Dataset Information

Suicide risk among refugees compared with non-refugee migrants and the Swedish-born majority population.

ABSTRACT: Background: It has been hypothesised that refugees have an increased risk of suicide.

Aims: To investigate whether risk of suicide is higher among refugees compared with non-refugee migrants from the same areas of origin and with the Swedish-born population, and to examine whether suicide rates among migrants converge to the Swedish-born population over time.

Method: A population-based cohort design using linked national registers to follow 1 457 898 people born between 1 January 1970 and 31 December 1984, classified by migrant status as refugees, non-refugee migrants or Swedish-born. Participants were followed from their 16th birthday or date of arrival in Sweden until death, emigration or 31 December 2015, whichever came first. Cox regression models estimated adjusted hazard ratios for suicide by migrant status, controlling for age, gender, region of origin and income.

Results: There were no significant differences in suicide risk between refugee and non-refugee migrants (hazard ratio 1.28, 95% CI 0.93-1.76) and both groups had a lower risk of suicide than Swedish born. During their first 5 years in Sweden no migrants died by suicide; however, after 21-31 years their suicide risk was equivalent to the Swedish-born population (hazard ratio 0.94, 95% CI 0.79-1.22). After adjustment for income this risk was significantly lower for migrants than the Swedish-born population.

Conclusions: Being a refugee was not an additional risk factor for suicide. Our findings regarding temporal changes in suicide risk suggest that acculturation and socioeconomic deprivation may account for a convergence of suicide risk between migrants and the host population over time.

Declaration of interest: None.

SUBMITTER: Hollander AC

PROVIDER: S-EPMC7705666 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Suicide risk among refugees compared with non-refugee migrants and the Swedish-born majority population.

Hollander Anna-Clara AC Pitman Alexandra A Sjöqvist Hugo H Lewis Glyn G Magnusson Cecilia C Kirkbride James B JB Dalman Christina C

The British journal of psychiatry : the journal of mental science 20201201 6

<h4>Background</h4>It has been hypothesised that refugees have an increased risk of suicide.<h4>Aims</h4>To investigate whether risk of suicide is higher among refugees compared with non-refugee migrants from the same areas of origin and with the Swedish-born population, and to examine whether suicide rates among migrants converge to the Swedish-born population over time.<h4>Method</h4>A population-based cohort design using linked national registers to follow 1 457 898 people born between 1 Janu ...[more]

PMID: 31608849

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Project description:ObjectivesThe aims were to investigate the associations between specific mental and somatic disorders and subsequent all-cause and cause-specific mortality (suicide, external and other causes) in young refugees and non-refugee migrants compared with Swedish-born individuals of similar age.MethodsIn this register-based prospective cohort study, all 1 003 760 individuals (40 305 refugees, 31 687 non-refugee migrants as the exposure groups and the rest as the Swedish-born comparison group), 16-25 years old, residing in Sweden on 31 December 2004 were included. These individuals were followed regarding the outcome of all-cause and cause-specific mortality (suicide and external causes) between 2005 and 2016. The study population was also stratified according to any use of specialised healthcare for mental or somatic diagnoses before baseline (2000-2004). Cox regression models yielding crude and multivariate Hazard Ratios (HR and aHR, respectively) with 95% Confidence Intervals (CI) were used to investigate the afore-mentioned associations.ResultsA lower proportion of both refugees (12%) and non-refugee migrants (10%) had college/university education compared with the Swedish-born individuals (17%). The proportion of unemployed (>180 days) among refugees (2.3%) and non-refugees (2.9%) was higher than the Swedish born (1.4%). Refugees and non-refugee migrants had about a 20% lower risk of all-cause mortality and external causes of mortality compared with Swedish-born individuals. An even greater reduction in suicide risk (aHR 0.51, 95% CI 0.37 to 0.70, and 0.63, 95% CI 0.49 to 0.82 for non-refugees and refugees, respectively) was found. When restricted to those with a mental or somatic disorder, a lower risk of both general and specific mortality was also found among both refugees and non-refugee migrants compared with Swedish-born individuals. Refugees had, however, equal point estimates of all-cause mortality associated with substance misuse disorder and neoplasms as their Swedish-born peers with these disorders.ConclusionsWith few exceptions, young migrants with specific mental and somatic disorders have a mortality advantage compared with their Swedish-born peers with the same disorders. Further research on protective factors is warranted.

Dataset Information

Suicide risk among refugees compared with non-refugee migrants and the Swedish-born majority population.

Publications

Suicide risk among refugees compared with non-refugee migrants and the Swedish-born majority population.

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