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  • 1.
    Di Thiene, Domitilla
    et al.
    Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
    Alexanderson, Kristina
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    Tinghög, Petter
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    La Torre, Giuseppe
    Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
    Mittendorfer-Rutz, Ellenor
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet.
    Suicide among first-generation and second-generation immigrants in Sweden: association with labour market marginalisation and morbidity.2014In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, no 5, p. 467-473Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research suggests that first-generation immigrants have a lower suicide risk than those both born in Sweden and with both parents born in Sweden (natives), while the suicide risk in the second generation seems higher. The aim of this study was to investigate to what extent suicide risk in first-generation and second-generation (both parents born abroad) and intermediate-generation (only one parent born abroad) immigrants compared with natives is associated with sociodemographic factors, labour market marginalisation and morbidity.

    METHODS: A prospective population-based cohort study of 4 034 728 individuals aged 16-50 years was followed from 2005 to 2010. HRs for suicide were calculated for first-generation, intermediate-generation and second-generation immigrants compared with natives. Analyses were controlled for sociodemographic factors, morbidity and labour market marginalisation.

    RESULTS: The HR of suicide was significantly lower in first-generation immigrants (HR 0.83 CI 0.76 to 0.91), and higher in second-generation (HR 1.32, CI 1.15 to 1.52) and intermediate-generation immigrants (HR 1.20, CI 1.08 to 1.33) in comparison to natives. The excess risk was explained by differences in sociodemographics, morbidity and labour market marginalisation. In the fully adjusted models, a higher HR remained only for the Nordic second generation (HR 1.29, CI 1.09 to 1.52). There were no sex differences in HRs.

    CONCLUSIONS: The risk of suicide was shown to be lower in the first generation and higher in the second generation compared with natives. The higher HR in the Nordic second generation was not explained by differences in sociodemographics, labour market marginalisation and morbidity. Further research is warranted to investigate factors underlying this excess risk.

  • 2.
    Helgesson, Magnus
    et al.
    Karolinska Institutet.
    Wang, Mo
    Karolinska Institutet.
    Niederkrotenthaler, Thomas
    Medical University of Vienna, Vienna, Austria.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Mittendorfer-Rutz, Ellenor
    Karolinska Institutet.
    Labour market marginalisation among refugees from different countries of birth: a prospective cohort study on refugees to Sweden2019In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 5, p. 407-415Article in journal (Refereed)
    Abstract [en]

    Background: The aim was to elucidate if the risk of labour market marginalisation (LMM), measured as long-term unemployment, long-term sickness absence, disability pension and a combined measure of these three measures, differed between refugees and non-refugee migrants with different regions of birth compared with native Swedes.

    Methods: All non-pensioned individuals aged 19-60 years who were resident in Sweden on 31 December 2009 were included (n= 4 441 813, whereof 216 930 refugees). HRs with 95% CIs were computed by Cox regression models with competing risks and time-dependent covariates with a follow-up period of 2010-2013.

    Results: Refugees had in general a doubled risk (HR: 2.0, 95% CI 1.9 to 2.0) and non-refugee migrants had 70% increased risk (HR: 1.7, 95% CI 1.7 to 1.7) of the combined measure of LMM compared with native Swedes. Refugees from Somalia (HR: 2.7, 95% CI 2.6 to 2.8) and Syria (HR: 2.5, 95% CI 2.5 to 2.6) had especially high risk estimates of LMM, mostly due to high risk estimates of long-term unemployment (HR: 3.4, 95% CI 3.3 to 3.5 and HR: 3.2, 95% CI 3.1 to 3.2). African (HR: 0.7, 95% CI 0.6 to 0.7) and Asian (HR: 1.0, 95% CI 1.0 to 1.1) refugees had relatively low risk estimates of long-term sickness absence compared with other refugee groups. Refugees from Europe had the highest risk estimates of disability pension (HR: 1.9, 95% CI 1.8 to 2.0) compared with native Swedes.

    Conclusion: Refugees had in general a higher risk of all measures of LMM compared with native Swedes. There were, however, large differences in risk estimates of LMM between subgroups of refugees and with regard to type of LMM. Actions addressing differences between subgroups of refugees is therefore crucial in order to ensure that refugees can obtain as well as retain a position on the labour market.

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