Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-23T13:47:15.808Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethnicity, socio-economic status and self-harm in Swedish youth: a national cohort study

Published online by Cambridge University Press:  26 March 2008

B. Jablonska ,
L. Lindberg ,
F. Lindblad  and
A. Hjern
B. Jablonska*
Affiliation:
Stockholm Centre for Public Health, Sweden
L. Lindberg
Affiliation:
Stockholm Centre for Public Health, Sweden
F. Lindblad
Affiliation:
Stress Research Institute, Stockholm University, Sweden Department of Neuroscience, Child and Adolescent Psychiatry, University Hospital of Uppsala, Sweden
A. Hjern
Affiliation:
Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden Department of Children's and Women's Health, Uppsala University, Uppsala, Sweden
*
*Address for correspondence: B. Jablonska, B.Sc., Stockholm Centre for Public Health, Stockholm County Council, Box 17533, SE-118 91, Stockholm, Sweden. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Previous studies have shown an elevated risk for self-harm in adolescents from ethnic minorities. However, potential contributions to this risk from socio-economic factors have rarely been addressed. The main aim of this article was to investigate any such effects.

Method

A national cohort of 1009 157 children born during 1973–1982 was followed prospectively from 1991 to 2002 in Swedish national registers. Multivariate Cox analyses of proportional hazards were used to estimate the relative risk of hospital admission for self-harm. Parental country/region of birth was used as proxy for ethnicity.

Results

Youth with two parents born outside Sweden (except those from Southern Europe) had higher age- and gender-adjusted hazard ratios (HRs) of self-harm than the majority population (HR 1.6–2.3). The HRs decreased for all immigrant groups when socio-economic factors were accounted for but remained significantly higher for immigrants from Finland and Western countries and for youth with one Swedish-born and one foreign-born parent.

Conclusions

Socio-economic factors explain much of the variation by parental country of birth of hospital admissions for self-harm in youth in Sweden.

Keywords

Adolescentsethnicityself-harm behavioursocio-economic statusyoung adults
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 1 , January 2009 , pp. 87 - 94
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bayard-Burfield, L, Sundquist, J, Johansson, SE, Träskman-bendz, L (1999). Attempted suicide among Swedish-born people and foreign-born migrants. Archives of Suicide Research 5, 43–56.CrossRefGoogle Scholar
Beautrais, AL (2003). Suicide and serious suicide attempts in youth: a multiple-group comparison study. American Journal of Psychiatry 160, 1093–1099.CrossRefGoogle ScholarPubMed
Beautrais, AL, Joyce, PR, Mulder, RT (1996). Risk factors for serious suicide attempts among youths aged 13 through 24 years. Journal of the American Academy of Child and Adolescent Psychiatry 35, 1174–1182.CrossRefGoogle ScholarPubMed
Berman, AL, Schwartz, RH (1990). Suicide attempts among adolescent drug users. American Journal of Diseases of Children 144, 310–314.Google ScholarPubMed
Cantor, CH, Slater, PJ, Najman, JM (1995). Socio-economic indices and suicide rate in Queensland. Australian Journal of Public Health 19, 417–420.CrossRefGoogle Scholar
Chishti, P, Stone, DH, Corcoran, P, Williamson, E, Petridou, E; EUROSAVE Working Group (2003). Suicide mortality in the European Union. European Journal of Public Health 13, 108–114.Google ScholarPubMed
Christoffersen, MN, Poulsen, HD, Nielsen, A (2003). Attempted suicide among young people: risk factors in a prospective register-based study of Danish children born in 1966. Acta Psychiatrica Scandinavica 108, 350–358.CrossRefGoogle Scholar
de Jong, JTVM (1994). Ambulatory mental health care for migrants in the Netherlands. Curare 17, 5–34.Google Scholar
Deykin, EY, Buka, SL (1994). Suicidal ideation and attempts among chemically dependent adolescents. American Journal of Public Health 84, 634–639.CrossRefGoogle ScholarPubMed
Eamon, MK, Zuehl, RM (2001). Maternal depression and physical punishment as mediators of the effect of poverty on socioemotional problems of children in single-mother families. American Journal of Orthopsychiatry 71, 218–226.CrossRefGoogle ScholarPubMed
Engström, K, Diderichsen, F, Laflamme, L (2004). Parental social determinants of risk for intentional injury. A cross-sectional study of Swedish adolescents. American Journal of Public Health 94, 640–645.Google Scholar
Fergusson, DM, Woodward, LJ, Horwood, LJ (2000). Risk factors and life processes associated with the onset of suicidal behaviour during adolescence and early adulthood. Psychological Medicine 30, 23–39.CrossRefGoogle ScholarPubMed
Franzén, E (2003). Waiting for welfare. Studies on social assistance among immigrants [in Swedish]. Department of Social Work, University of Gothenburg, Sweden.Google Scholar
Hallberg, H, Mattsson, B (1991). Premature deaths among men in a Swedish municipality: social characteristics prior to death. Scandinavian Journal of Social Medicine 19, 181–186.Google Scholar
Hernandez, DJ, Charney, E (eds) (1998). From Generation to Generation: The Health and Wellbeing of Children in Immigrant Families. National Academy Press: Washington, DC.Google Scholar
Hjern, A (2004). Illicit drug abuse in second-generation immigrants: a register study in a national cohort of Swedish residents. Scandinavian Journal of Public Health 32, 40–46.CrossRefGoogle Scholar
Hjern, A, Allebeck, P (2002). Suicide in first- and second-generation immigrants in Sweden: a comparative study. Social Psychiatry and Psychiatric Epidemiology 37, 423–429.CrossRefGoogle ScholarPubMed
Hjern, A, Allebeck, P (2003). Alcohol-related disorders in first- and second-generation immigrants in Sweden: a national cohort study. Addiction 99, 229–236.CrossRefGoogle Scholar
Hjern, A, Haglund, B, Persson, G, Rosen, M (2001). Is there equality in access to health services for ethnic minorities in Sweden? European Journal of Public Health 11, 147–152.CrossRefGoogle Scholar
Hjern, A, Lindblad, F, Vinnerljung, B (2002). Suicide, psychiatric illness, and social maladjustment in intercountry adoptees in Sweden: a cohort study. Lancet 360, 443–448.Google Scholar
Hovey, JD, King, CA (1996). Acculturative stress, depression, and suicidal ideation among immigrant and second-generation Latino adolescents. Journal of American Child and Adolescent Psychiatry 35, 1183–1192.CrossRefGoogle ScholarPubMed
Hovey, JD, King, CA (1997). Suicidality among acculturating Mexican Americans: current knowledge and direction for research. Suicide and Life-Threatening Behavior 27, 92–103.CrossRefGoogle ScholarPubMed
Johnson, JG, Cohen, P, Gould, MS, Kasen, S, Brown, J, Brook, JS (2002). Childhood adversities, interpersonal difficulties, and risk for suicide attempts during late adolescence and early adulthood. Archives of General Psychiatry 59, 741–749.CrossRefGoogle ScholarPubMed
Karmi, G (1997). Migration and health in the United Kingdom. In Country Reports on Migration and Health in Europe (ed. Huismann, A., Weilandt, C. and Geiger, A.), pp. 451–467. Wissenschaftliches Institut der Ärzte Deutschlands eV: Bonn.Google Scholar
Lau, AS, Jernewall, NM, Zane, N, Myers, HF (2002). Correlates of suicidal behaviour among Asian-American outpatient youths. Cultural Diversity and Ethnic Minority Psychology 8, 199–213.CrossRefGoogle ScholarPubMed
Mäkinen, IH, Wasserman, D (2003). Suicide mortality among immigrant Finnish Swedes. Archives of Suicide Research 7, 93–106.CrossRefGoogle Scholar
McDonald, B, Steel, Z (1997). Immigrants and Mental Health: An Epidemiological Analysis. Transcultural Mental Health Centre: Parramatta, Australia.Google Scholar
McLanahan, SS, Sandefur, G (1994). Growing Up with a Single Parent. Harvard University Press: Cambridge, MA.Google Scholar
McLeod, JD, Shanahan, MJ (1996). Trajectories of poverty and children's mental health. Journal of Health and Social Behavior 37, 207–220.CrossRefGoogle ScholarPubMed
Ministry of Health and Social Affairs (2004). Economically vulnerable children [in Swedish]. Stockholm, DS 2004: 41.Google Scholar
National Board of Health and Welfare (2001). Social Report 2001. National Board of Health and Welfare: Stockholm, Sweden.Google Scholar
National Board of Health and Welfare (2006 a). Intentional self-destructive behaviour in Sweden – a report. National Board of Health and Welfare: Stockholm, Sweden.Google Scholar
National Board of Health and Welfare (2006 b). Social Report 2006. National Board of Health and Welfare: Stockholm, Sweden.Google Scholar
Ponizowsky, AM, Ristner, MS, Modai, I (1999). Suicidal ideation and suicide attempts among immigrant adolescents from the former Soviet Union to Israel. Journal of the American Academy of Child and Adolescent Psychiatry 38, 1433–1441.Google Scholar
Schmidtke, A, Bille-Brahe, U, De Leo, D, Kerkhof, A, Bjerke, T, Crepet, P, Haring, C, Hawton, K, Lönnqvist, J, Michel, K, Pommereau, X, Querejeta, I, Phillipe, I, Salander-Renberg, E, Temesváry, E, Wasserman, D, Fricke, S, Weinacker, B, Sampaio-Faria, JG (1996). Attempted suicide in Europe: rates, trends and sociodemographic characteristics of suicide attempters, 1989–1992. Results of the WHO/EURO Multicentre Study on Parasuicide. Acta Psychiatrica Scandinavica 93, 327–338.CrossRefGoogle ScholarPubMed
Sorenson, SB, Golding, JM (1988). Suicide ideation and attempts in Hispanics and non-Hispanic whites: demographic and psychiatric disorder issues. Suicide and Life-Threatening Behavior 18, 205–218.CrossRefGoogle ScholarPubMed
Statistics Sweden (2006). Children and their Families 2005. Demographic Reports, 2006: 3.Google Scholar
Syed, HR, Dalgard, OS, Dalen, I, Claussen, B, Hussain, A, Selmer, R, Ahlberg, N (2006). Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway. BMC Public Health 6, 182.Google Scholar
Tinghög, P, Hemmingsson, T, Lundberg, I (2007). To what extent may the association between immigrant status and mental illness be explained by socioeconomic factors? Social Psychiatry and Psychiatric Epidemiology 42, 990–996.Google Scholar
Tomori, M, Kienhorst, CWM, de Wilde, EJ, van den Bout, J (2001). Suicidal behaviour and family factors among Dutch and Slovenian high school students: a comparison. Acta Psychiatrica Scandinavica 104, 198–203.Google Scholar
von Reuden, U, Gosch, A, Rajmil, L, Bisegger, C, Ravens-Sieberer, U (2006). Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. Journal of Epidemiology and Community Health 60, 130–135.CrossRefGoogle Scholar
Weitoft, GR, Gullberg, A, Hjern, A, Rosén, M (1999). Mortality statistics in immigration research: method for adjusting underestimation of mortality. International Journal of Epidemiology 28, 756–763.Google Scholar
Weitoft, GR, Hjern, A, Haglund, B, Rosen, M (2003). Mortality, severe morbidity, and injury in children living with single parents in Sweden: a population-based study. Lancet 361, 289–295.Google Scholar
Westman, J, Hasselström, J, Johansson, SE, Sundquist, J (2003). The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people. Archives of General Psychiatry 60, 409–414.Google Scholar