Suicide risk among refugees compared with non-refugee migrants and the Swedish-born majority population.
Suicide
epidemiology
mortality
social deprivation
transcultural psychiatry
Journal
The British journal of psychiatry : the journal of mental science
ISSN: 1472-1465
Titre abrégé: Br J Psychiatry
Pays: England
ID NLM: 0342367
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
15
10
2019
medline:
28
4
2021
entrez:
15
10
2019
Statut:
ppublish
Résumé
It has been hypothesised that refugees have an increased risk of suicide. To investigate whether risk of suicide is higher among refugees compared with non-refugee migrants from the same areas of origin and with the Swedish-born population, and to examine whether suicide rates among migrants converge to the Swedish-born population over time. A population-based cohort design using linked national registers to follow 1 457 898 people born between 1 January 1970 and 31 December 1984, classified by migrant status as refugees, non-refugee migrants or Swedish-born. Participants were followed from their 16th birthday or date of arrival in Sweden until death, emigration or 31 December 2015, whichever came first. Cox regression models estimated adjusted hazard ratios for suicide by migrant status, controlling for age, gender, region of origin and income. There were no significant differences in suicide risk between refugee and non-refugee migrants (hazard ratio 1.28, 95% CI 0.93-1.76) and both groups had a lower risk of suicide than Swedish born. During their first 5 years in Sweden no migrants died by suicide; however, after 21-31 years their suicide risk was equivalent to the Swedish-born population (hazard ratio 0.94, 95% CI 0.79-1.22). After adjustment for income this risk was significantly lower for migrants than the Swedish-born population. Being a refugee was not an additional risk factor for suicide. Our findings regarding temporal changes in suicide risk suggest that acculturation and socioeconomic deprivation may account for a convergence of suicide risk between migrants and the host population over time. None.
Sections du résumé
BACKGROUND
It has been hypothesised that refugees have an increased risk of suicide.
AIMS
To investigate whether risk of suicide is higher among refugees compared with non-refugee migrants from the same areas of origin and with the Swedish-born population, and to examine whether suicide rates among migrants converge to the Swedish-born population over time.
METHOD
A population-based cohort design using linked national registers to follow 1 457 898 people born between 1 January 1970 and 31 December 1984, classified by migrant status as refugees, non-refugee migrants or Swedish-born. Participants were followed from their 16th birthday or date of arrival in Sweden until death, emigration or 31 December 2015, whichever came first. Cox regression models estimated adjusted hazard ratios for suicide by migrant status, controlling for age, gender, region of origin and income.
RESULTS
There were no significant differences in suicide risk between refugee and non-refugee migrants (hazard ratio 1.28, 95% CI 0.93-1.76) and both groups had a lower risk of suicide than Swedish born. During their first 5 years in Sweden no migrants died by suicide; however, after 21-31 years their suicide risk was equivalent to the Swedish-born population (hazard ratio 0.94, 95% CI 0.79-1.22). After adjustment for income this risk was significantly lower for migrants than the Swedish-born population.
CONCLUSIONS
Being a refugee was not an additional risk factor for suicide. Our findings regarding temporal changes in suicide risk suggest that acculturation and socioeconomic deprivation may account for a convergence of suicide risk between migrants and the host population over time.
DECLARATION OF INTEREST
None.
Identifiants
pubmed: 31608849
doi: 10.1192/bjp.2019.220
pii: S0007125019002204
pmc: PMC7705666
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
686-692Subventions
Organisme : Medical Research Council
ID : G0802441
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 101272/Z/13/Z
Pays : United Kingdom
Références
Global Health. 2016 Aug 25;12(1):47
pubmed: 27558472
J Immigr Minor Health. 2011 Apr;13(2):361-70
pubmed: 19621261
Psychol Med. 2003 Apr;33(3):395-405
pubmed: 12701661
Crisis. 2020 Jul;41(4):314-317
pubmed: 31859565
BMJ Open. 2015 Nov 25;5(11):e009120
pubmed: 26608638
J Affect Disord. 2013 Mar 20;146(1):1-14
pubmed: 22917940
Eur J Public Health. 2015 Feb;25(1):63-71
pubmed: 25096258
Int J Epidemiol. 2012 Aug;41(4):1153-61
pubmed: 22552872
Int J Environ Res Public Health. 2012 May;9(5):1927-38
pubmed: 22754482
BMJ. 2016 Mar 15;352:i1030
pubmed: 26979256
Clin Psychol Rev. 2014 Apr;34(3):181-92
pubmed: 24534642
Am J Epidemiol. 1988 Mar;127(3):640-53
pubmed: 3341364
Wien Klin Wochenschr. 2007;119(15-16):463-75
pubmed: 17721766
Inj Prev. 2013 Apr;19(2):100-5
pubmed: 22627779
J Psychiatr Res. 2016 Jun;77:92-108
pubmed: 27014850
Eur J Epidemiol. 2016 Feb;31(2):125-36
pubmed: 26769609
Int J Epidemiol. 1999 Aug;28(4):756-63
pubmed: 10480707
Psychol Med. 2014 Jan;44(2):267-77
pubmed: 23611138
J Epidemiol Community Health. 2015 May;69(5):467-73
pubmed: 25516610
JAMA. 2009 Aug 5;302(5):537-49
pubmed: 19654388
Health Policy. 2010 Dec;98(2-3):263-9
pubmed: 20667618
Lancet. 2005 Apr 9-15;365(9467):1309-14
pubmed: 15823380