1. ”The healthy migrant effect in the Swedish context”

2. Research Group Magnus Helgesson Bo Johansson Tobias Nordqvist
Eva Vingård
Magnus Svartengren
Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Sweden

3. Background
Today, around 18 % of the population in Sweden are born abroad
Some studies have observed a “healthy migrant effect” (HME)
Many studies from Europe have, however, not found a HME
The HME might differ between subgroups of migrants

4. Aim
To investigate if the “healthy migrant” hypothesis is applicable in a Swedish context, and if there were differences between migrants from Western and non-Western countries. We also examined if there was any correlation between work attachment and the HME. 

5. Study Design Cohort study based on Swedish registers
Immigrants from six regions (18-47 years)
A control group of native Swedes (in same age)
Follow-up period of 18 years (three six-year intervals)

6. Study Design
Study population at baseline All persons that immigrated to Sweden from six regions* and were years in 1990
Native Swedes
Western migrants
Non-Western migrants 1 
14 199
60 755
*Western migrants: Western Europe except Nordic countries, North America and Oceania
Non-Western migrants: Middle East, Latin America and north/northeast Africa

7. Outcome measures Five separate measures of the HME
Inpatient health care for: Cardiovascular and Psychiatric disorders
Mortality
Societal health measures: Sick leave and Disability pension

8. Results
Risk of five measures of morbidity/mortality in comparison to the Swedish reference population*
Year 1-6
Cardivascular
Psychiatric
Mortality
Sick leave
Disab.pension
Western
Equal
Lower
Non-Western
Higher
Year 7-12
Cardivascular
Psychiatric
Mortality
Sick leave
Disab.pension
Western
Lower
Equal
Non-Western
Higher
Year 13-18
Cardivascular
Psychiatric
Mortality
Sick leave
Disab.pension
Western
Equal
Lower
Non-Western
Higher
*Adjusted for sex, age, educational level, occupation and work attachment

9. Results
Risk of morbidity/mortality with regard to work attachment (in year 1–6) in comparison to the Swedish reference population
Year 7-12
LMA
Cardivascular
Psychiatric
Mortality
Low year 1-6
Western
Lower
Non-Western
Higher
Equal
High year 1-6
Year 13-18
LMA
Cardivascular
Psychiatric
Mortality
Low year 1-6
Western
Equal
Lower
Non-Western
Higher
High year 1-6
*Adjusted for sex, age, educational level and occupation

10. Conclusion
The HME seem to hold partly for Western migrants, i.e. mostly labour migrants to Sweden
The HME do not hold among non-Western migrants, mostly refugees and family reunion migrants
When stratifying for work attachment, the HME still hold for Western migrants with low work attachment

11. Thank you for your attention!