Against the Grain: International Migration, Mortality and Population Health in Sweden, 1990-2019

International migrants and their children represent increasing shares of the populations of major host countries and have growing potential to affect national mortality. Yet, while many studies have observed mortality differences between immigrants, their children, and ancestral native-born populations, few have progressed beyond this to quantify the impact of these differences upon wider population health. Studies that have reveal that immigrants increasingly enhance national life expectancy over time, but do not progress beyond an average generational effect. We aim to quantify and unpack the impact of the first and second-generations upon population health in Sweden, with a dedicated emphasis on age and origin variations. We use traditional demographic methods in the calculation of death rates and ratios, lifetables, and decompositions of life expectancy by age, generation, and origin. Going “against the grain” relative to other countries, we reveal a migrant mortality disadvantage and initial negative effect of the first-generation on wider population health in 1990, followed by a gradual waning by 2019. This is attributable to the transformation over time in origin composition of immigrants from majority (higher mortality) Nordic origins to (lower mortality) majority non-Western origins, notably at working ages. For the second-generation, all ages and origins contribute to an increasingly negative impact on national life expectancy over time. The unique, disparate mortality risks of immigrants, their children, and ancestral native-born population suggest a need to monitor their health attainment separately to maximise the potential for future gains in population health in Sweden.