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Between Two Worlds: Studies of migration, work, and health
Stockholm University, Faculty of Social Sciences, Department of Sociology.
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aims to investigate the extent to which work-related factors contribute to the health inequalities often observed between foreign-origin and native-origin persons in Sweden. Four empirical studies using survey data and population-based registers assessed the health impact of different labor market adversities among groups of foreign-origin persons who were both in and outside the labor market relative to native-origin Swedes.

Studies I and II examined associations between different measures of working life quality, including adverse psychosocial and physical working conditions and educational mismatch, and self-reported health among the employed. Adverse psychosocial and physical working conditions minimally contributed to the excess risk of poor health found among workers from low- and middle-income countries. Over-education had a stronger association with increased risk of poor health, most notably among foreign-born workers from countries outside of Western Europe. Under-educated women from these countries also demonstrated an elevated risk of poor health.  There was no association between educational mismatch and poor health among native-born workers. 

Studies III and IV focused on the health implications of labor market exclusion, and examined relationships between employment status and risk of all-cause mortality and suicide. The majority of foreign-origin groups that experienced unemployment showed an elevated risk of both mortality and suicide. The magnitude of excess risk varied by generational status and region of origin. Variations in patterns of suicide risk were also evident among migrants by age at arrival and duration of residence. Yet within many foreign-origin groups, health advantages were observed among the employed.

The health of migrants is affected by the confluence of several different pre- and post-migration factors.  The extent to which health inequalities are found among persons of foreign-origin in Sweden is influenced by the degree to which they experience labor market adversities, as well as differential vulnerability to the negative effects of these adversities across foreign-origin groups.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockhom University , 2017. , 93 p.
Series
Health Equity Studies, ISSN 1651-5390 ; 21
Keyword [en]
Sweden, foreign-origin, health, working conditions, educational mismatch, unemployment
National Category
Sociology
Research subject
Sociology
Identifiers
URN: urn:nbn:se:su:diva-141188ISBN: 978-91-7649-671-8 (print)ISBN: 978-91-7649-672-5 (electronic)OAI: oai:DiVA.org:su-141188DiVA: diva2:1086876
Public defence
2017-05-19, Aula Svea, Socialhögskolan, Sveavägen 160, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Manuscript. Paper 4: Manuscript.

Available from: 2017-04-26 Created: 2017-04-04 Last updated: 2017-04-21Bibliographically approved
List of papers
1. Health Inequalities among Workers with a Foreign Background in Sweden: Do Working Conditions Matter?
Open this publication in new window or tab >>Health Inequalities among Workers with a Foreign Background in Sweden: Do Working Conditions Matter?
2013 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, no 7, 2871-2887 p.Article in journal (Refereed) Published
Abstract [en]

Employment and working conditions are key social determinants of health, yet current information is lacking regarding relationships between foreign background status, working conditions and health among workers in Sweden. This study utilized cross-sectional data from the 2010 Swedish Level of Living Survey (LNU) and the Level of Living Survey for Foreign Born Persons and their Children (LNU-UFB) to assess whether or not health inequalities exist between native Swedish and foreign background workers and if exposure to adverse psychosocial and physical working conditions contributes to the risk for poor health among foreign background workers. A sub-sample of 4,021 employed individuals aged 18–65 was analyzed using logistic regression. Eastern European, Latin American and Other Non-Western workers had an increased risk of both poor self-rated health and mental distress compared to native Swedish workers. Exposure to adverse working conditions only minimally influenced the risk of poor health. Further research should examine workers who are less integrated or who have less secure labor market attachments and also investigate how additional working conditions may influence associations between health and foreign background status.

Keyword
health inequalities, working conditions, foreign background populations, social determinants of health, Sweden
National Category
Sociology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-92858 (URN)10.3390/ijerph10072871 (DOI)000322182400019 ()
Available from: 2013-08-22 Created: 2013-08-22 Last updated: 2017-04-04Bibliographically approved
2. Educational mismatch and health status among foreign-born workers in Sweden
Open this publication in new window or tab >>Educational mismatch and health status among foreign-born workers in Sweden
2016 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 154, 36-44 p.Article in journal (Refereed) Published
Abstract [en]

Foreign-born workers have been shown to experience poorer working conditions than native-born workers. Yet relationships between health and educational mismatch have been largely overlooked among foreign-born workers. This study uses objective and self-reported measures of educational mismatch to compare the prevalence of educational mismatch among native (n = 2359) and foreign born (n = 1789) workers in Sweden and to examine associations between educational mismatch and poor self-rated health. Findings from weighted multivariate logistic regression which controlled for social position and individual-level demographic characteristics suggested that over-educated foreign-born workers had greater odds ratios for poor-self rated health compared to native-born matched workers. This association was particularly evident among men (OR = 2.14, 95% CI: 1.04-4.39) and women (OR = 2.13, 95% CI: 1.12-4.03) from countries outside of Western Europe, North America, and Australia/New Zealand. Associations between under-education and poor-self rated health were also found among women from countries outside of Western Europe, North America, and Australia/New Zealand (OR = 2.02, 95% CI: 1.27-3.18). These findings suggest that educational mismatch may be an important work-related social determinant of health among foreign-born workers. Future studies are needed to examine the effects of long-term versus short-term states of educational mismatch on health and to study relationships over time.

Keyword
Sweden, Immigrant health, Employment, Over-education, Under-education, Health inequalities
National Category
Sociology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-130194 (URN)10.1016/j.socscimed.2016.02.018 (DOI)000374073400005 ()26943012 (PubMedID)
Available from: 2016-05-10 Created: 2016-05-09 Last updated: 2017-04-04Bibliographically approved
3. Unemployment status and risk of all-cause mortality among native- and foreign-origin persons in Sweden: An open cohort study from 1993-2008
Open this publication in new window or tab >>Unemployment status and risk of all-cause mortality among native- and foreign-origin persons in Sweden: An open cohort study from 1993-2008
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: The association between exposure to unemployment and increased risk of mortality is well established. Yet migrants and their children often experience a number of stressors in the country of residence which could exacerbate the negative effects of job loss or unemployment. This study examined the extent to which region of origin and generational status modified associations between employment status and risk of all-cause mortality.

Methods: Using population-based registers, an open cohort study of 2,178,321 individuals aged 25-64 was followed from 1993-2008. Hazard ratios for mortality were calculated using Cox regression. Employment status and socio-demographic covariates were included as time-varying variables in all models.

Results: Relative to employed native-origin Swedes, excess risk of mortality was found among most groups of foreign-origin persons exposed to unemployment. The excess risk of mortality found among African women exposed to long-term unemployment (HR=3.26, 95% CI: 2.30-4.63),  Finnish men exposed to short-and long-term unemployment (HR=2.74, 95% CI: 2.32-3.24 and HR=2.39, 95% CI: 2.12-2.69), and  second generation Swedish men exposed to short-term unemployment (HR=2.34, 95% CI: 2.06-2.64) was significantly greater (p<0.05) than that found among their unemployed native-origin counterparts. Decreased risk of mortality was observed among the employed in nearly all foreign-origin groups.

Conclusions: Our findings suggest that the mortality health advantage often observed among foreign-origin groups is most evident among the employed, while the magnitude of excess risk for mortality in the foreign-origin exposed to unemployment varies by generational status and region of origin.

National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-141185 (URN)
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2017-04-18Bibliographically approved
4. The effect of migration background characteristics on the association between unemployment and risk of suicide: A longitudinal study
Open this publication in new window or tab >>The effect of migration background characteristics on the association between unemployment and risk of suicide: A longitudinal study
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: To examine the extent to which generational status, region of origin, age at arrival, and duration of residence modify the relationship between employment status and suicide risk.

Methods: Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993-2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models.

Results: Elevated hazard ratios for suicide were observed among the majority of foreign-origin persons exposed to unemployment. Second generation Swedish men exposed to unemployment demonstrated significantly greater (p<0.05) excess risk of suicide than that observed among native-origin men exposed to unemployment.  In unemployed foreign-born men, younger age at arrival and longer duration of residence were associated with increased risk of suicide, whereas those who arrived as adults and had a shorter duration of residence did not show excess risk.

Conclusions: Overall, analyses indicated that the majority of the foreign-origin exposed to unemployment demonstrated excess risk of suicide that was often of a similar magnitude to that observed among their native-origin counterparts. There were notable differences in patterns of association by generational status, region of origin, age at arrival, and duration of residence.

National Category
Sociology
Research subject
Sociology
Identifiers
urn:nbn:se:su:diva-141183 (URN)
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2017-04-18Bibliographically approved

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