I denna artikel presenteras resultaten av en experimentell studie om etnisk diskriminering. Undersökningen visar att det främst är infödda män som tenderar att ha ett diskriminerande beteende. I Sverige finns lagstiftning som förbjuder etnisk diskriminering. Vi har också en särskild myndighet – diskrimineringsombudsmannen – som skall motverka etnisk diskriminering. Den presenterade undersökningen kan ge en ny infallsvinkel. Ett sätt att motverka diskriminering av invandrare kan vara att se till att andelen kvinnor som är personalchefer i företag och myndigheter ökar. Frågan om etnisk diskriminering är kanske också en jämställdhetsfråga.

Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations. 

Aim: to analyze the pattern of mortality in deceased foreign-born persons living in Sweden during the years 1970-1999 in relation to distance mobility.

MEthods: Data from Statistics Sweden and the National Board of Health and Welfare was used, and the study population consisted of 281,412 foreign-born persons aged 16 years and over who were registered as living in Sweden in 1970.

Results: Distance mobility did not have a negative effect on health. Total mortality was lower (OR 0.71; 95% CI 0.69-0.73) in foreign-born persons in Sweden who had changed their county of residence during the period 1970-1990. Higher death rates were observed, after adjustment for age, in three ICD diagnosis groups "Injury and poisoning", "External causes of injury and poisoning", and "Diseases of the digestive system" among persons who had changed county of residence.

In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987–1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970–1999, was used. Persons were selected if they were admitted to hospital during 1987–1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care.

Abstract

Will future immigration to a country with a large public sector alleviate

the increasing burden on the public welfare system due to an ageing population?

The question is based on the experience that the age structure of

immigrants differs from that of the native population. Fiscal impacts due to

immigration depend mainly on the size, the age composition and the labour market

integration of the additional population which arises because of immigration. A

projection from Statistics Sweden about future immigration combined with the

latest Long-Term Survey of the Swedish Economy has been used in this study.

Calculations for Sweden up to the year 2050 show that the positive net contribution

to the public sector from the additional population is rather small even with

good integration into the labour market. The reason is that future immigration will

increase the size of the population and thereby raise not only revenue from taxation

but also public expenses. The fiscal impact is sensitive to the labour market

integration of the additional population. The yearly positive/negative net contribution

effect is less than 1% of GDP for most of the years. On the whole, the

results are about the same even if we change the assumptions concerning the

composition of future public revenues, the growth of public expenses, return

migration, or the age-specific birth and death rates in the additional population.

More considerable net fiscal effects would require a much higher and probably

unrealistic level of future immigration.

 Sweden and many other Western countries are facing a demographic development with an ageing population which will burden their public finances. Already today, the sum of yearly public expenditures in Sweden is about 50 percent of gross national product (GNP). Will future immigration alleviate the burden on the welfare system? Immigrants usually have a low proportion of old people and a high proportion of people of working age. Calculations for Sweden up to the year 2050 show, however, that the positive net fiscal contribution of immigrants is small even if they are well integrated on the labour market. The reason is that future immigration will increase the size of the population and thereby raise not only tax receipts but also public expenses. The fiscal impact is sensitive to immigrants’ integration into the labour market. If, for example, the rate of labour force participation of future immigrants will be the same as that of foreign born now living in Sweden, the fiscal consequences would be negative, but small also in that case. For most years up to 2050, the calculated positive/negative net contribution effect is less than one percent of GNP. The same positive net contribution could be achieved through a better integration of immigrants already living in Sweden.

This paper presents a Seemingly Unrelated Regressions estimation of earnings differentials between three generations of immigrants and natives in Sweden. The results show that male first-generation immigrants were at an earnings advantage compared to male natives. Among male second-generation immigrants the earnings differentials compared to natives were very small, while third-generation immigrants were at an earnings disadvantage compared to natives. The same pattern was found among females. Thus, the results indicate that ethnic differences in earnings are likely to occur even after several generations spent in a country and that the problem of immigrant assimilation that exists in many European countries may last for several generations.

The article investigates incomes and especially state pensions 2008 among elderly immigrants who arrived in Sweden before 1970. At age 70 and above, the level of state old-age pension for immigrant men was nearly the same and for immigrant women somewhat higher than for natives with similar characteristics. At age 65-66 the state pension was lower for immigrants than for their native counterparts. The differences in pensions for immigrants of different ages are probably due to changed rules in the Swedish state old-age pension system from 2003. The new rules have hit different age groups in different ways. The gaps are partially levelled out when other incomes are included. The extent to which levelling occurs varies greatly between different immigrant groups. For immigrants who have arrived during the last decades, the future state old-age pension outcomes are expected to be worse.

Previous studies have shown that the participation of first-generation immigrants in the Swedish income security system deviates from that of the native population. However, so far there has been no research that has focused on this issue where second-generation immigrants are concerned. This study shows that the rates of participation in different parts of the income security system vary considerably between different groups of second-generation immigrants. Second-generation immigrants whose parents come from Western Europe have low participa-tion rates in all the studied parts of the income security system. Their participation rates are even lower than for natives with both parents born in Sweden. Second-generation immigrants with parents from southern Europe and from outside Europe, on the other hand, have very high participation rates in especi-ally social assistance. The differences between the groups are of course to a great extent explained by differences in their labour market situation. According to the findings of the study, there are reasons to be concerned about the future labour market integration of second-generation immigrants with parents of non-European origin.

Background Refugee immigrants have poorer health than other immigrant groups but little is known about their mortality. A comparison of mortality among refugees and non- refugee immigrants is liable to exaggerate the former if the latter includes labour migrants, whose mortality risk may be lower than that of the general population. To avoid bias, labour migrants are not included in this study. The aim was to investigate mortality risks among refugees compared with non- labour non- refugee immigrants in Sweden. Methods Population-based cohort design, starting 1 January 1998 and ending with death or censoring 31 December 2006. Persons included in the study were those aged 18-64 years, had received a residence permit in Sweden 1992-98 and were defined by the Swedish Board of Migration as either a refugee or a non-labour non-refugee immigrant. The outcomes were all-cause and cause-specific mortalities and the main exposure was being a refugee. Cox-regression models estimated hazard ratios (HRs) of mortality. Results The study population totalled 86 395 persons, 49.3% women, 24.2 % refugees. Adjusted for age and origin, refugee men had an over-risk of cardiovascular mortality (HR = 1.58, 95% CI = 1.08-2.33). With socio-economic factors added to the model, refugee men still had an over-risk mortality in cardiovascular disease (HR = 1.53, 95% CI = 1.04-2.24) and external causes (HR = 1.59, 95% CI = 1.01-2.50). Conclusion Refugee men in Sweden have a higher mortality risk in cardiovascular and external causes compared with male non-labour non-refugee immigrants. This study suggests that the refugee experience resembles other stressors in terms of the association with cardiovascular mortality.

Background The association between unemployment and poor mental health in general is explained by both causation and selection. The aim was to study whether experiencing unemployment was a risk factor for hospitalisation for depressive disorder specifically, and whether gender and immigrant status modified the hypothesised risk. Methods A register-based prospective cohort study, 2000-2006, of persons aged 18-64 with a strong connection to the Swedish labour market. Outcome: hospital admission for a depressive episode; F32 in International Classification of Diseases, 10th revision. Exposure: employment status. Explanatory variables: gender and immigrant status. Confounders: age group, education and marital status. Cox regression models were used to estimate HRs with 95% CIs. Results The cohort comprised 3 284 896 adults, 47.5% women. An excess relative risk for hospitalisation was found among those who became unemployed (HR=1.94, 95% CI 1.85 to 2.03). Foreign-born women who experienced unemployment had the highest relative risk (HR=3.47 95% CI 3.02 to 3.98). Conclusions Among persons with a strong connection to the labour market experiencing unemployment, is a risk factor for hospitalisation for depressive disorders. Unemployed foreign-born women had the highest relative risk compared with all Swedish born, all foreign-born men and to employed foreign-born women.

Objective: Research into medical and licit drug use in resettled refugee populations is scarce, despite the fact that mental health status often has been found to be poorer than in general populations. Hence the aim of this study was to estimate the prevalence of self-rated use of medicine and licit drugs among adults who came to Sweden from Bosnia-Herzegovina (1993/94) and who in 2001 were living in either an urban (low employment context) or a rural (high employment context) region (n=4185).

Methods: Prevalence was estimated from a cross-sectional questionnaire distributed to a representative sample (n=650) in 2001 (63.5% response rate).

Results: The study population estimates of usage of sedatives (26.5%), sleeping tablets (26.2%) and antidepressants (22.3%) did not differ by gender but did so by region, with a higher urban prevalence. The consumption of alcohol (5.1%) and cigarettes (41.0%) did not differ by region but men reported higher alcohol consumption than women.

Conclusion: The high consumption of medicine (compared with general populations) raises the question of treatment efficiency and the need for public health attention and evaluation many years after resettlement. Factors to consider for further research with analytic prerequisites concern indications that regional differences may be influenced, not only by urban employment being lower but also by urban/rural differences in prescription rates and/or access to health care; moreover, there might have been a selection to the urban region of older people, with a more vulnerable family situation, and/or poorer mental health. Finally, the overall alcohol (low) and cigarettes (high) consumption in the study population followed prevalence patterns found in Bosnia-Herzegovina rather than in Sweden.