Citation

Haukka J, Suvisaari JM, Sarvimäki M, Martikainen P. Epidemiology 2017; 28(4): 587-593.

Affiliation

Clinicum, Department of Public Health, University of Helsinki, Finland 2.Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland 3.Department of Economics, Aalto University, Helsinki, Finland 4.VATT Institute for Economic Research, Helsinki, Finland 5.Population Research Unit, Department of Social Research, University of Helsinki, Finland 6.Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Sweden 7.Max Planck Institute for Demographic Research, Germany.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/EDE.0000000000000669

PMID

28368943

Abstract

BACKGROUND: The stresses and life changes associated with migration may have harmful long-term health effects, especially for mental health. These effects are exceedingly difficult to establish, because migrants are typically a highly selected group.

METHODS: We examined the impact of migration on health using 'naturally occurring' historical events. In this paper, we use the forced migration of 11% of the Finnish population after WWII as such a natural experiment. We observed the date and cause of death starting from 1 January 1971 and ending in 31 December 2010 for the cohort of 242,075 people. Data were obtained by linking individual-level data from the 1950 and 1970 population censuses and the register of death certificates from 1971 to 2010 (10% random sample). All-cause and cause-specific mortalities were modeled using Poisson regression.

RESULTS: Models with full adjustment for background variables showed that both all-cause mortality (RR 1.03, 95% CI 1.01-1.05), and ischemic heart disease mortality (RR 1.11, 95% CI 1.08-1.15) were higher in the displaced population than in the non-displaced population. Suicide mortality was lower (RR 0.77, 95% CI 0.64-0.92) in displaced than in the general population.

CONCLUSIONS: In our long term follow-up study, forced migration was associated with increased risk of death due to ischemic heart diseases. In contrast, lower suicide mortality was observed in association with forced migration 25 years or more.

Language: en