SRRD_2020_44_V2.pdf (653.68 kB)

Lack of acculturation does not explain excess COVID-19 mortality among immigrants. A population-based cohort study

Download (653.68 kB)
preprint
posted on 20.10.2020, 07:35 by Siddartha Aradhya, Maria Brandén, Sven Drefahl, Ognjen Obućina, Gunnar Andersson, Mikael Rostila, Eleonora Mussino, Sol P. Juárez

Objective. To examine how excess mortality from COVID-19 among immigrants is associated with acculturation.

Methods. A cohort study was conducted using Swedish register data. The study includes all Stockholm residents in co-residential unions who were 30 years of age or older and alive on March 4th, 2020 and living in Sweden in December 2019 (n=836,390). The follow-up period was March 4 until May 7, 2020. Cox regression models were conducted to assess the association between different constellations of immigrant-native couples (measure of acculturation) and COVID-19 mortality and all other causes of deaths. Models were adjusted for relevant confounders.

Results. Compared to Swedish-Swedish couples, both immigrants partnered with another immigrant and a native showed excess mortality for COVID-19 (HR 1.45; 95%CI 1.12, 1.88 and HR 1.53; 95%CI 1.15, 2.05, respectively). Moreover, similar results are found for natives partnered with an immigrant (HR 1.39; 95%CI 1.03, 1.88).

Conclusions. Immigrants experience excess mortality relative to Swedes from COVID-19 across levels of acculturation.

Policy implications. Public health strategies based on cultural differences might not only be inefficient but also reinforce stereotypes and health inequalities.

Funding

The Swedish Research Council for Health, Working Life and Welfare (FORTE), grant numbers 2016-07115, 2016-07105, 2016-07128, 2019-00603

The Swedish Foundation for Humanities and Social Sciences (Riksbankens Jubileumsfond), grant M18-0214:1

History

ISSN

2002-617X

Original title

Lack of acculturation does not explain excess COVID-19 mortality among immigrants. A population-based cohort study

Original language

English

Publication date

19/10/2020

Licence

Exports