Background
Methods
Study population
Data sources
Analysis
Results
Population characteristics
Refugees | Danish-born matched to refugees | Family reunification immigrants | Danish-born matched to family reunification immigrants | |||||
---|---|---|---|---|---|---|---|---|
% | % | % | % | |||||
Total (n) | 42,696 | 100 | 256,452 | 100 | 59,198 | 100 | 355,482 | 100 |
Females (n) | 17,903 | 41.9 | 107,556 | 41.9 | 42,227 | 71.3 | 253,487 | 71.3 |
Median age at study start (years) | 33.0 | 33.0 | 28.0 | 28.0 | ||||
Civil status (n) | ||||||||
Married/Cohabiting | 28,167 | 66.0 | 134,081 | 52.3 | 40,946 | 69.2 | 161,759 | 45.5 |
Single/divorced/ widowed | 11,924 | 27.9 | 122,354 | 47.7 | 10,356 | 17.5 | 193,661 | 54.5 |
Missing | 2605 | 6.1 | 17 | 0 | 7896 | 13.3 | 62 | 0 |
Family income level (euros) | ||||||||
< 13,400 | 10,388 | 24.3 | 11,460 | 4.5 | 9043 | 15.3 | 16,722 | 4.7 |
13,400 - 26,800 | 29,115 | 68.2 | 129,578 | 50.5 | 35,196 | 59.5 | 179,114 | 50.4 |
26,800 - 40,200 | 745 | 1.8 | 81,775 | 31.9 | 6894 | 11.6 | 111,815 | 31.4 |
> 40,200 | 56 | 0.1 | 17,363 | 6.8 | 1023 | 1.7 | 20,923 | 5.9 |
Missing | 2392 | 5.6 | 16,276 | 6.3 | 7042 | 11.9 | 26,908 | 7.6 |
Region of origin (n) | ||||||||
Former Yugoslavia and Eastern Europe | 17,931 | 42.0 | 11,669 | 19.7 | ||||
Somalia and Sub-Sahara | 6598 | 15.5 | 6597 | 11.1 | ||||
Southern and Eastern Asia | 7169 | 16.8 | 19,563 | 33.0 | ||||
Western Asia and North Africa incl. Turkey and Iraq | 10,954 | 25.7 | 17,790 | 30.1 | ||||
South America | 44 | 0.1 | 3579 | 6.0 | ||||
Top 5 Countries of origin (n) | ||||||||
Bosnia-Hercegovina | 13,874 | 32.5 | 794 | 1.3 | ||||
Iraq | 8222 | 19.3 | 3556 | 6.0 | ||||
Turkey | 60 | 0.1 | 7938 | 13.4 | ||||
Somalia | 5195 | 12.2 | 2674 | 4.5 | ||||
Thailand | 0 | 0.0 | 5135 | 8.7 | ||||
Median Follow-up (years) | 13.4 | 14.0 | 10.5 | 11.2 | ||||
End of follow-up (n) | ||||||||
Emigrations to any country | 5454 | 12.8 | 13,222 | 5.2 | 9678 | 16.3 | 20,520 | 5.8 |
Death | 2223 | 5.2 | 24,723 | 9.6 | 830 | 1.4 | 13,001 | 3.6 |
Population at study end | 35,019 | 82.0 | 218,507 | 85.2 | 48,690 | 82.3 | 321,961 | 90.6 |
Charlson comorbidity index (CCI) diagnoses | Refugees | Danish-born matched to refugees | Family reunification immigrants | Danish-born matched to family reunification immigrants | ||||
---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | |
Acute myocardial infarction | 1118 | 2.6 | 4159 | 1.6 | 342 | 0.6 | 2229 | 0.6 |
Congestive heart Failure | 692 | 1.6 | 3436 | 1.3 | 278 | 0.5 | 1945 | 0.5 |
Peripheral vascular disease | 331 | 0.8 | 2250 | 0.9 | 104 | 0.2 | 1404 | 0.4 |
Cerebrovascular disease | 1192 | 2.8 | 7675 | 3.0 | 619 | 1.0 | 5517 | 1.6 |
Dementia | 137 | 0.3 | 1199 | 0.5 | 70 | 0.1 | 733 | 0.2 |
Chronic pulmonary disease | 1877 | 4.4 | 9870 | 3.8 | 1538 | 2.6 | 10,748 | 3.0 |
Connective tissue disease | 352 | 0.8 | 2326 | 0.9 | 307 | 0.5 | 2660 | 0.7 |
Peptic ulcer | 1960 | 4.6 | 3861 | 1.5 | 948 | 1.6 | 2861 | 0.8 |
Liver disease (mild) | 150 | 0.4 | 1206 | 0.5 | 96 | 0.2 | 749 | 0.2 |
Diabetes | 2648 | 6.2 | 7005 | 2.7 | 1222 | 2.1 | 5813 | 1.6 |
Diabetes complications | 494 | 1.2 | 1621 | 0.6 | 172 | 0.3 | 1249 | 0.4 |
Paraplegia/hemiplegia | 79 | 0.2 | 384 | 0.1 | 40 | 0.1 | 365 | 0.1 |
Renal disease | 387 | 0.9 | 1781 | 0.7 | 201 | 0.3 | 1394 | 0.4 |
Cancer | 1655 | 3.9 | 12,657 | 4.9 | 922 | 1.6 | 10,097 | 2.8 |
Metastatic cancer | 376 | 0.9 | 2891 | 1.1 | 168 | 0.3 | 1922 | 0.5 |
Moderate or severe liver disease | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
HIV/AIDS | 196 | 0.5 | 314 | 0.1 | 492 | 0.8 | 241 | 0.1 |
1 CCI diagnose | 6357 | 14.9 | 28,321 | 11.0 | 4775 | 8.1 | 28,446 | 8.0 |
Multimorbidity (>1 CCI diagnose) | ||||||||
2 diagnoses | 1808 | 4.2 | 8841 | 3.4 | 854 | 1.4 | 6241 | 1.8 |
3 diagnoses | 616 | 1.4 | 3026 | 1.2 | 184 | 0.3 | 1670 | 0.5 |
>3 diagnoses | 399 | 0.9 | 1692 | 0.7 | 105 | 0.2 | 886 | 0.2 |
Multimorbidity (> 1 CCI diagnose) in total | 2823 | 6.6 | 13,559 | 5.3 | 1143 | 1.9 | 8797 | 2.5 |
Psychiatric diagnoses | ||||||||
Substance use (F10- F19) | 807 | 1.9 | 9283 | 3.6 | 682 | 1.2 | 9258 | 2.6 |
Schizophrenia and psychosis (F20-F29) | 218 | 0.5 | 918 | 0.4 | 101 | 0.2 | 1001 | 0.3 |
Affective disorders (F30-F39) | 815 | 1.9 | 2862 | 1.1 | 626 | 1.1 | 3653 | 1.0 |
Nervous disorders (F40-F49) | 1127 | 2.6 | 2597 | 1.0 | 803 | 1.4 | 4015 | 1.1 |
1 CCI or psychiatric diagnose | 7278 | 17.0 | 32,526 | 12.7 | 5733 | 9.7 | 35,712 | 10.0 |
Multimorbidity (> 1 CCI or psychiatric diagnose) | ||||||||
2 diagnoses | 2275 | 5.3 | 10,874 | 4.2 | 1233 | 2.1 | 8776 | 2.5 |
3 diagnoses | 803 | 1.9 | 4045 | 1.6 | 295 | 0.5 | 2663 | 0.7 |
>3 diagnoses | 515 | 1.2 | 2615 | 1.0 | 141 | 0.2 | 1457 | 0.4 |
Multimorbidity (> 1 CCI or psychiatric diagnose) in total | 3593 | 8.4 | 17,534 | 6.8 | 1669 | 3.0 | 12,896 | 3.6 |
Incidence of multimorbidity
Somatic and psychiatric multimorbidity (CCI + psychiatric diagnoses) | Somatic multimorbidity (only CCI) | |||||
---|---|---|---|---|---|---|
Crude HR (95% CI) | Adjusted HR1 (95% CI) | Adjusted HR2 (95% CI) | Crude HR (95% CI) | Adjusted HR1 (95% CI) | Adjusted HR2 (95% CI) | |
Native Danes (ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Refugees | 1.29* (1.25-1.34) | 1.20* (1.16-1.24) | 0.95* (0.92-0.99) | 1.31* (1.26-1.36) | 1.20* (1.15-1.25) | 0.97 (0.93–1,02) |
Former Yugoslavia and Eastern Europe | 1.38* (1.33–1.47) | 1.09* (1.04-1.14) | 0.89* (0.85-0.94) | 1.49* (1.41-1.57) | 1.12* (1.06-1.18) | 0.92* (0.87-0.97) |
Somalia and Sub-Sahara | 0.71* (0.64–0.80) | 1.04 (0.93–1.17) | 0.75* (0.66-0.84) | 0.72* (0.64-0.82) | 1.15* (1.01-1.31) | 0.85* (0.75-0.97) |
Southern and Eastern Asia | 1.33* (1.21–1.47) | 1.36* (1.23-1.49) | 1.04 (0.95–1.15) | 1.22* (1.09-1.36) | 1.25* (1.12-1.40) | 0.99 (0.88–1.12) |
Western Asia and North Africa incl. Turkey and Iraq | 1.43* (1.34–1.53) | 1.51* (1.42-1.62) | 1.18* (1.10-1.26) | 1.36* (1.26-1.47) | 1.46* (1.35-1.58) | 1.18* (1.08-1.27) |
Family-reunified immigrants | 0.86* (0.82–0.91) | 0.85* (0.81-0.89) | 0.79* (0.74-0.84) | 0.86* (0.81-0.92) | 0.85* (0.80-0.90) | 0.78* (0.72-0.84) |
Former Yugoslavia and Eastern Europe | 0.78* (0.70–0.88) | 0.69* (0.61-0.77) | 0.64* (0.56-0.72) | 0.79* (0.68-0.90) | 0.68* (0.59-0.78) | 0.61* (0.53-0.71) |
Somalia and Sub-Sahara | 0.97 (0.84–1.11) | 1.10 (0.96–1.26) | 1.04 (0.90–1.20) | 1.04 (0.89–1.22) | 1.24* (1.05-1.45) | 1.16 (0.98–1.37) |
Southern and Eastern Asia | 0.86* (0.79–0.94) | 0.74* (0.68-0.81) | 0.68* (0.62-0.75) | 0.89* (0.81-0.99) | 0.73* (0.66-0.81) | 0.68* (0.61-0.76) |
Western Asia and North Africa incl. Turkey and Iraq | 0.89* (0.82–0.96) | 1.03 (0.94–1.11) | 0.94 (0.86–1.03) | 0.85* (0.77-0.94) | 1.02 (0.92–1.13) | 0.93 (0.83–1.04) |
Multimorbidity patterns
Multimorbidity-associated mortality
Migrant status | Mortality among people with multimorbidity (CCI + psychiatric diagnoses) | Mortality among people with only somatic diagnoses (CCI) | Mortality among people with only psychiatric diagnoses | |||
---|---|---|---|---|---|---|
Crude HR (95% CI) | Adjusted HR1 (95% CI) | Crude HR (95% CI) | Adjusted HR1 (95% CI) | Crude HR (95% CI) | Adjusted HR1 (95% CI) | |
Danish born (ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 |
Refugees | 0.56*(0.52-0.59) | 0.50*(0.46-0.53) | 0.59*(0.55-0.63) | 0.52*(0.49-0.56) | 0.31*(0.22-0.46) | 0.34*(0.23-0.50) |
Former Yugoslavia and Eastern Europe | 0.73*(0.68–0.78) | 0.59*(0.56-0.64) | 0.74*(0.69-0.80) | 0.61*(0.57-0.67) | 0.31*(0.17-0.54) | 0.29*(0.16-0.52) |
Somalia and Sub-Sahara | 0.40*(0.32–0.51) | 0.43*(0.33-0.55) | 0.41*(0.32-0.56) | 0.43*(0.33-0.56) | 0.22*(0.06-0.88) | 0.28 (0.07–1.14) |
Southern and Eastern Asia | 0.36*(0.23–0.44) | 0.35*(0.28-0.44) | 0.41*(0.33-0.51) | 0.39*(0.31-0.49) | 0.43*(0.20-0.91) | 0.39*(0.18-0.83) |
Western Asia and North Africa incl. Turkey and Iraq | 0.37*(0.32–0.42) | 0.36*(0.31-0.41) | 0.39*(0.34-0.46) | 0.37*(0.32-0.44) | 0.29*(0.15-0.59) | 0.41*(0.20-0.83) |
Family-reunified immigrants | 0.51*(0.45–0.57) | 0.39*(0.34-0.45) | 0.53*(0.47-0.60) | 0.40*(0.35-0.46) | 0.36*(0.20-0.63) | 0.53*(0.28-0.98) |
Former Yugoslavia and Eastern Europe | 0.80*(0.65–0.99) | 0.59*(0.47-0.74) | 0.86 (0.69–1.06) | 0.60*(0.48-0.76) | 0.50 (0.19–1.34) | 0.99 (0.36–2.72) |
Somalia and Sub-Sahara | 0.48*(0.35–0.66) | 0.57*(0.41-0.80) | 0.46*(0.33-0.65) | 0.57*(0.40-0.81) | 0.29 (0.04–2.07) | 0.67 (0.09–4.87) |
Southern and Eastern Asia | 0.44*(0.35–0.54) | 0.28*(0.23-0.35) | 0.45*(0.37-0.56) | 0.29*(0.23-0.36) | 0.53 (0.22–1.29) | 0.68 (0.27–1.70) |
Western Asia and North Africa incl. Turkey and Iraq | 0.44*(0.36–0.53) | 0.35*(0.28-0.44) | 0.47*(0.39-0.58) | 0.36*(0.29-0.45) | 0.09*(0.01-0.65) | 0.12*(0.02-0.83) |