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The role of refugee status and mental disorders regarding subsequent labour market marginalisation: a register study from Sweden
Medical University of Vienna, Vienna, Austria.ORCID iD: 000-0001-9550-628X
Karolinska Institutet.
The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.ORCID iD: 0000-0001-5376-5048
Karolinska Institutet.
2020 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: This study aimed to assess the role of refugee status and specific mental disorders regarding subsequent labour market marginalisation.

METHODS: Prospective cohort study of all refugees (n = 216,930) and Swedish-borns (n = 3,841,788), aged 19-60 years, and resident in Sweden in 2009. Hazard ratios (HRs) with 95% Confidence Intervals (CIs)  for long-term unemployment (> 180 days) and disability pension (DP) were calculated with Cox regression analyses.

RESULTS: Mental disorders were more prevalent in refugees compared to Swedish-born individuals, with greatest differences seen for post-traumatic stress disorder (PTSD; refugees 1.3%; Swedish-born individuals 0.1%). Regarding long-term unemployment, refugees without a mental disorder had an adjusted HR (aHR) of 2.68 (95% CI 2.65-2.71) compared to Swedish-born individuals without mental disorders, which was above the aHR of refugees (aHR 2.33, 95% CI 2.29-2.38) and Swedish-born individuals (aHR 1.44, 95% CI 1.43-1.45) with mental disorders. Regarding DP, compared to Swedish-born individuals without mental disorders, the aHRs were 1.44 (95% CI 1.34-1.54) for refugees without, but 6.11 (95% CI 5.84-6.39) for refugees with mental disorders. Swedish-born individuals with mental disorder had an aHR of 3.96 (95% CI 3.85-4.07). With regard to specific disorders, the aHRs for refugees, as compared to Swedish-born individuals without mental disorders, were markedly increased for all disorders (e.g. PTSD: long-term unemployment aHR: 2.03 (95% CI 1.89-2.18); DP 7.07 (95% CI 6.42-7.78).

CONCLUSION: Mental disorders are more prevalent in refugees than in Swedish-born individuals but do not appear to increase their risk of long-term unemployment. Refugee status and mental disorders strongly contribute to the risk of DP, indicating that factors beyond medical considerations contribute to their granting of DP.

Place, publisher, year, edition, pages
Springer, 2020.
Keywords [en]
Disability pension, Labour, Mental disorders, Migration, Sweden, Unemployment
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-3336DOI: 10.1007/s00127-020-01842-8PubMedID: 32055893OAI: oai:DiVA.org:rkh-3336DiVA, id: diva2:1404188
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07194Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2020-03-26Bibliographically approved

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Saboonchi, Fredrik

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