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- Title
Mental health by native–immigrant intermarriage in Sweden: a register-based retrospective cohort study.
- Authors
Honkaniemi, Helena; Juárez, Sol Pía; Rostila, Mikael
- Abstract
Background Native–immigrant intermarriage is often regarded as a proxy for integration, given that intermarried immigrants are more socioeconomically and culturally similar to natives than intramarried immigrants. This study aimed to assess whether integration affects mental health and care-seeking behaviours, examining prescription hazards for psychotropic medications by native–immigrant marital composition in Sweden. Methods Total population register data were used to identify first-time married couples residing in Sweden between 31 December 2005 and 31 December 2016. Index persons were distinguished by gender and partners' origin (native vs. immigrant), as well as by immigrants' regions of origin, with intramarried natives as references. Using Cox regression, hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated for antidepressant and anxiolytic prescriptions and adjusted for socioeconomic factors, presence of children and length and quality of marriage. Results Intramarried immigrant women had higher psychotropic prescription hazards than intramarried native references (HR 1.11, 95% CI 1.10–1.12), whereas intermarried immigrant women had equal hazards. Immigrant women's hazards were lower than native references after adjustment. Intramarried immigrant men had the greatest prescription hazards (HR 1.33, 95% CI 1.32–1.34), and intermarried immigrant men slightly higher hazards (HR 1.11, 95% CI 1.10–1.13), than intramarried natives. All were partly attenuated after adjustment. Intermarriage hazards increased by similarities in regions of origin, especially among men. Conclusions Integration indicated by intermarriage appears to be protective for the mental health of immigrants, especially for immigrant men. Future research should empirically disentangle the social, cultural and socioeconomic mechanisms underlying these health differences.
- Subjects
SWEDEN; COMPETENCY assessment (Law); MARRIAGE &; psychology; IMMIGRANTS; ANTIDEPRESSANTS; PSYCHIATRIC drugs; HEALTH services accessibility; CONFIDENCE intervals; HELP-seeking behavior; RETROSPECTIVE studies; ACQUISITION of data; SPOUSES; COMPARATIVE studies; SEX distribution; SOCIOECONOMIC factors; PSYCHOSOCIAL factors; DRUG prescribing; MEDICAL records; DESCRIPTIVE statistics; INDIGENOUS peoples; PHYSICIAN practice patterns; SOCIAL integration; LONGITUDINAL method; PROPORTIONAL hazards models; TRANQUILIZING drugs
- Publication
European Journal of Public Health, 2022, Vol 32, Issue 6, p877
- ISSN
1101-1262
- Publication type
Article
- DOI
10.1093/eurpub/ckac158