title: Mortality in adult offspring of immigrants: a Swedish national cohort study.
abstract: BACKGROUND
  Higher risks of psychiatric disorders and lower-than-average subjective health in adulthood have been demonstrated in offspring of immigrants in Sweden compared with offspring of native Swedes, and linked to relative socioeconomic disadvantage. The present study investigated mortality rates in relation to this inequity from a gender perspective.
  
  
  METHODS
  We used data from national registers covering the entire Swedish population aged 18-65 years. Offspring of foreign-born parents who were either Swedish born or had received residency in Sweden before school age (<7 years) were defined as "offspring of immigrants." We used Cox regression models to examine the association between parental country of birth and mortality between 1990 and 2008, with adjustment for education, income, age and family type.
  
  
  RESULTS
  Male offspring of immigrants from the Middle East (HR:2.00, CI:1.66-2.26), other non-European countries (HR:1.80, CI:1.36-2.36) and Finland (HR:1.56, CI:1.48-1.65) showed an age-adjusted excess mortality risk from all causes of death when compared to offspring with Swedish-born parents. Income, but not education, greatly attenuated these increased mortality risks. No excess mortality rates were found among female offspring of immigrants, with the exception of external cause of death among offspring of Finnish immigrants.
  
  
  CONCLUSIONS
  The study demonstrates high mortality rates in male offspring of immigrants from Finland and non-European countries that are associated with economic, but not educational, disadvantage. No increased mortality rates were found among female offspring of immigrants. Future studies are needed to explain this gender differential and why income, but not education, predicts mortality in male offspring of immigrants.
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hélio
authors.initials: H
authors.lastname: Manhica
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden.
authors.forename: Susanna
authors.initials: S
authors.lastname: Toivanen
authors.affiliation: Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden; Department of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Hjern
authors.affiliation: Department of Sociology and Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Rostila
mesh_terms: D000293:Adolescent; D000328:Adult; D032721:Adult Children / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult