'Avoidable' mortality among immigrants in Sweden

Abstract

Background: The concept of studying 'avoidable' mortality as an indicator of the outcome of health care has been applied mainly in studies of time-trends and geographical and socio-economic variation.

Methods: In this study, indicators of 'avoidable' mortality among immigrants in Sweden have been studied. Comparisons of death rates among immigrants and those born in Sweden were made using a linkage of the Population Census and the Cause of Death Register, nationwide sources.

Results: For a group of health policy indicators, such as liver cirrhosis and malignant neoplasms of the trachea, bronchus and lung, death rates were about 40-100% higher among immigrants from other Nordic countries, Yugoslavia and Eastern Europe than among the Swedish born population. For causes of death considered amenable to medical care intervention there were, however, small differences. For some conditions, such as cerebrovascular disease, malignant neoplasms of colon and rectum, chronic bronchitis and emphysema, high death rates were found among immigrants from other Nordic countries. For immigrants from other countries, there were no high death rates based on medical care indicators when compared to the Swedish-born population.

Conclusion: There were few indications of inequity reflected in the mortality outcome of medical care. The variation found in death rates from health policy indicators may reflect differences in smoking and alcohol habits.