Long-term illness among indigenous and foreign-born people in Sweden

This study shows the influence on self-reported health of ethnicity, operationalised as Swedes and foreign-born people from Finland, Western countries (Western Europe--except for Finland and South Europe--the United States, Canada, Australia, New Zealand and Japan), South Europe and all other countries (East Europe and non-European, non-Western countries). A simple random sample of 23,864 Swedes and foreign-born people were interviewed in 1980-1981 and 1988-1989 by Statistics Sweden. In successive models starting with only ethnicity and age, one variable at a time was included in the two main models, one with material and economic factors and another with lifestyle factors as independent variables, in order to study how the importance of ethnicity changed. The age-adjusted relations between male and female Finns and severe long-term illness were reduced from an odds ratio of 2.37 and 1.86, respectively, to 1.90 and 1.70 after including educational status, marital status, exercise, smoking, and body mass index in the final model. The high odds ratios for males and females born in South Europe or born in non-Western countries decreased with the inclusion of lifestyle factors but were still high 2.26 and 2.50 in South Europeans and 1.94 and 1.81 in non-Westerners. Males and females born in Finland, South Europe or in non-Western countries had high odds ratios for severe long-term illness when education, material standard, economic resources, leisure opportunities and social network were simultaneously controlled for. People born in Western countries showed no association to limiting long-term illness. The conclusion of the present study is that ethnicity, defined as foreign-born people, was strongly associated with limiting long-term illness when controlling for social, material and lifestyle factors.