Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context

Summary: Background: Evidence shows that both the mortality advantage and the lower income inequalities in mortality that characterise recent international migrants tend to disappear with time spent in the receiving country. This study examines whether absolute and relative income inequalities in m...

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Main Authors: Alexander Miething, Andrea Dunlavy, Sol P. Juárez
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:The Lancet Regional Health. Europe
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Online Access:http://www.sciencedirect.com/science/article/pii/S266677622500136X
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author Alexander Miething
Andrea Dunlavy
Sol P. Juárez
author_facet Alexander Miething
Andrea Dunlavy
Sol P. Juárez
author_sort Alexander Miething
collection DOAJ
description Summary: Background: Evidence shows that both the mortality advantage and the lower income inequalities in mortality that characterise recent international migrants tend to disappear with time spent in the receiving country. This study examines whether absolute and relative income inequalities in mortality also increase by migrant generation in Sweden. Methods: Longitudinal data from Sweden’s population registries (2004–2018) was used to identify residents aged 25–64. An open cohort design was employed using slope (SII) and relative (RII) indices of inequality from negative binomial regressions to estimate associations between income rank position and all-cause mortality among majority population Swedes and individuals with a foreign background, classified by generation and by European or non-European origin. Sub-analyses assessed the contribution of external causes to income inequalities in mortality. Findings: Male descendants of migrants with non-European backgrounds exhibited higher relative income inequalities in mortality (ranging from RIIG2.5: 6.72 to RIIG2: 11.47) than first generation non-European migrant (RII: 1.7; 95% confidence interval (CI): 1.28–2.26) and majority population men (RII: 4.73; 95% CI: 4.36–5.12). External causes accounted for 56–60% of these inequalities in mortality. Absolute income inequalities in mortality among men showed similar patterns to those observed for relative inequalities. Women showed lower absolute and relative inequalities compared to men across origins and by generation. Interpretation: Income-related inequalities in mortality appear to increase by migrant generation, particularly among men with non-European backgrounds, with external causes playing a significant role. Health and non-health targeted interventions focusing on social determinants are needed to address income inequalities in mortality. Funding: Swedish Research Council for Health, Working Life and Welfare, and Swedish Research Council.
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spelling doaj-art-6b51d1d119174886af2a62fc9bdaec5d2025-08-20T02:33:12ZengElsevierThe Lancet Regional Health. Europe2666-77622025-08-015510134410.1016/j.lanepe.2025.101344Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in contextAlexander Miething0Andrea Dunlavy1Sol P. Juárez2Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden; Corresponding author. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, SwedenDepartment of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, SwedenSummary: Background: Evidence shows that both the mortality advantage and the lower income inequalities in mortality that characterise recent international migrants tend to disappear with time spent in the receiving country. This study examines whether absolute and relative income inequalities in mortality also increase by migrant generation in Sweden. Methods: Longitudinal data from Sweden’s population registries (2004–2018) was used to identify residents aged 25–64. An open cohort design was employed using slope (SII) and relative (RII) indices of inequality from negative binomial regressions to estimate associations between income rank position and all-cause mortality among majority population Swedes and individuals with a foreign background, classified by generation and by European or non-European origin. Sub-analyses assessed the contribution of external causes to income inequalities in mortality. Findings: Male descendants of migrants with non-European backgrounds exhibited higher relative income inequalities in mortality (ranging from RIIG2.5: 6.72 to RIIG2: 11.47) than first generation non-European migrant (RII: 1.7; 95% confidence interval (CI): 1.28–2.26) and majority population men (RII: 4.73; 95% CI: 4.36–5.12). External causes accounted for 56–60% of these inequalities in mortality. Absolute income inequalities in mortality among men showed similar patterns to those observed for relative inequalities. Women showed lower absolute and relative inequalities compared to men across origins and by generation. Interpretation: Income-related inequalities in mortality appear to increase by migrant generation, particularly among men with non-European backgrounds, with external causes playing a significant role. Health and non-health targeted interventions focusing on social determinants are needed to address income inequalities in mortality. Funding: Swedish Research Council for Health, Working Life and Welfare, and Swedish Research Council.http://www.sciencedirect.com/science/article/pii/S266677622500136XMigrantInequalityIncome inequalityGenerationSecond generationMortality
spellingShingle Alexander Miething
Andrea Dunlavy
Sol P. Juárez
Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
The Lancet Regional Health. Europe
Migrant
Inequality
Income inequality
Generation
Second generation
Mortality
title Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
title_full Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
title_fullStr Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
title_full_unstemmed Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
title_short Income inequalities and mortality by generation among individuals with a foreign background in Sweden: a population-based studyResearch in context
title_sort income inequalities and mortality by generation among individuals with a foreign background in sweden a population based studyresearch in context
topic Migrant
Inequality
Income inequality
Generation
Second generation
Mortality
url http://www.sciencedirect.com/science/article/pii/S266677622500136X
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