Dataset Information

How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography.

ABSTRACT: In an increasingly interconnected world, the demographic effects of wars are not confined only to war zones and neighbouring areas; wars and conflicts may also change populations far away. Without the war in Syria under President Assad and the associated mass exodus of Syrian refugees, the population trends in distant countries like Sweden and Norway over the last few years would have been different. We create hypothetical scenarios of the population developments in Sweden and Norway without a war in Syria from 2011 onwards, where excess immigration due to the war and associated excess births are removed. The results indicate that population growth in 2016 would have been roughly 36% lower in Sweden and 26% lower in Norway without the Syrian war. The number of births in 2017 would have been about 3% lower in Sweden and 1% lower in Norway. One in ten municipalities would have had a population decline in 2016 instead of a population increase, and the largest immigrant group in Sweden by January 2019 would still be of Finnish origin.

SUBMITTER: Tonnessen M

PROVIDER: S-EPMC7816981 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography.

Tønnessen Marianne M Aradhya Siddartha S Mussino Eleonora E

PloS one 20210120 1

In an increasingly interconnected world, the demographic effects of wars are not confined only to war zones and neighbouring areas; wars and conflicts may also change populations far away. Without the war in Syria under President Assad and the associated mass exodus of Syrian refugees, the population trends in distant countries like Sweden and Norway over the last few years would have been different. We create hypothetical scenarios of the population developments in Sweden and Norway without a w ...[more]

PMID: 33471846

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Project description:BackgroundUnderstanding the differential utilization of healthcare services is essential to address the public health challenges. Through the migration process, refugees move from one set of health risk factors to another and can face multiple healthcare challenges along their journey. Yet how these changing risk factors influence refugees' use of health care services is poorly understood.MethodsA longitudinal survey assessing health care utilization of 353 adult Syrian refugees was conducted; first in a transit setting in Lebanon and after one year of resettlement in Norway. The main outcomes are the utilization of general practitioner services, emergency care, outpatient and/or specialist care and hospitalization during the previous 12 months. Associations between use of healthcare services and several sociodemographic, migration-related and health status variables at both time points were found using regression analysis. We also analyzed longitudinal changes in utilization rates using generalized estimating equations.ResultsThe use of general practitioner and emergency care increased after resettlement while outpatient/specialist care markedly dropped, and hospitalization rates remained the same. Undocumented status and poor self-rated health (SRH) prior to resettlement were identified as predictors for use of health care after arrival. After resettlement, higher health literacy, higher education, higher social support and poor SRH and quality of life were significantly associated with use of healthcare services.ConclusionsUtilization of health services changes post migration to the destination country and are associated with migration-related and socio-demographic factors. Poor SRH is associated with use of services, both pre-arrival and post-resettlement. Our findings have implications for future resettlements, health care policies and service provision to newly arrived refugees with regard to both health needs as well as delivery of services.

Project description:A number of post-migration stressors have been shown to adversely affect mental health in refugees resettled in high-income countries, including poor social integration, financial difficulties and discrimination, and recent evidence suggests that these effects are gender specific. Social support has been found to buffer against post-migration stress in some studies on refugee populations, though the evidence on this is mixed. The present study used cross-sectional survey data from a nationwide, randomly sampled group of adult refugees from Syria resettled in Sweden between 2008 and 2013 (N sample = 4,000, n respondents = 1,215, response rate 30.4%) to investigate gender-specific associations between post-migration stressors and subjective well-being (SWB) and whether these associations were modified by social support. SWB was measured with the WHO-5 Well-being Index (scaled 0-100), dichotomized into high (≥50) and low (<50) SWB. Main analyses were stratified by gender, and regressed SWB on four domains of post-migration stress (financial strain, social strain, competency strain and discrimination) using logistic regression, adjusting for sociodemographic variables and traumatic experiences. Social support was tested as an effect modifier. In fully adjusted models, main risk factors for low SWB were high financial strain, especially in males (ORhigh vs. low strain, males = 10.30 [4.91-21.6], p < 0.001 vs. ORhigh vs. low strain, females= 3.84 [1.68-8.79], p = 0.002), and high social strain, only in males (ORhigh vs. low strain, males = 9.21 [3.96-21.4], p < 0.001 vs. ORhigh vs. low strain, females = 1.03 [0.40-2.64], p = ns). There was some evidence that social support buffered the adverse association of financial strain with SWB. In conclusion, the present study found clear support of gender-specific effects of post-migration stressors on SWB. Mitigation strategies and interventions should be aware of and sensitive to these potential gendered effects, and future research exploring mental health in the context of resettlement stress should have a heightened focus on the important role of gender.

Project description:BACKGROUND:The health of forcibly displaced individuals changes along their migration path and estimates of disease burden are essential to develop health care policies and practices adequately corresponding to their health care needs. This study aims to describe the health status and use of medication among Syrian refugees in two different migration phases: in a transit setting and in a recipient country. Further, we aim to investigate the associations between migration related exposures and both chronic pain and mental health among Syrian refugees. METHODS:This is a cross-sectional study based on survey data collected among 827 adult Syrian refugees in Lebanon and Norway during 2017-2018. The survey instrument included items measuring somatic status (including chronic pain), mental health (using the HSCL-10 and HTQ items), use of medication and migration related exposures. We used descriptive statistics to calculate standardised prevalence proportions and regression analyses to study associations between migration related exposures and health outcomes. RESULTS:The response rate was 85%. The mean age in the sample was 33 years and 41% were women. Half of the participants reported that they had never had any health problems. The prevalence of non-communicable diseases was 12%. Headache and musculoskeletal complaints were the most prevalent conditions reported, with 30% reporting chronic pain lasting for more than six months. Symptoms indicating anxiety and/or depression were presented by 35%, while 7% revealed symptoms compatible with post-traumatic stress disorder. Among those reporting non-communicable diseases a substantial share did not seem to receive adequate treatment. Trauma experiences were associated with both chronic pain and anxiety/depression symptoms, and the latter were also associated with migrating without family members. CONCLUSIONS:Migrant-friendly public health policies and practises should acknowledge migration related risks, address discontinuity in care of chronic conditions and target common complaints such as chronic pain and mental health problems among forcibly displaced individuals.

Project description:AimsTo investigate the patterns of use of different forms of psychiatric care in refugees who settled in Sweden as teenagers.MethodCox proportional hazards models were used to estimate the use of different forms of psychiatric care from 2009 to 2012 in a population of 35 457 refugees, aged from 20 to 36, who had settled in Sweden as teenagers between 1989 and 2004. These findings were compared with 1.26 million peers from the same birth cohorts in the general Swedish population.ResultsUnaccompanied and accompanied refugees were more likely to experience compulsory admission to a psychiatric hospital compared with the native Swedish population, with hazard ratios (HRs) of 2.76 (1.86-4.10) and 1.89 (1.53-2.34), respectively, as well as psychiatric inpatient care, with HRs of 1.62 (1.34-1.94) and 1.37 (1.25-1.50). Outpatient care visits by the young refugees were similar to the native Swedish population. The longer the refugees had residency in Sweden, the more they used outpatient psychiatric care. Refugees born in the Horn of Africa and Iran were most likely to undergo compulsory admission, with HRs of 3.98 (2.12-7.46) and 3.07 (1.52-6.19), respectively. They were also the groups who were most likely to receive inpatient care, with HRs of 1.55 (1.17-2.06) and 1.84 (1.37-2.47), respectively. Our results also indicated that the use of psychiatric care services increased with the level of education in the refugee population, while the opposite was true for the native Swedish population. In fact, the risks of compulsory admissions were particularly higher among refugees who had received a secondary education, compared with native Swedish residents, with HRs of 4.72 (3.06-7.29) for unaccompanied refugees and 2.04 (1.51-2.73) for accompanied refugees.ConclusionsYoung refugees received more psychiatric inpatient care than the native Swedish population, with the highest rates seen in refugees who were not accompanied by their parents. The discrepancy between the use of inpatient and outpatient care by young refugees suggests that there are barriers to outpatient care, but we did note that living in Sweden longer increased the use of outpatient services. Further research is needed to clarify the role that education levels among Sweden's refugee populations have on their mental health and health-seeking behaviour.

Dataset Information

How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography.

Publications

How Assad changed population growth in Sweden and Norway: Syrian refugees' impact on Nordic national and municipal demography.

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