Psychosocial working conditions and self-reported long-term illness: a population-based study of Swedish-born and foreign-born employed persons.
BACKGROUND
Knowledge pertaining to the relationship between migration status and psychosocial job characteristics and long-term illness is not readily available in the international literature. The aim of this study is to analyse the cross-sectional associations between high psychological job demands and low decision latitude (high job strain), work-related social support and long-term illness among foreign-born and Swedish-born people.


METHODS
The present study combines four annual simple random samples covering 1994-97 from the Swedish Annual Level of Living Survey (SALLS). A sub-sample, including only employed persons and consisting of 10,072 Swedish-born persons, 710 labour migrants and 333 refugees aged 25-64 years, was analysed using logistic regression.


RESULTS
Refugees had a higher risk (OR=1.33; 95% CI: 1.05-1.69) of long-term illness than Swedes. Moreover, those experiencing both high job demands and a low decision latitude ran an increased risk (OR=1.74; 95% CI: 1.42-2.13) of long-term illness. About 63% of the refugees among the unskilled/skilled manual workers had low decision latitudes in comparison with 17% of the intermediate and senior salaried employees. There were only small differences in job demands between labour immigrants, refugees and Swedes. There was no interaction between migration status and high job strain. However, refugees with low social support had nearly twice as high a risk of long-term illness as Swedes with high-level work-related social support.


CONCLUSIONS
Refugees ran a higher risk of long-term illness than Swedes. Although there were no differences in risk between labour immigrants, refugees and Swedes under job strain, refugees with low work-related social support had a high risk of long-term illness. Unskilled/skilled refugee workers had lower decision latitudes than Swedes.
Sundquist
Jan
J
Karolinska Institute, Family Medicine Stockholm, Centre for Research on Migration Medicine & Psychiatry, MigraMed, Sweden. jan.sundquist@klinvet.ki.se
Ostergren
Per-Olof
PO
Sundquist
Kristina
K
Johansson
Sven-Erik
SE
D000328:Adult; D003625:Data Collection; D003657:Decision Making; D004651:Employment / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000208:ethnology* / Q000523:psychology; D012036:Refugees / Q000523:psychology*; D018570:Risk Assessment; D012803:Sick Role; D012944:Social Support; D013548:Sweden / Q000453:epidemiology; D014171:Transients and Migrants / Q000523:psychology*; D017132:Workplace / Q000523:psychology*