Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Hospital admission and criminality associated with substance misuse in young refugees – a Swedish national cohort study
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Show others and affiliations
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 11, e0166066Article in journal (Refereed) Published
Abstract [en]

Background

High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers.

Methods

Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort.

Results

The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population.

Conclusion

The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.

Place, publisher, year, edition, pages
2016. Vol. 11, no 11, e0166066
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Sciences
Identifiers
URN: urn:nbn:se:su:diva-136461DOI: 10.1371/journal.pone.0166066ISI: 000389474100010OAI: oai:DiVA.org:su-136461DiVA: diva2:1052896
Available from: 2016-12-07 Created: 2016-12-07 Last updated: 2017-09-20Bibliographically approved
In thesis
1. Mental health, substance misuse and labour market participation in teenage refugees in Sweden – A longitudinal perspective
Open this publication in new window or tab >>Mental health, substance misuse and labour market participation in teenage refugees in Sweden – A longitudinal perspective
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: To fill the knowledge gap about the importance of contextual factors after resettlement on mental health, substance misuse and labour market participation among young refugees who immigrate to Sweden as teenagers. Methods: Register studies in national registers of national cohorts of young refugees, unaccompanied and accompanied, who settled in Sweden as teenagers. Studies 1-4 used Cox regression models to study the risks of psychiatric care consumption and substance misuse, while Study 5 used multinomial regression to study position on the labour. These findings were compared with peers from the same birth cohorts in the general Swedish population and non-European intercountry adoptees (Studies 2 and 5). Results: The overall results suggest that young accompanied and unaccompanied refugees were more likely to be admitted to psychiatric inpatient and compulsory hospital care, but not outpatient care, with refugees born in the Horn of Africa and Iran having the highest risk (Study 1). Young accompanied and unaccompanied refugees also had higher risk of hospitalization and criminal conviction associated with substance misuse (Study 3). Longer duration of residence in Sweden was associated with increased risks of outpatient care (Study 1) and hospitalization related to substance misuse (studies 3 and 4). These increase risks of young refugees were associated with their socioeconomic living conditions (Studies 3 and 4), but risk factors associated with the country of origin of the refugee population and the intercountry adoptees were more important determinants of schizophrenia than socioeconomic conditions in Sweden (Study 2). Young accompanied and unaccompanied refugees and intercountry adoptees had a lower likelihood of being in full employment than native Swedes with comparable levels of education. Secondary education, however, increased employment chances and reduced the risk of being neither employed nor in education or training (Study 5). Conclusion: Evidence suggests that several groups of young refugees are at higher risk of mental health problems and substance misuse. They also face employment disadvantages and barriers to psychiatric care in the early stages of developing a psychiatric disorder.

Abstract [sv]

Syfte: Att undersöka betydelsen av kontextuella faktorer för psykisk hälsa, alkohol- och narkotikamissbruk samt sysselsättning bland unga flyktingar som invandrat till Sverige som tonåringar.Metod: Avhandlingen baseras i sin helhet på studier i nationella register av nationella kohorter av flyktingar som anlände till Sverige i åldern 13-19 år och var folkbokförda i Sverige 2005, jämförda med övrig svensk befolkning och utlandsadopterade (Studier 2 och 5) i samma åldrar. Studierna 1-4 använder sig av Cox regressionsmodeller för att undersöka psykiatrisk vårdkonsumtion inklusive vård relaterad till alkohol- och narkotikamissbruk. Studie 5 undersöker position på arbets-marknaden bland unga ensamkommande och icke-ensamkommande flyktingar med hjälp av multinominal regression. Resultat: Unga ensamkommande och icke-ensamkommande flykting-ungdomar vårdas i större utsträckning i psykiatrisk sluten- och tvångs-vård, men ej öppenvård, med störst risk för flyktingar födda på Afrikas Horn och i Iran (Studie 1). Unga ensamkommande och icke-ensamkommande flyktingungdomar hade också högre risk för sjukhusvård och att dömas för brott i samband med alkohol- och narkotikamissbruk (Studie 3). Denna ökade vårdkonsumtion förklaras till en del av de unga flyk-tingarnas socioekonomiska levnadsförhållanden (Studier 3 och 4). Konsumtionen av psykiatrisk öppenvård ökade med tiden efter ankomsten till Sverige (Studie 1), liksom sjukhusvård till följd av alkohol- och narkotikamissbruk (Studier 3 och 4). Sjukhusvård och kriminalitet i sam-band med missbruk av alkohol och narkotika är vanligare bland unga manliga flyktingar än för kvinnliga. Faktorer associerade med flyktingars och utlandsadopterades ursprungsland var mer betydande riskfaktorer för schizofreni än de socioekonomiska förhållandena i Sverige (Studie 2). Unga ensamkommande och icke-ensamkommande flyktingar hade en högre risk att varken arbeta eller delta i en utbildning och hade också sämre utsikter till anställning än inhemska svenskar med jämförbar utbildningsnivå. Gymnasiekompetens ökade chanserna för inträde på arbetsmarknaden (Studie 5). Slutsats: Resultaten tyder på att flera grupper av unga flyktingar har en högre risk för problem med psykisk ohälsa och substansmissbruk. De konfronteras även i högre grad med arbetslöshet och olika hinder för att få psykiatrisk vård i tidiga stadier av psykisk ohälsa.

Place, publisher, year, edition, pages
Stockholm: Centre for Health Equity Studies (CHESS), Stockholm University, 2017. 83 p.
Series
Health Equity Studies, ISSN 1651-5390 ; 22
Keyword
Young refugees, mental health, substance misuse, care consumption, labour market
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:su:diva-143219 (URN)978-91-7649-864-4 (ISBN)978-91-7649-865-1 (ISBN)
Public defence
2017-08-25, Aula Svea, Socialhögskolan, Sveavägen 160, Stockholm, 10:00 (English)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 1453203
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 4: Manuscript. Paper 5: Manuscript.

Available from: 2017-06-07 Created: 2017-05-18 Last updated: 2017-09-20Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Manhica, HélioGauffin, KarlAlmquist B., YlvaRostila, MikaelHjern, Anders
By organisation
Centre for Health Equity Studies (CHESS)
In the same journal
PLoS ONE
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 39 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf