Healthy migrant effect in the Swedish context: a register-based, longitudinal cohort study.
Healthy migrant effect in the Swedish context: a register-based, longitudinal cohort study.
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DOI：
10.1136/bmjopen-2018-026972
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Svartengren, Magnus
中科院分区：
文献类型：
--
作者：
Helgesson, Magnus;Johansson, Bo;Svartengren, Magnus
研究发现，在抵达的移民中存在“健康移民效应”（HME），即与母国其他人相比，以及与东道国人口相比，健康状况更好。其目的是调查是否HME假说适用于瑞典的情况下，也就是说，如果健康结果之间的一组主要是劳动力移民不同（西方移民）和一群主要是难民/家庭团聚移民（非西方移民）与瑞典本地人口相比，以及劳动力市场依恋（LMA）与这些健康结果之间是否存在任何相关性。纵向队列研究。参与者队列定义于1990年12月31日，由1985-1990年抵达瑞典的所有18-47岁的移民（n=74 954）和同一年龄段的本地瑞典人（n=1 405 047）的参考人群组成。他们被跟踪了三个连续6年的时期（1991-1996年，1997-2002年和2003-2008年），并对五项健康指标进行了评估：结果西方移民与瑞典本地人相比，在所有时间段内，所有健康指标的HR均较低或相等，而非西方移民在所有时间段内，除死亡率外，所有健康指标的HR均较高或相等。年龄、教育水平、职业和LMA解释了移民和本地瑞典人之间的部分差异。高LMA与西方移民中心血管疾病的HR较高，非西方移民中精神疾病的HR较高，两个移民群体中死亡率的HR较高，与本地Swedes.Conclusions相比，有迹象表明西方移民中的HME，而非西方移民中的HME证据较少。LMA和不同移民类别的分层显示出一些有趣的差异，如果不按移民类别或其他相关变量分层，HME的测量可能是不确定的。
Objectives Studies have found a 'healthy-migrant effect' (HME) among arriving migrants, that is, a better health status compared with others in the home country, but also in comparison with the population in the host country. The aims were to investigate whether the HME hypothesis is applicable to the Swedish context, that is, if health outcomes differed between a group of mainly labour migrants (Western migrants) and a group of mainly refugee/ family reunion migrants (non-Western migrants) compared with the native Swedish population, and if there were any correlations between labour market attachment (LMA) and these health outcomes.Design Register-based, longitudinal cohort study.Participants The cohort was defined on 31 December 1990 and consisted of all migrants aged 18-47 years who arrived in Sweden in 1985-1990 (n=74 954) and a reference population of native Swedes (n=1 405 047) in the same age span. They were followed for three consecutive 6-year periods (1991-1996, 1997-2002 and 2003-2008) and were assessed for five measures of health: hospitalisation for cardiovascular and psychiatric disorders, mortality, disability pension, and sick leave.Results Western migrants had, compared with native Swedes, lower or equal HRs for all health measures during all time periods, while non-Western migrants displayed higher or equal HRs for all health measures, except for mortality, during all time periods. Age, educational level, occupation and LMA explained part of the difference between migrants and native Swedes. High LMA was associated with higher HRs for cardiovascular disorders among Western migrants, higher HRs of psychiatric disorders among non-Western migrants and higher HRs of mortality among both migrant groups compared with native Swedes.Conclusions There were indications of a HME among Western migrants, while less proof of a HME among non-Western migrants. Stratification for LMA and different migrant categories showed some interesting differences, and measurements of the HME may be inconclusive if not stratified by migrant category or other relevant variables.