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2025 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 35, no 6, p. 1288-1294Article in journal (Refereed) Published
Abstract [en]
This study examines COVID-19 mortality across long-term care settings comparing migrants and Swedish-born during the first 2 years of the pandemic. Previous research shows that migrants faced higher risks of severe COVID-19 outcomes, contrasting with the observed Migrant Mortality Advantage. Using Swedish total population data (2019–22), we stratified participants aged 70+ by care setting and migration status. We analysed the first pandemic year (March 2020–February 2021) and the second year (March 2021–February 2022), alongside pre-pandemic mortality data for context. Outcome measures included all deaths from COVID-19 and other causes. Cox proportional hazards models were employed adjusting for sociodemographic and health variables. Our findings highlight the significant impact of care settings on COVID-19 mortality in the first pandemic year, exceeding that for other causes of death. Migrants born in low- or middle-income countries in institutional care had higher mortality rates (HR = 42.88, 95% CI = 36.69–50.13) than Swedish-born individuals in institutional care (HR = 25.83, 95% CI = 24.12–27.65) relative to Swedish-born with no care. This contrasts with mortality patterns for non-COVID causes before and during the pandemic, indicating a specific migrant disadvantage during the first year. In the second year, the excess COVID-19 mortality in care settings decreased yet continued to be higher for migrants than for Swedish-born, likely influenced by the equalizing effect of vaccinations. Despite mitigation efforts, a clear migrant mortality disadvantage persisted among those receiving home care or living in care homes.
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:su:diva-251450 (URN)10.1093/eurpub/ckaf155 (DOI)001599281000001 ()41133898 (PubMedID)2-s2.0-105025170292 (Scopus ID)
2026-01-212026-01-212026-01-21Bibliographically approved