Disparities in Coronavirus Disease 2019 Mortality by Country of Birth in Stockholm, Sweden: A Total-Population–Based Cohort Study

Rostila, Mikael; Cederström, Agneta; Wallace, Matthew; Brandén, Maria; Malmberg, Bo; Andersson, Gunnar

Abstract

Preliminary evidence points to higher morbidity and mortality from coronavirus disease 2019 (COVID-19) in certain racial and ethnic groups, but population-based studies using microlevel data are lacking so far. We used register-based cohort data including all adults living in Stockholm, Sweden, between January 31, 2020 (the date of the first confirmed case of COVID-19) and May 4, 2020 (n = 1,778,670) to conduct Poisson regression analyses with region/country of birth as the exposure and underlying cause of COVID-19 death as the outcome, estimating relative risks and 95% confidence intervals. Migrants from Middle Eastern countries (relative risk (RR) = 3.2, 95% confidence interval (CI): 2.6, 3.8), Africa (RR = 3.0, 95% CI: 2.2, 4.3), and non-Sweden Nordic countries (RR = 1.5, 95% CI: 1.2, 1.8) had higher mortality from COVID-19 than persons born in Sweden. Especially high mortality risks from COVID-19 were found among persons born in Somalia, Lebanon, Syria, Turkey, Iran, and Iraq. Socioeconomic status, number of working-age household members, and neighborhood population density attenuated up to half of the increased COVID-19 mortality risks among the foreign-born. Disadvantaged socioeconomic and living conditions may increase infection rates in migrants and contribute to their higher risk of COVID-19 mortality.

Citation

Rostila, M., Cederström, A., Wallace, M., Brandén, M., Malmberg, B., & Andersson, G. (2021). Disparities in Coronavirus Disease 2019 Mortality by Country of Birth in Stockholm, Sweden: A Total-Population–Based Cohort Study. American Journal of Epidemiology, 190(8), 1510–1518. https://doi.org/10.1093/aje/kwab057

• Journal Article Type: Article
• Acceptance Date: Mar 8, 2021
• Publication Date: Mar 12, 2021
• Deposit Date: Oct 7, 2024
• Publicly Available Date: Oct 7, 2024
• Journal: American Journal of Epidemiology
• Print ISSN: 0002-9262
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 190
• Issue: 8
• Pages: 1510–1518
• DOI: https://doi.org/10.1093/aje/kwab057