PMID- 34465581
OWN - NLM
STAT- MEDLINE
DCOM- 20210903
LR  - 20240403
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 9
DP  - 2021 Aug 31
TI  - Intermarriage and COVID-19 mortality among immigrants. A population-based cohort 
      study from Sweden.
PG  - e048952
LID - 10.1136/bmjopen-2021-048952 [doi]
LID - e048952
AB  - OBJECTIVES: To evaluate the role of language proficiency and institutional 
      awareness in explaining excess COVID-19 mortality among immigrants. DESIGN: 
      Cohort study with follow-up between 12 March 2020 and 23 February 2021. SETTING: 
      Swedish register-based study on all residents in Sweden. PARTICIPANTS: 3 963 356 
      Swedish residents in co-residential unions who were 30 years of age or older and 
      alive on 12 March 2020 and living in Sweden in December 2019. OUTCOME MEASURES: 
      Cox regression models were conducted to assess the association between different 
      constellations of immigrant-native couples (proxy for language proficiency and 
      institutional awareness) and COVID-19 mortality and all other causes of deaths 
      (2019 and 2020). Models were adjusted for relevant confounders. RESULTS: Compared 
      with Swedish-Swedish couples (1.18 deaths per thousand person-years), both 
      immigrants partnered with another immigrant and a native showed excess mortality 
      for COVID-19 (HR 1.43; 95% CI 1.29 to 1.58 and HR 1.24; 95% CI 1.10 to 1.40, 
      respectively), which translates to 1.37 and 1.28 deaths per thousand 
      person-years. Moreover, similar results are found for natives partnered with an 
      immigrant (HR 1.15; 95% CI 1.02 to 1.29), which translates to 1.29 deaths per 
      thousand person-years. Further analysis shows that immigrants from both 
      high-income and low-income and middle-income countries (LMIC) experience excess 
      mortality also when partnered with a Swede. However, having a Swedish-born 
      partner is only partially protective against COVID-19 mortality among immigrants 
      from LMIC origins. CONCLUSIONS: Language barriers and/or poor institutional 
      awareness are not major drivers for the excess mortality from COVID-19 among 
      immigrants. Rather, our study provides suggestive evidence that excess mortality 
      among immigrants is explained by differential exposure to the virus.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published 
      by BMJ.
FAU - Aradhya, Siddartha
AU  - Aradhya S
AUID- ORCID: 0000-0003-3748-6270
AD  - Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm 
      University, Stockholm, Sweden.
FAU - Branden, Maria
AU  - Branden M
AD  - Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm 
      University, Stockholm, Sweden.
AD  - The Institute for Analytical Sociology (IAS), Linkoping University, Linkoping, 
      Sweden.
FAU - Drefahl, Sven
AU  - Drefahl S
AD  - Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm 
      University, Stockholm, Sweden.
FAU - Obucina, Ognjen
AU  - Obucina O
AD  - Institut national d'etudes demographiques (INED), Aubervilliers, France.
FAU - Andersson, Gunnar
AU  - Andersson G
AD  - Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm 
      University, Stockholm, Sweden.
FAU - Rostila, Mikael
AU  - Rostila M
AD  - Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
FAU - Mussino, Eleonora
AU  - Mussino E
AD  - Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm 
      University, Stockholm, Sweden.
FAU - Juarez, Sol Pia
AU  - Juarez SP
AUID- ORCID: 0000-0001-9086-7588
AD  - Department of Public Health Sciences, Stockholm University, Stockholm, Sweden 
      sol.juarez@su.se.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210831
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - *COVID-19
MH  - Cohort Studies
MH  - *Emigrants and Immigrants
MH  - Humans
MH  - Marriage
MH  - Registries
MH  - SARS-CoV-2
MH  - Sweden/epidemiology
PMC - PMC8413476
OTO - NOTNLM
OT  - COVID-19
OT  - demography
OT  - epidemiology
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2021/09/02 06:00
MHDA- 2021/09/04 06:00
PMCR- 2021/08/31
CRDT- 2021/09/01 06:40
PHST- 2021/09/01 06:40 [entrez]
PHST- 2021/09/02 06:00 [pubmed]
PHST- 2021/09/04 06:00 [medline]
PHST- 2021/08/31 00:00 [pmc-release]
AID - bmjopen-2021-048952 [pii]
AID - 10.1136/bmjopen-2021-048952 [doi]
PST - epublish
SO  - BMJ Open. 2021 Aug 31;11(9):e048952. doi: 10.1136/bmjopen-2021-048952.