title: Multimorbidity among registered immigrants in Norway: the role of reason for migration and length of stay.
abstract: OBJECTIVE
  International migration is rapidly increasing worldwide. However, the health status of migrants differs across groups. Information regarding health at arrival and subsequent periodic follow-up in the host country is necessary to develop equitable health care to immigrants. The objective of this study was to determine the impact of the length of stay in Norway and other sociodemographic variables on the prevalence of multimorbidity across immigrant groups (refugees, labour immigrants, family reunification immigrants and education immigrants).
  
  
  METHODS
  This is a register-based study merging data from the National Population Register and the Norwegian Health Economics Administration database. Sociodemographic variables and multimorbidity across the immigrant groups were compared using Persons' chi-square test and anova as appropriate. Several binary logistic regression models were conducted.
  
  
  RESULTS
  Multimorbidity was significantly lower among labour immigrants (OR (95% CI) 0.23 (0.21-0.26) and 0.45 (0.40-0.50) for men and women, respectively) and education immigrants (OR (95% CI) 0.40 (0.32-0.50) and 0.38 (0.33-0.43)) and higher among refugees (OR (95% CI) 1.67 (1.57-1.78) and 1.83 (1.75-1.92)), compared to family reunification immigrants. For all groups, multimorbidity doubled after a five-year stay in Norway. Effect modifications between multimorbidity and sociodemographic characteristics across the different reasons for migration were observed.
  
  
  CONCLUSIONS
  Multimorbidity was highest among refugees at arrival but increased rapidly among labour immigrants, especially females. Health providers need to ensure tailor-made preventive and management strategies that take into account pre-migration and post-migration experiences for immigrants in order to address their needs.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Norwegian Centre for Minority Health Research, Oslo, Norway.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Diaz
authors.affiliation: Norwegian Centre for Minority Health Research, Oslo, Norway.|Institute for Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Bernadette N
authors.initials: BN
authors.lastname: Kumar
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.|University of Zaragoza, Zaragoza, Spain.|San Pablo Health Centre, Zaragoza, Spain.
authors.forename: Luis-Andrés
authors.initials: LA
authors.lastname: Gimeno-Feliu
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain.
authors.forename: Amaia
authors.initials: A
authors.lastname: Calderón-Larrañaga
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Poblador-Pou
authors.affiliation: EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain.|University of Zaragoza, Zaragoza, Spain.|Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Prados-Torres
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009664:Norway; D016017:Odds Ratio; D011320:Primary Health Care; D012036:Refugees; D012042:Registries; D012737:Sex Factors; D012959:Socioeconomic Factors; D014171:Transients and Migrants; D055815:Young Adult
keywords: chronic disease; emigrants and immigrants; immigrant status; multimorbidity; population register; primary health care