed.
- The study included 74,954 migrants and 1,405,047 native Swedes, followed over three 6-year periods.
- Health outcomes assessed included hospitalizations (cardiovascular, psychiatric), mortality, disability pension, and sick leave.
Main Results:
- Western migrants showed lower or equal hazard ratios (HRs) for all health measures compared to native Swedes.
- Non-Western migrants exhibited higher or equal HRs for most health measures, except mortality.
- Labor market attachment (LMA) explained some differences, with high LMA correlating with increased HRs for specific disorders and mortality in migrants.
Conclusions:
- Evidence suggests an HME among Western migrants in Sweden, but less so for non-Western migrants.
- Stratifying by migrant category and LMA is crucial for accurate HME assessment.
- The HME may be inconclusive if not stratified by relevant variables.
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