TY - JOUR
T1 - Labour market marginalisation subsequent to suicide attempt in young migrants and native Swedes
AU - Niederkrotenthaler, T.
AU - Wang, M.
AU - Helgesson, M.
AU - Wilcox, H.
AU - Gould, M.
AU - Mittendorfer-Rutz, E.
N1 - Funding Information:
Open access funding provided by Medical University of Vienna. This work was funded by the Swedish Research Council–Vetenskaspsradet, (Grant number 2014–3335, see http://www.vr.se ). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2017, The Author(s).
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Purpose: This study aimed to compare young individuals who differed in terms of birth region and history of suicide attempt regarding socio-demographic and healthcare factors, and with regard to their risks of subsequent unemployment, sickness absence and disability pension. Methods: Prospective cohort study based on register linkage of 2,801,558 Swedish residents, aged 16–40 years in 2004, without disability pension and with known birth country, followed up 2005–2011. Suicide attempters treated in inpatient care during 2002–2004 (N = 9149) were compared to the general population of the same age without attempt 1987–2011 (N = 2,792,409). Hazard ratios (HR) and 95% confidence intervals (CIs) for long-term unemployment (>180 days), sickness absence (>90 days), and disability pension were calculated with Cox regression, adjusted for several risk markers. Results: Compared to Swedish natives with suicide attempt, migrants of non-Western origin with attempt received less specialised mental healthcare. Distinct differences between native Swedes and migrants were present for the three labour market outcomes, but differences between migrant subgroups were inconsistent. As compared to native Swedes without attempts, non-European migrants with suicide attempt had adjusted HRs and CIs for subsequent unemployment 2.8 (2.5–3.1), sickness absence 2.0 (1.7–2.3) and disability pension 2.2 (1.8–2.6). Respective estimates for natives with suicide attempt were 2.0 (1.9–2.1); 2.7 (2.6–2.9) and 3.4 (3.2–3.6), respectively. Conclusions: Migrant suicide attempters receive less specialised mental health care before their attempt than native Swedes, and their marginalzation patterns are different. Healthcare and policy makers need to take the differential risk profile for migrant and native populations into account.
AB - Purpose: This study aimed to compare young individuals who differed in terms of birth region and history of suicide attempt regarding socio-demographic and healthcare factors, and with regard to their risks of subsequent unemployment, sickness absence and disability pension. Methods: Prospective cohort study based on register linkage of 2,801,558 Swedish residents, aged 16–40 years in 2004, without disability pension and with known birth country, followed up 2005–2011. Suicide attempters treated in inpatient care during 2002–2004 (N = 9149) were compared to the general population of the same age without attempt 1987–2011 (N = 2,792,409). Hazard ratios (HR) and 95% confidence intervals (CIs) for long-term unemployment (>180 days), sickness absence (>90 days), and disability pension were calculated with Cox regression, adjusted for several risk markers. Results: Compared to Swedish natives with suicide attempt, migrants of non-Western origin with attempt received less specialised mental healthcare. Distinct differences between native Swedes and migrants were present for the three labour market outcomes, but differences between migrant subgroups were inconsistent. As compared to native Swedes without attempts, non-European migrants with suicide attempt had adjusted HRs and CIs for subsequent unemployment 2.8 (2.5–3.1), sickness absence 2.0 (1.7–2.3) and disability pension 2.2 (1.8–2.6). Respective estimates for natives with suicide attempt were 2.0 (1.9–2.1); 2.7 (2.6–2.9) and 3.4 (3.2–3.6), respectively. Conclusions: Migrant suicide attempters receive less specialised mental health care before their attempt than native Swedes, and their marginalzation patterns are different. Healthcare and policy makers need to take the differential risk profile for migrant and native populations into account.
KW - Labour market
KW - Migration
KW - Suicide attempt
KW - Sweden
KW - Unemployment
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U2 - 10.1007/s00127-017-1344-6
DO - 10.1007/s00127-017-1344-6
M3 - Article
C2 - 28220213
AN - SCOPUS:85013149667
SN - 0933-7954
VL - 52
SP - 549
EP - 558
JO - Social psychiatry and psychiatric epidemiology
JF - Social psychiatry and psychiatric epidemiology
IS - 5
ER -