Top

BMC Public Health

Published in:

Open Access 01-12-2006 | Research article

Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations

Authors: Malin Gadd, Sven-Erik Johansson, Jan Sundquist, Per Wändell

Published in: BMC Public Health | Issue 1/2006

Abstract

Background

Mortality from cardiovascular diseases is higher among immigrants than native Swedes. It is not clear whether the high mortality persists from the country of birth or is a result of migration. The purpose of the present study was to analyse whether all-cause and coronary heart disease mortality differ between immigrants in Sweden and in the country of birth.

Methods

Two cohorts including the total population from Swedish national registers and WHO were defined. All-cause and CHD mortality are presented as age-adjusted incidence rates and incidence density ratios (IDR) in eight immigrant groups in Sweden and in their country of birth. The data were analysed using Poisson regression.

Results

The all-cause mortality risk was lower among seven of eight male immigrant groups (IDR 0.39–0.97) and among six of eight female immigrant groups (IDR 0.42–0.81) than in their country of birth. The CHD mortality risk was significantly lower in male immigrants from Norway (IDR = 0.84), Finland (IDR = 0.91), Germany (IDR = 0.84) and Hungary (IDR = 0.59) and among female immigrants from Germany (IDR = 0.66) and Hungary (IDR = 0.54) than in their country of birth. In contrast, there was a significantly higher CHD mortality risk in male immigrants from Southern Europe (IDR = 1.23) than in their country of birth.

Conclusion

The all-cause mortality risk was lower in the majority of immigrant groups in Sweden than in their country of birth. The differences in CHD mortality risks were more complex. For countries with high CHD mortality, such as Finland and Hungary, the risk was lower among immigrants in Sweden than in their country of birth. For low-risk countries in South Europe, the risk was higher in immigrants in Sweden than in South Europe.

Gadd M, Johansson SE, Sundquist J, Wandell P: Morbidity in cardiovascular diseases in immigrants in Sweden. J Intern Med. 2003, 254 (3): 236-43. 10.1046/j.1365-2796.2003.01178.x.CrossRefPubMed

Marmot MG, Adelstein AM, Bulusu L, Great Britain: Office of Population Censuses and Surveys, Immigrant mortality in England and Wales, 1970–78: causes of death by country of birth. Studies on medical and population subjects; no. 47. 1984, London: H.M.S.O., xii: 144-

Wild S, McKeigue P: Cross sectional analysis of mortality by country of birth in England and Wales, 1970–92. Bmj. 1997, 314 (7082): 705-10.CrossRefPubMedPubMedCentral

Singh GK, Siahpush M: All-cause and cause-specific mortality of immigrants and native born in the United States. Am J Public Health. 2001, 91 (3): 392-9.CrossRefPubMedPubMedCentral

Balarajan R: Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. Bmj. 1991, 302 (6776): 560-4.CrossRefPubMedPubMedCentral

Robertson TL, Kato H, Gordon T, Kagan A, Rhoads GG, Land CE, Worth RM, Belsky JL, Dock DS, Miyanishi M, Kawamoto S: Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Coronary heart disease risk factors in Japan and Hawaii. Am J Cardiol. 1977, 39 (2): 244-9. 10.1016/S0002-9149(77)80198-7.CrossRefPubMed

Worth RM, Kato H, Rhoads GG, Kagan K, Syme SL: Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality. Am J Epidemiol. 1975, 102 (6): 481-90.PubMed

Cruickshank JK, Beevers DG: Ethnic factors in health and disease. 1994, Oxford Boston: Butterworth Heinemann, xx: 324-

Razum O, Zeeb H, Gerhardus A: Cardiovascular mortality of Turkish nationals residing in West Germany. Ann Epidemiol. 1998, 8 (5): 334-41. 10.1016/S1047-2797(97)00232-9.CrossRefPubMed

10.

Lechner I, Mielck A: [Decrease in the "healthy migrant effect": trends in the morbidity of foreign and German participants in the 1984–1992 Socioeconomic Panel]. Gesundheitswesen. 1998, 60 (12): 715-20.PubMed

11.

Razum O, Zeeb H, Akgun HS, Yilmaz S: Low overall mortality of Turkish residents in Germany persists and extends into a second generation: merely a healthy migrant effect?. Trop Med Int Health. 1998, 3 (4): 297-303. 10.1046/j.1365-3156.1998.00233.x.CrossRefPubMed

12.

Abraido-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner JB: The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses. Am J Public Health. 1999, 89 (10): 1543-8.CrossRefPubMedPubMedCentral

13.

Stern MP, Wei M: Do Mexican Americans really have low rates of cardiovascular disease?. Prev Med. 1999, 29 (6 Pt 2): S90-5. 10.1006/pmed.1998.0464.CrossRefPubMed

14.

Gadd M, Sundquist J, Johansson SE, Wandell P: Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease?. Eur J Cardiovasc Prev Rehabil. 2005, 12 (6): 535-41. 10.1097/00149831-200512000-00004.CrossRefPubMed

15.

Malmstrom M, Sundquist J, Bajekal M, Johansson SE: Ten-year trends in all-cause mortality and coronary heart disease mortality in socio-economically diverse neighbourhoods. Public Health. 1999, 113 (6): 279-84. 10.1016/S0033-3506(99)00180-8.CrossRefPubMed

16.

Marmot MG, Syme SL: Acculturation and coronary heart disease in Japanese-Americans. Am J Epidemiol. 1976, 104 (3): 225-47.PubMed

17.

Singh GK, Siahpush M: Ethnic-immigrant differentials in health behaviors, morbidity, and cause-specific mortality in the United States: an analysis of two national data bases. Hum Biol. 2002, 74 (1): 83-109.CrossRefPubMed

18.

Sundquist x, Winkleby MA: Cardiovascular risk factors in Mexican American adults: a transcultural analysis of NHANES III, 1988–1994. Am J Public Health. 1999, 89 (5): 723-730.CrossRefPubMedPubMedCentral

19.

Sundquist J, Malmstrom M, Johansson SE: Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis. Int J Epidemiol. 1999, 28 (5): 841-5. 10.1093/ije/28.5.841.CrossRefPubMed

20.

Salmond CE, Prior IA, Wessen AF: Blood pressure patterns and migration: a 14-year cohort study of adult Tokelauans. Am J Epidemiol. 1989, 130 (1): 37-52.PubMed

21.

Sundquist J, Johansson SE: The influence of country of birth on mortality from all causes and cardiovascular disease in Sweden 1979–1993. Int J Epidemiol. 1997, 26 (2): 279-87. 10.1093/ije/26.2.279.CrossRefPubMed

22.

WHOSIS website. [http://www3.who.int/whosis]

23.

Breslow NE, Day NE: Statistical methods in cancer research. The design and analysis of cohort studies. 1987, IARC Sci Publ, II (82): 1-406.

24.

StataCorp, Stata Statistical Software. Release 7.0. College Station. 2001, TX: Stata Corporation

25.

Nilsson Å: Brister i folkbokföringen – övertäckningen bland utomnordiska invandrare. PM. 1995, 1995: 2-

26.

Qvist: Täckningsproblem i Registret över totalbefolkningen RTB. R&D Report. 1999, 1999 (1):

27.

Silcocks PB, Jenner DA, Reza R: Life expectancy as a summary of mortality in a population: statistical considerations and suitability for use by health authorities. J Epidemiol Community Health. 2001, 55 (1): 38-43. 10.1136/jech.55.1.38.CrossRefPubMedPubMedCentral

28.

Wilson M, Daly M: Life expectancy, economic inequality, homicide, and reproductive timing in Chicago neighbourhoods. Bmj. 1997, 314 (7089): 1271-4.CrossRefPubMedPubMedCentral

29.

Kristenson M, Kucinskiene Z, Bergdahl B, Calkauskas H, Urmonas V, Orth-Gomer K: Increased psychosocial strain in Lithuanian versus Swedish men: the LiVicordia study. Psychosom Med. 1998, 60 (3): 277-82.CrossRefPubMed

30.

Benfante R: Studies of cardiovascular disease and cause-specific mortality trends in Japanese-American men living in Hawaii and risk factor comparisons with other Japanese populations in the Pacific region: a review. Hum Biol. 1992, 64 (6): 791-805.PubMed

31.

Kushi LH, Lenart EB, Willett WC: Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products. Am J Clin Nutr. 1995, 61 (6 Suppl): 1407S-1415S.PubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/6/102/prepub

Title: Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations
Authors: Malin Gadd
Sven-Erik Johansson
Jan Sundquist
Per Wändell
Publication date: 01-12-2006
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/1471-2458-6-102

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2006

Carboxyhaemoglobin levels and their determinants in older British men

Prevalence of self-reported hypertension and its relation to dietary habits, in adults; a nutrition & health survey in Greece

The role country of birth plays in receiving disability pensions in relation to patterns of health care utilisation and socioeconomic differences: a multilevel analysis of Malmo, Sweden

Changes in Scottish suicide rates during the Second World War

Racial/Ethnic and social class differences in preventive care practices among persons with diabetes

Impact of vaccine economic programs on physician referral of children to public vaccine clinics: a pre-post comparison