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Midlife migration, employment status, and mental health: A Swedish register-based study
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).ORCID iD: 0000-0002-8707-180x
Stockholm University, Faculty of Social Sciences, Department of Sociology. Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Aging Research Center (ARC), (together with KI).ORCID iD: 0000-0002-6973-0381
Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0003-4661-3462
Number of Authors: 42026 (English)In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 256, article id 106328Article in journal (Refereed) Published
Abstract [en]

Objectives Employment status is a key health determinant that impacts mental health through multiple mechanisms. Individuals who migrate in midlife may face particular labor market integration challenges, yet research on the mental health impacts of unemployment among midlife migrants, and how this varies by origin and gender, remains limited. This study investigates associations between employment status and psychiatric disorders among individuals who migrated after age 40, compared with Swedish-born individuals. Study design Using Swedish administrative register data from 1997 to 2016, a retrospective cohort study was conducted among individuals who migrated after age 40 (n = 21,154) and an age-matched Swedish-born cohort (n = 1,403,098). Methods Gender-stratified Cox proportional hazard models estimated hazard ratios (HR) for outpatient and inpatient psychiatric care. Employed, Swedish-born individuals served as the primary reference group. Results Unemployment was associated with increased risks of psychiatric care across all origin groups (HRs from 1.35 to 3.74). For most migrant groups, risks were comparable to those of the unemployed Swedish-born. Nonetheless, indications of mental health inequalities between unemployed migrants and Swedish-born individuals were evident, most notably by the greater magnitudes of increased risk observed among European women and Nordic men. Conclusions Among midlife migrants, unemployment was consistently associated with poorer mental health, yet its contribution to migrant-native mental health inequalities was only seen in specific groups. Findings highlight the importance of examining how migration background, together with gender and other social factors, shapes health risks, and promoting the socio-economic integration of midlife migrants to support health in later life.

Place, publisher, year, edition, pages
2026. Vol. 256, article id 106328
Keywords [en]
Health inequalities, Migration, Psychiatric disorders, Work-related health determinants
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:su:diva-256081DOI: 10.1016/j.puhe.2026.106328ISI: 001761350300001Scopus ID: 2-s2.0-105037493394OAI: oai:DiVA.org:su-256081DiVA, id: diva2:2064679
Available from: 2026-06-02 Created: 2026-06-02 Last updated: 2026-06-02Bibliographically approved

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Mullally, DeirdreBerg, LisaRostila, MikaelDunlavy, Andrea
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Department of Public Health SciencesCentre for Health Equity Studies (CHESS)The Swedish Institute for Social Research (SOFI)Department of SociologyAging Research Center (ARC), (together with KI)
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