Explaining COVID-19 mortality among immigrants in Sweden: A social determinants of health perspective

Immigrants from low- to high-income countries have experienced excess COVID-19 mortality in Sweden to an extent that contrasts sharply with the immigrant mortality advantage observed for other causes before and during the pandemic. This finding is a major concern given its vast implications for increasing inequalities in a post-pandemic society.

The purpose of this project is to study the extent to which disproportionate COVID-19 mortality among immigrants in Sweden is explained by social determinants of health operating through differential exposure to the virus (e.g., by being more likely to work in high-exposure occupations) and differential effects of infection arising from socially-patterned, pre-existing health conditions or discrepancies in individual healthcare seeking and structural provision of healthcare.

Individual-level longitudinal information comprised of national social, migration, and health registers will be analyzed using a variety of advanced statistical modelling techniques.

The main contribution of this project lies in its thorough empirical evaluation of how social conditions shape group risks in the context of a pandemic giving rise to native-immigrant inequalities in COVID-19 mortality.

Furthermore, we will offer a comprehensive understanding of native-immigrant inequalities across the COVID-19 disease pathway (i.e., positive test, hospitalization, intensive care unit admission and death).

The identification of the social determinants leading to health inequalities between immigrants and natives (as well as across immigrant groups) is crucial to planning interventions that may help mitigate the unequal impacts of future pandemics on health and mortality.