Employment and working conditions are key social determinants of health, yet current information is lacking regarding relationships between foreign background status, working conditions and health among workers in Sweden. This study utilized cross-sectional data from the 2010 Swedish Level of Living Survey (LNU) and the Level of Living Survey for Foreign Born Persons and their Children (LNU-UFB) to assess whether or not health inequalities exist between native Swedish and foreign background workers and if exposure to adverse psychosocial and physical working conditions contributes to the risk for poor health among foreign background workers. A sub-sample of 4,021 employed individuals aged 18–65 was analyzed using logistic regression. Eastern European, Latin American and Other Non-Western workers had an increased risk of both poor self-rated health and mental distress compared to native Swedish workers. Exposure to adverse working conditions only minimally influenced the risk of poor health. Further research should examine workers who are less integrated or who have less secure labor market attachments and also investigate how additional working conditions may influence associations between health and foreign background status.
References
[1]
Mackenbach, J.P. The persistence of health inequalities in modern welfare states: The explanation of a paradox. Soc. Sci. Med. 2012, 75, 761–769, doi:10.1016/j.socscimed.2012.02.031.
[2]
Frieden, T.R. Forward: CDC health disparities and inequalities report—United States, 2011. MMWR Surveill. Sum. (Washington, D.C.) 2011, 60 Suppl, 1–2.
[3]
Kautto, M.; Fritzell, J.; Hvinden, B.; Kvist, J.; Uusitalo, H. Nordic Welfare States in the European Context; Routledge: London, UK and New York, NY, USA, 2001.
[4]
Rostila, M.; Toivanen, S. Den Or？ttvisa H？lsan: Om Socioekonomiska Skillnader i H？lsa och Livsl？ngd; Liber AB: Stockholm, Sweden, 2012.
[5]
Graham, H. Unequal Lives: Health and Socioeconomic Inequalities; Open University Press, McGraw Hill Education: Berkshire, UK, 2007.
[6]
Commission on Social Determinants of Health. Fair Employment and Decent Work. In Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health; World Health Organization, Ed.; World Health Organization: Geneva, Switzerland, 2008; pp. 72–83.
[7]
Marmot, M.; Wilkinson, R.G. Social Determinants of Health; Oxford University Press: Oxford, UK, 2006.
[8]
Cox, T.; Griffiths, A.; Rial-Gonzalz, E. Research on Work-Related Stress; European Agency for Safety and Health at Work: Luxembourg, 2000.
[9]
Robert Wood Johnson Foundation. Issue Brief 4: Work Matters for Health. Available online: http://www.commissiononhealth.org/PDF/0e8ca13d-6fb8-451d-bac8-7d15343aacff/Issue%20Brief% 204%20Dec%2008%20-%20Work%20and%20Health.pdf (accessed on 6 January 2013).
[10]
Marmot, M. The Status Syndrome; Owl Books: New York, NY, USA, 2004.
[11]
Kivimaki, M.; Virtanen, M.; Elovainio, M.; Kouvonen, A.; Vaananen, A.; Vahtera, J. Work stress in the etiology of coronary heart disease—A meta-analysis. Scand. J. Work Environ. Health 2006, 32, 431–442, doi:10.5271/sjweh.1049.
[12]
Rostila, M. The Swedish labour market in the 1990s: The very last of the healthy jobs? Scand. J. Public Health 2008, 36, 126–134, doi:10.1177/1403494807085067.
[13]
Rostila, M. Birds of a feather flock together—And fall ill? Migrant homophily and health in Sweden. Soc. Health Illn. 2010, 32, 382–399, doi:10.1111/j.1467-9566.2009.01196.x.
[14]
Nyampame, I. Invandrade kvinnors h？lsa i Sverige: Om genus och etnicitet. Soc. Tidskr. 2008, 85, 219–226.
[15]
Daryani, A.; Berglund, L.; Andersson, A.; Kocturk, T.; Becker, W.; Vessby, B. Risk factors for coronary heart disease among immigrant women from Iran and Turkey, compared to women of Swedish ethnicity. Ethn. Dis. 2005, 15, 213–220.
[16]
Dotevall, A.; Rosengren, A.; Lappas, G.; Wilhelmsen, L. Does immigration contribute to decreasing CHD incidence? Coronary risk factors among immigrants in Goteborg, Sweden. J. Intern. Med. 2000, 247, 331–339, doi:10.1046/j.1365-2796.2000.00619.x.
[17]
Borne, Y.; Engstrom, G.; Essen, B.; Hedblad, B. Immigrant status and increased risk of heart failure: The role of hypertension and life-style risk factors. BMC Cardiovasc. Disord. 2012, 12, 20, doi:10.1186/1471-2261-12-20.
[18]
Albin, B.; Hjelm, K.; Ekberg, J.; Elmstahl, S. Mortality among 723,948 foreign- and native-born Swedes 1970–1999. Eur. J. Public Health 2005, 15, 511–517, doi:10.1093/eurpub/cki026.
[19]
Johansson, B.; Helgesson, M.; Lundberg, I.; Nordquist, T.; Leijon, O.; Lindberg, P.; Vingard, E. Work and health among immigrants and native Swedes 1990–2008: A register-based study on hospitalization for common potentially work-related disorders, disability pension and mortality. BMC Public Health 2012, 12, No. 845.
[20]
Loeb, S.; Drevin, L.; Robinson, D.; Holmberg, E.; Carlsson, S.; Lambe, M.; Stattin, P. Risk of localized and advanced prostate cancer among immigrants versus native-born Swedish men: A nation-wide population-based study. Cancer Causes Control 2013, 24, 383–390, doi:10.1007/s10552-012-0124-6.
[21]
Statistics Sweden. Statistical Yearbook of Sweden 2012: Population; Statistics Sweden: Stockholm, Sweden, 2012.
[22]
Statistics Sweden. The Future Population of Sweden, 2012–2060; Statistics Sweden: Stockholm, Sweden, 2011.
[23]
Ingelby, D. Ethnicity, migration and the 'social determinants of health' agenda. Psychosoc. Int. 2012, 21, 331–341.
[24]
B？ckman, O.; Edling, C. Work Environment and Work-related Health Problems in the 1990s. In Worklife and Health in Sweden 2000; Marklund, S., Ed.; National Institute for Working Life: Stockholm, Sweden, 2001.
[25]
Hjerm, M. A Welfare State for Everyone? The Position of Immigrants In and Outside the Labour Market. In Worklife and Health in Sweden 2004; Gustafsson, R.A., Lundberg, I., Eds.; National Institute for Working Life: Stockholm, Sweden, 2005.
[26]
Akhavan, S.; Bildt, C.; Wamala, S. Work-related health factors for female immigrants in Sweden. Work 2007, 28, 135–143.
[27]
De los Reyes, P. Etnisk Diskriminering i Arbetsliv: Kunskapl？ge och Kunskapsbehov; Landsorganisationen i Sverige (LO): Stockholm, Sweden, 2008.
[28]
Rydgren, J. Mechanisms of exclusion: Ethnic discrimination in the Swedish labour market. J. Ethn. Migr. Stud. 2004, 30, 697–716, doi:10.1080/13691830410001699522.
[29]
Akhavan, S.; Bildt, C.O.; Franzen, E.C.; Wamala, S. Health in relation to unemployment and sick leave among immigrants in Sweden from a gender perspective. J. Immgr. Health 2004, 6, 103–118, doi:10.1023/B:JOIH.0000030226.59785.38.
[30]
Sundquist, J.; Ostergren, P.O.; Sundquist, K.; Johansson, S.E. Psychosocial working conditions and self-reported long-term illness: A population-based study of Swedish-born and foreign-born employed persons. Ethn. Health 2003, 8, 307–317, doi:10.1080/1355785032000163939.
[31]
Johansson, B.; Ving？rd, E. Migration, Arbetsmilj？, och H？lsa; Arbetsmilj？verket: Stockholm, Sweden, 2012.
[32]
Todorova, I.L.; Tucker, K.L.; Jimenez, M.P.; Lincoln, A.K.; Arevalo, S.; Falcon, L.M. Determinants of self-rated health and the role of acculturation: Implications for health inequalities. Ethn. Health 2013. Epub ahead of print, doi:10.1080/13557858.2013.771147.
[33]
Idler, E.L.; Benyamini, Y. Self-rated health and mortality: A review of twenty-seven community studies. J. Health Soc. Behav. 1997, 38, 21–37, doi:10.2307/2955359.
[34]
Fritzell, J.; Lundberg, O. Health Inequalities and Welfare Resources: Continuity and Change in Sweden; The Policy Press: Bristol, UK, 2007.
[35]
Theorell, T. Working Conditions and Health. In Social Epidemiology; Berkman, L.F., Kawachi, I., Eds.; Oxford University Press: New York, NY, USA, 2000; pp. 95–117.
[36]
Johnson, J.V.; Stewart, W.; Hall, E.M.; Fredlund, P.; Theorell, T. Long-term psychosocial work environment and cardiovascular mortality among Swedish men. Amer. J Public Health 1996, 86, 324–331, doi:10.2105/AJPH.86.3.324.
[37]
Karasek, R.; Theorell, T. Healthy Work: Stress, Productivity, and the Reconstruction of Working Life; Basic Books: New York, NY, USA, 1990.
[38]
Ari？ns, G.A.M.; van Mechelen, W.; Bongers, P.M.; Bouter, L.M.; van der Wal, G. Psychosocial risk factors for neck pain: A systematic review. Am. J. Ind. Med. 2001, 39, 180–193, doi:10.1002/1097-0274(200102)39:2<180::AID-AJIM1005>3.0.CO;2-#.
[39]
Karasek, R. Job demands, job decisions latitude and mental strain: Implications for job redesign. Admini. Sci. Quart. 1979, 24, 285–308, doi:10.2307/2392498.
[40]
Fredriksson, K.; Alfredsson, L.; Ahlberg, G.; Josephson, M.; Kilbom, A.; Wigaeus Hjelm, E.; Wiktorin, C.; Vingard, E. Work environment and neck and shoulder pain: The influence of exposure time. Results from a population based case-control study. Occup. Environ. Med. 2002, 59, 182–188.
[41]
Johnson, N.J.; Backlund, E.; Sorlie, P.D.; Loveless, C.A. Marital status and mortality: The national longitudinal mortality study. Ann. Epidemiol. 2000, 10, 224–238, doi:10.1016/S1047-2797(99)00052-6.
[42]
Schenker, M.B. A global perspective of migration and occupational health. Amer. J. Ind. Med. 2010, 53, 329–337, doi:10.1002/ajim.20834.
[43]
？slund, O.; Nordstr？m Skans, O. Will I See You at Work? Ethnic Workplace Segregation in Sweden, 1985–2002; Institute for Labour Market Policy Evaluation: Uppsala, Sweden, 2002.
[44]
Lundberg, J. Working and Employment Conditions of Migrant Workers-Sweden; Eurofond: Dublin, Ireland, 2007.
[45]
Leao, T.S.; Sundquist, J.; Johansson, S.E.; Sundquist, K. The influence of age at migration and length of residence on self-rated health among Swedish immigrants: A cross-sectional study. Ethn. Health 2009, 14, 93–105, doi:10.1080/13557850802345973.
[46]
Lindstrom, M.; Sundquist, J.; Ostergren, P.O. Ethnic differences in self reported health in Malm？ in southern Sweden. J. Epidemiol. Commun. H. 2001, 55, 97–103, doi:10.1136/jech.55.2.97.
[47]
Blomstedt, Y.; Johansson, S.E.; Sundquist, J. Mental health of immigrants from the former Soviet Bloc: A future problem for primary health care in the enlarged European Union? A cross-sectional study. BMC Public Health 2007, 7, 27, doi:10.1186/1471-2458-7-27.
[48]
Sundquist, J. Refugees, labour migrants and psychological distress. A population-based study of 338 Latin-American refugees, 161 South European and 396 Finnish labour migrants, and 996 Swedish age-, sex- and education-matched controls. Soc. Psych Psych Epid. 1994, 29, 20–24.
[49]
Taloyan, M.; Sundquist, J.; Al-Windi, A. The impact of ethnicity and self-reported health on psychological well-being: A comparative study of Kurdish-born and Swedish-born people. Nord. J. Psychiat. 2008, 62, 392–398, doi:10.1080/08039480801984263.
[50]
Steiner, K.H.; Johansson, S.E.; Sundquist, J.; Wandell, P.E. Self-reported anxiety, sleeping problems and pain among Turkish-born immigrants in Sweden. Ethn. Health 2007, 12, 363–379, doi:10.1080/13557850701300673.
[51]
World Health Organization. Promoting Mental Health: Concepts, Emerging Evidence, Practice; Hermann, H., Saxena, S., Moodie, R., Eds.; World Health Organization: Geneva, Switzerland, 2005.
[52]
World Health Organization. Mental Health and Work: Impact, Issues, and Good Practices; Harnois, G., Gabriel, P., Eds.; World Health Organization: Geneva, Switzerland, 2002.
[53]
Regeringskansliet. Swedish Integration Policy. Available online: http://www.government.se/content/1/c6/13/77/34/5b7683a6.pdf (accessed 5 May 2013).
[54]
Socialstyrelsen. Social Report 2010: The National Report on Social Conditions in Sweden; Stockholm, Sweden, 2010.
[55]
Smith, P.M.; Mustard, C.A. Comparing the risk of work-related injuries between immigrants to Canada and Canadian-born labour market participants. Occup. Environ. Med. 2009, 66, 361–367, doi:10.1136/oem.2007.038646.
[56]
Smith, P.M.; Chen, C.; Mustard, C. Differential risk of employment in more physically demanding jobs among a recent cohort of immigrants to Canada. Inj. Prev. 2009, 15, 252–258, doi:10.1136/ip.2008.021451.
[57]
Newbold, B. The short-term health of Canada's new immigrant arrivals: Evidence from LSIC. Ethn. Health 2009, 14, 315–336, doi:10.1080/13557850802609956.
[58]
Yakushko, O.; Watson, M.; Thomspson, S. Stress and coping in the lives of recent immigrants and refugees: Considerations for counseling. Int. J. Adv. Couns. 2008, 30, 167–178, doi:10.1007/s10447-008-9054-0.
[59]
Meerding, W.J.; IJzelenberg, W.; Koopmanschap, M.A.; Severens, J.L.; Burdorf, A. Health problems lead to considerable productivity loss at work among workers with high physical load jobs. J. Clin. Epidemiol. 2005, 58, 517–523, doi:10.1016/j.jclinepi.2004.06.016.
[60]
Wynne-Jones, G.; Buck, R.; Varnava, A.; Phillips, C.; Main, C.J. Impacts on work absence and performance: What really matters? Occup. Med. (Lond.) 2009, 59, 556–562.
[61]
Siegrist, J. Adverse health effects of high-effort/low-reward conditions. J. Occup. Health Psychol. 1996, 1, 27–41, doi:10.1037/1076-8998.1.1.27.
[62]
Laszlo, K.D.; Pikhart, H.; Kopp, M.S.; Bobak, M.; Pajak, A.; Malyutina, S.; Salavecz, G.; Marmot, M. Job insecurity and health: A study of 16 European countries. Soc. Sci. Med. 2010, 70, 867–874, doi:10.1016/j.socscimed.2009.11.022.
[63]
Faragher, E.B.; Cass, M.; Cooper, C.L. The relationship between job satisfaction and health: A meta-analysis. Occup. Environ. Med. 2005, 62, 105–112, doi:10.1136/oem.2002.006734.
[64]
Li, C.Y.; Sung, F.C. A review of the healthy worker effect in occupational epidemiology. Occup. Environ. Med. 2005, 62, 105–112.
[65]
？stlin, P. Occupational career and health: Methodological considerations on the healthy worker effect. Ph.D. Thesis, Uppsala University, Uppsala, Sweden, 1989.
