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To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors?
Tema Health and Society, Dept. of Health and Society, Linköping University.ORCID iD: 0000-0001-6138-6427
National Institute for Working Life, Stockholm; Division of Occupational Health, Dept. of Public Health Sciences, Karolinska Institute .
National Institute for Working Life, Stockholm; Division of Occupational Health, Dept. of Public Health Sciences, Karolinska Institute.
2007 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 42, no 12, 990-996 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Immigrants in Sweden have a higher rate of mental illness than the native Swedes. This study investigated to what extent the association between immigrant status and mental illness can be explained by a different distribution of known risk factors for impaired mental health between groups of immigrants and persons born in Sweden.

METHODS: The study is based on data from the Swedish PART-study, designed to identify risk factors for, and social consequences of, mental illness. The study population consists of a random sample of 10,423 Swedish citizens, whereof 1,109 were immigrants. The data was collected in the year 2000. The immigrants were divided into three groups based on country of origin (Scandinavians born outside Sweden, Europeans born outside Scandinavia, non-Europeans). The occurrence of mental illness among immigrants and native Swedes were compared not adjusting and adjusting for indicators of socioeconomic advantage/disadvantage (education, income, labour market position, etc). Mental illness was approximated with the WHO (ten) wellbeing index scale and depressive symptoms were measured with the major depression inventory scale (MDI).

RESULTS: Immigrants' excess risk for low subjective wellbeing was completely accounted for by adjustment for known risk factors in all the immigrant groups. However, social-economic disadvantages could not account for the non-European immigrants' higher prevalence of depression (MDI), although the increased relative risk found in univariate analyses was substantially reduced.

CONCLUSIONS: The findings in this study suggest that the association between immigrant status and mental illness appears above all to be an effect of a higher prevalence of social and economic disadvantage.

Place, publisher, year, edition, pages
2007. Vol. 42, no 12, 990-996 p.
Keyword [en]
immigrants, mental illness, prevalence, Sweden, risk factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-1591DOI: 10.1007/s00127-007-0253-5PubMedID: 17846697OAI: oai:DiVA.org:rkh-1591DiVA: diva2:801450
Available from: 2015-04-09 Created: 2015-03-17 Last updated: 2016-02-09Bibliographically approved
In thesis
1. Migration, Stress and Mental Ill Health: Post-migration Factors and Experiences in the Swedish Context
Open this publication in new window or tab >>Migration, Stress and Mental Ill Health: Post-migration Factors and Experiences in the Swedish Context
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This predominantly empirical dissertation deals with how socio-economic living conditions and immigrant-specific factors can be linked to immigrants’ mental ill health. It is also explored how cultural representations can affect stress and whether mental ill health is expressed differently among immigrants from Iraq and Iran than among individuals of Nordic origin. Moreover, a conceptual analysis is conducted, where a phenomenological conceptualisation of stress is outlined with a special focus on how this stress approach can be related to culture and migration.

The empirical material consists of eleven in-depth interviews with Iraqi and Iranian immigrant women and two population-based surveys.

The main findings of this thesis suggest as follows: 1) Mental ill health is more common among foreign-born than among native-born Swedes and can to a great extent be attributed to their poorer socio-economic living conditions. 2) Immigrants’ mental health is independently associated with different types of factors, such as traumatic episodes, socio-cultural adaptation level and socioeconomic living conditions. 3) The self-reporting mental health instruments, HSCL-25 and WHO (ten) Wellbeing Index, produce scores that are comparable between Scandinavians and immigrants of Middle Eastern descent. 4) Nonuniversal representations that can be found in Iraq and Iran can amplify, or even be necessary ingredients in certain types of stressful experiences among immigrant women from these countries. 5) The distinctions between universal and non-universal stress, and between immigrant/minority and non-immigrant/nonminority stress appear to be crucial for an adequate comprehension of immigrants’ stressful experiences.

Abstract [sv]

Denna huvudsakligen empiriska avhandling behandlar hur socioekonomiska levnadsvillkor och invandrarspecifika faktorer kan kopplas till invandrares mentala hälsa. I avhandlingen undersöks även hur kulturella representationer kan påverka stressfulla upplevelser och huruvida mental ohälsa uttrycks annorlunda bland invandrare från Irak och Iran än bland nordbor. Vidare genomförs en begreppsanalys av stress skisserad utifrån ett fenomenologiskt perspektiv. Fokus ligger här på hur ett sådant perspektiv på stress kan relateras till kultur och migration.

Det empiriska materialet består av elva djupintervjuer med invandrarkvinnor från Irak och Iran, samt två populationsbaserade enkätundersökningar.

De huvudsakliga fynden i denna avhandling är följande: 1) Mental ohälsa bland utrikesfödda är vanligare än bland svenskfödda och detta kan till stor del ”förklaras” av ogynnsammare socioekonomiska levnadsvillkor. 2) Invandrares mentala ohälsa har ett direkt samband med olika typer av faktorer som traumatiska episoder, sociokulturell anpassningsnivå och socioekonomiska levnadsvillkor. 3) Självskattningsinstrumenten för mental hälsa, HSCL-25 och WHO (ten) Wellbeing Index, producerar värden som är jämförbara mellan nordbor och invandrare från Mellanöstern. 4) Icke-universella representationer som kan påvisas i Irak och Iran kan förstärka, eller till och med vara nödvändiga komponenter för vissa typer av stressfulla upplevelser bland invandrarkvinnor från dessa länder. 5) Distinktionerna mellan universell och icke-universell stress, och mellan invandrar/minoritets och icke-invandrar/icke-minoritets stress, tycks vara centrala för en adekvat förståelse av invandrares stressfulla upplevelser.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2009. 81 p.
Series
Linköping Studies in Arts and Science, ISSN ISSN 0282-9800 ; 480
Keyword
Cross-cultural equivalence, foreign-born, Hopkins Symptom Checklist (HSCL-25), Living conditions, mental ill health, migration, phenomenology, population-based, Risk factors, Stress, WHO Wellbeing Index
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:rkh:diva-2149 (URN)978-91-7393-627-9 (ISBN)
Public defence
2009-05-29, Aulan, Hus 240, Campus US, Linköping, Linköping, 10:00 (Swedish)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: In press (title: Immigrantand non-immigrant-specific factors’ association with mental ill health among immigrants in Sweden). Paper 3: Submitted (title: Cross-cultural equivalence of HSCL- 25 and WHO (ten) Wellbeing Index: findings from a population-based survey of immigrants and non-immigrants in Sweden). Paper 4: Manuscript (title: A phenomenological approach to the study of stress among immigrants – the case of Iraqi and Iranian women in Sweden).

Serie: Linköping Dissertations on Health and Society, ISSN 1651-1646 ; 16

Available from: 2016-02-09 Created: 2016-02-09 Last updated: 2016-02-10Bibliographically approved

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