Research has shown that married individuals live longer lives than unmarried women and men. A smaller number of studies have included non-marital cohabitation and have found that their mortality falls between the married and other unmarried groups. There are indications that the cohabiting population is diverse in terms of mortality risk, yet very little is known about how the association is related to age and stages of the life course. Sweden is a forerunner in family trends, and this is the first study that examines cohabitation and mortality in a Swedish context. Using Swedish register data for the years 2012–2017, we investigated how different partnership statuses are related to mortality for men and women at different ages (N = 5,572,011). We also examine whether the association between cohabitation and mortality is similar after accounting for family-of-origin effects through the use of a sibling comparison design. Our findings confirmed the notion of cohabiters as a diverse group whose relative mortality risk differs depending on the timing of cohabitation. Never-married cohabiters had a mortality risk similar to married couples at younger ages and a gradually increased risk with age. Divorced and widowed cohabiters exhibited an age gradient in the opposite direction. Future research should consider how the context of cohabitation changes across the life course.

Children of immigrants born in the host country–the second generation (G2)–face higher risks of unemployment and overqualification compared to the majority native population in Western Europe. While the health effects of unemployment and overqualification are well documented, it remains unclear whether these factors impact the mental health of the G2 in the same way as in the majority population. This study uses Swedish register data to examine the association between different labor market disadvantages, i.e., unemployment and overqualification, and mental health outcomes among the G2 and the majority population. The outcome was measured as time to the first prescription of psychotropic medications (anxiolytics, sedatives, hypnotics, and antidepressants). Descriptive findings showed that psychotropic prescription rates are higher among G2 groups compared to the majority population. Cox proportional hazards models, adjusted for demographic and socioeconomic factors, indicated that unemployment similarly impacts mental health across origin groups, suggesting that being unemployed does not contribute to the mental health inequality between the G2 and the majority population. G2 individuals, especially G2 European individuals, showed higher risks of psychotropic prescriptions across all employment types. These findings imply that improving the labor market position is not sufficient to address mental health inequalities between the G2 and the majority population.

International migrants and their children represent increasing shares of the populations of major host countries and have growing potential to affect estimates of national mortality. Yet, while many studies have observed mortality differences between migrants, their children, and the majority population, few have progressed beyond this point to quantify the actual impact of these differences upon national life expectancy levels. Studies that have, reveal that migrants increasingly enhance national life expectancy, but do not progress beyond a single average generational effect. Here, using established demographic methods, we aim to quantify and unpack the impact of migrants and the children of migrants on national life expectancy in Sweden, with emphasis on potential differences by age, generations, and migration background. Going “against the grain” relative to other countries, we reveal an initial negative effect of first-generation migrants on national life expectancy levels in Sweden, followed by a gradual waning and disappearance of this effect over time. This change is attributable to the transformation in origin composition of Sweden's migrant population from migrants born in Nordic countries (that have higher mortality than the majority population) to migrants born in non-Western countries (that have lower mortality than the majority population), particularly at working ages. For children of migrants, nearly all ages and migrant backgrounds contribute to an increasingly negative effect on national life expectancy over time. The unique and disparate mortality risks of migrants, the children of migrants, and the majority population suggest a need to monitor their mortality separately so as to maximise potential future gains in national life expectancy in Sweden.

Background: Explanations for the disproportional COVID-19 burden among immigrants relative to host-country natives include differential exposure to the virus and susceptibility due to poor health conditions. Prior to the pandemic, immigrants displayed deteriorating health with duration of residence that may be associated with increased susceptibility over time. The aim of this study was to compare immigrant–native COVID-19 mortality by immigrants’ duration of residence to examine the role of differential susceptibility. Methods: A population-based cohort study was conducted with individuals between 18 and 100 years old registered in Sweden between 1 January 2015 and 15 June 2022. Cox regression models were run to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Inequalities in COVID-19 mortality between immigrants and the Swedish-born population in the working-age group were concentrated among those of non-Western origins and from Finland with more than 15 years in Sweden, while for those of retirement age, these groups showed higher COVID-19 mortality HRs regardless of duration of residence. Both age groups of immigrants from Africa and the Middle East showed consistently higher COVID-19 mortality HRs. For the working-age population: Africa: HR<15: 2.46, 95%CI: 1.78, 3.38; HR≥15: 1.49, 95%CI: 1.01, 2.19; and from the Middle East: HR<15: 1.20, 95%CI: 0.90, 1.60; HR≥15: 1.65, 95%CI: 1.32, 2.05. For the retirement-age population: Africa: HR<15: 3.94, 95%CI: 2.85, 5.44; HR≥15: 1.66, 95%CI: 1.32, 2.09; Middle East: HR<15: 3.27, 95%CI: 2.70, 3.97; HR≥15: 2.12, 95%CI: 1.91, 2.34. Conclusions: Differential exposure, as opposed to differential susceptibility, likely accounted for the higher COVID-19 mortality observed among those origins who were disproportionately affected by the pandemic in Sweden.

In Denmark and Sweden, statutory retirement age is indexed to life expectancy to account for mortality improvements in their populations. However, mortality improvements have not been uniform across different sub-populations. Notably, in both countries, individuals of lower socioeconomic status (SES) have experienced slower mortality improvements. As a result, a uniform rise in the statutory retirement age could disproportionally affect these low-SES groups and may unintentionally lead to a reverse redistribution effect, shifting benefits from short-lived low-SES individuals to long-lived high-SES individuals. The aim of this study is twofold: to quantify and contextualise mortality inequalities by SES in Denmark and Sweden, and to assess how indexing retirement age will affect future survival to retirement age by SES in these countries. We used Danish and Swedish registry data (1988–2019), to aggregate individuals aged 50 + based on their demographic characteristics and SES. We computed period life tables by year, sex, and SES to estimate the difference in survival across different SES groups. We then forecast mortality across SES groups to assess how indexing retirement age will affect survival inequalities to retirement age, using two forecasting models—the Mode model and the Li-Lee model. Mortality inequalities are comparable in Denmark and Sweden, even though the latter generally has higher survival. We also find that indexing retirement age to life expectancy will have two main consequences: it will reduce the probability of reaching retirement for all SES groups, particularly those of low SES, and time spent in retirement will be reduced, particularly for those of high SES.

Background: The number of confirmed COVID-19 deaths differed across countries and across waves of the pandemic. Patterns also differed between groups within a country.

Objective: We combine data on excess mortality with data on cause-of-death-specific mortality in the case of Sweden to identify which groups had excess mortality beyond what can be captured by analyses of COVID-19-specific deaths. We also explore the possibility that some groups may have benefited in terms of reduced all-cause mortality, potentially due to home-centered living conditions during the pandemic.

Methods: We produced and compared three sets of group-specific incidence rates: deaths from (1) any cause in 2020, (2) any cause in 2019, (3) any cause excluding COVID-19 in 2020. We compared rates across different socioeconomic profiles based on combinations of sex, age, marital status, education, and country of birth.

Contribution: We show that many of those who died during 2020 would not have done so in the absence of the pandemic. We find some evidence of COVID-19 mortality underestimation, mainly among individuals with a migration background. We also found groups for which mortality decreased during the pandemic, even when including COVID-19 mortality. Progression across the first and second waves of the pandemic shows that more groups appeared to become protected over time and that there was less underestimation of COVID-19 mortality in the second part of 2020.

Background: Denmark and Sweden index their statutory retirement ages to life expectancy. When lifespan increases, so does retirement age. This policy does not consider demographic heterogeneity in life expectancy, e.g., between migrants and non-migrants, posing possible issues for pension policies that index retirement age to life expectancy.

Objective: To understand how mortality inequalities between migrants and non-migrants interact with the indexation of statutory retirement age in Denmark and Sweden.

Methods: We used Danish and Swedish registry data from 1988–2018, and included individuals aged 50+. Migrants were classified as European-born or non-European-born. We calculated the probability of dying before retirement age, remaining life expectancy at retirement age, lifespan inequalities after retirement age, and the likelihood that a non-migrant would outlive a migrant. We also classified the Danish-born population into four income levels and compared them to migrant groups.

Results: Non-European-born migrants had the survival advantage in both countries, but equal or higher lifespan inequality at retirement. Sweden had a proportionally larger migrant population, but Denmark’s was more diverse. The probability that a non-migrant would outsurvive a migrant was 40%–50% in both countries.

Conclusions: The healthy migrant effect was observed in both Denmark and Sweden. Despite mortality advantages, migrants do not contribute to increasing life expectancy in Denmark or Sweden.

Contribution: This study contributes to the literature on mortality differences between migrants and non-migrants in Scandinavia. The novel contributions of this paper are the consideration of the socioeconomic status of non-migrants in Denmark, and the calculation of probabilities that migrants will outsurvive non-migrants, all within the context of pension policy.

The growing necessity for evidence-based policy built on rigorous research has never been greater. However, the ability of researchers to provide such evidence is invariably tied to the availability of high-quality data. Bias stemming from over-coverage in official population registers, i.e. resident individuals whose death or emigration is not registered, can lead to serious implications for policymaking and research. Using Swedish Population registers and the statistical framework of multiple systems estimation, we estimate the extent of over-coverage among foreign-born individuals’ resident in Sweden for the period 2003–2016. Our study reveals that, although over-coverage is low during this period in Sweden, we observed a distinct heterogeneity in over-coverage across various sub-populations, suggesting significant variations among them. We also evaluated the implications of omitting each of the considered registers on real data and simulated data, and highlight the potential bias introduced when the omitted register interacts with the included registers. Our paper underscores the broad applicability of multiple systems estimation in addressing and mitigating bias from over-coverage in scenarios involving incomplete but overlapping population registers. 

Over-coverage occurs when individuals who reside in a country leave or pass away, and this demographic event is not recorded in population registers, leading to population size overestimation. This problem can have important policy and decision-making consequences. With the increased reliance on incomplete but overlapping official registers for documenting whole populations or subgroups of populations, there is a need for more sophisticated modelling techniques that reliably estimate population size, and hence over-coverage, from such registers. Previous approaches have considered multiple systems estimation (MSE) for monitoring over-coverage, but MSE does not naturally extend to cases where individuals are followed over time. In this paper, motivated by the case study of Sweden, we develop a capture-recapture (CR) modelling framework for population registers that allows us to estimate the population size each year, the probability of presence for each individual in the population, conditional on their records, each year and to quantify the effect of demographic characteristics on the probability of emigration and re-immigration, amongst other parameters. Our results suggest that the CR approach, which accounts for the whole time series for each individual, gives a more realistic estimate of the population size compared to existing, deterministic approaches, especially when considering the subgroup of newly arrived individuals, and that it provides new insights on individual behaviour in terms of migration patterns than existing MSE approaches.

Previous research has investigated several different aspects of the relationship between having a child and parental mortality. One aspect of research that has been neglected until now is the age of the child. If children have an effect on parental mortality, this is likely to change as they grow up. We apply hazard regression models to longitudinal Swedish register data of the total population for men and women separately. Adjusting for a variety of control variables, we find that parents with younger children experience a substantive mortality advantage compared to parents—of the same age—who have older children. The mortality advantage decreases gradually as the age of the youngest child increases. Robustness checks confirm that this result cannot be explained by differences in the parent’s age and parental age at first birth. Childless women and men of the same age experience the highest mortality. Additional models for different causes of death suggest that selection, behavioral changes, and unobserved protective effects contribute to this pattern.