A new study on the role of social determinants in COVID-19 disparities by migration status has been published in Nature- Communications Medicine by researchers Yan Ma, Anders Ledberg, Siddartha Aradhya, and Sol P Juarez.
Immigrants in Sweden, particularly those from low- and middle-income countries, had higher risks of COVID-19 mortality and morbidity compared to the Swedish-born. However, prior studies have not quantified the contribution of the differential distribution of health and social determinants to the increased risks.
This study used total population registers from Sweden to investigate disparities in COVID-19 hospitalization between five groups of immigrants and Swedish-born, using a cohort of 577 911 working-age adults (18–65 years) living in Stockholm during the first two waves of the COVID-19 pandemic. Applying a decomposition analysis, the researchers quantified the relative contribution of age, sex, income, education, occupation type, residential area, and pre-existing medical conditions to these disparities.
The study shows that immigrants have higher risks of hospitalization compared to Swedish-born, and that the investigated factors accounted for these disparities to varying degrees across immigrant groups. For the most affected immigrant groups (from Africa and Middle East), the examined factors together accounted for only a minor part of the disparities (21% and 18% for Wave 1; 16% and 11% for Wave 2), with occupation type and residential area contributing substantially.
Common observable social determinants of health accounted for a moderate share of the overall disparities in COVID-19 hospitalizations between Swedish-born individuals and immigrant from the most affected regions of origin.