International Journal of Epidemiology, Vol 26, 279-287, Copyright © 1997 by International Epidemiological Association
J Sundquist and SE Johansson
BACKGROUND: Epidemiological data on ethnicity and health in Sweden have
mostly been derived from small populations and focused on morbidity. The
present study highlights the relation between country of birth, adjusted
for other social variables, and total mortality and mortality from
circulatory diseases and coronary heart disease (CHD). METHODS: The
interviews with 21,420 males and 21,977 females aged 20-74 were conducted
during a 7-year period, 1979-1985. The data consist of seven independent
samples of the Swedish population. The present investigation was designed
as a longitudinal follow-up study ranging from the day of the interview to
31 December 1993. Mortality data were obtained from the Cause of Death
Register based on the Swedish national registration number. Person-years at
risk were calculated from the date of the interview until death, or for
those who survived, until the end of the follow-up period. The data were
analysed by sex, using a proportional hazard model. RESULTS: Men born in
Finland had an increased mortality from all causes of death. Women born in
Finland had an increased mortality risk for circulatory diseases with a
relative risk (RR) of 2.15 (95% confidence interval [CI] : 1.45-3.20) when
adjusted for age, marital status, form of housing tenure and years of
education. The relationship between being a woman born in Finland or
Eastern Europe and mortality for coronary heart disease (CHD) was
significant with an RR of 2.18 (95% CI : 1.24-3.81) and 3.02 (95% CI :
1.24-7.34) respectively. The form of housing tenure was significantly
associated with mortality in all models. Education showed a graded relation
to total mortality and to mortality from circulatory diseases and CHD.
CONCLUSIONS: The increased mortality risk for Finnish males and females
and, in addition the increased circulatory disease mortality risk for
Finnish females and the strongly increased risk for CHD mortality for
females born in Finland and Eastern Europe could not be explained by
confounding by age, marital status or socioeconomic position.
ARTICLES
The influence of country of birth on mortality from all causes and cardiovascular disease in Sweden 1979-1993
Department of Community Health Sciences, Dalby/Lund, University of Lund, Sweden.
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