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Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Jul 2004; 58(7): 574–582.
PMCID: PMC1732838

Ethnicity, acculturation, and self reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden


Study objective: To analyse the association between ethnicity and poor self reported health and explore the importance of any mediators such as acculturation and discrimination.

Design: A simple random sample of immigrants from Poland (n = 840), Turkey (n = 840), and Iran (n = 480) and of Swedish born persons (n = 2250) was used in a cross sectional study in 1996. The risk of poor self reported health was estimated by applying logistic models and stepwise inclusion of the explanatory variables. The response rate was about 68% for the immigrants and 80% for the Swedes. Explanatory variables were: age, ethnicity, educational status, marital status, poor economic resources, knowledge of Swedish, and discrimination.

Main results: Among men from Iran and Turkey there was a threefold increased risk of poor self reported health than Swedes (reference) while the risk was five times higher for women. When socioeconomic status was included in the logistic model the risk decreased slightly. In an explanatory model, Iranian and Turkish women and men had a higher risk of poor health than Polish women and men (reference). The high risks of Turkish born men and women and Iranian born men for poor self reported health decreased to non-significance after the inclusion of SES and low knowledge of Swedish. The high risks of Iranian born women for poor self reported health decreased to non-significance after the inclusion of low SES, low knowledge of Swedish, and discrimination.

Conclusions: The strong association between ethnicity and poor self reported health seems to be mediated by socioeconomic status, poor acculturation, and discrimination.

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Selected References

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  • Sundquist J. Ethnicity, social class and health. A population-based study on the influence of social factors on self-reported illness in 223 Latin American refugees, 333 Finnish and 126 south European labour migrants and 841 Swedish controls. Soc Sci Med. 1995 Mar;40(6):777–787. [PubMed]
  • Gadd M, Johansson S-E, Sundquist J, Wändell P. Morbidity in cardiovascular diseases in immigrants in Sweden. J Intern Med. 2003 Sep;254(3):236–243. [PubMed]
  • Westman Jeanette, Hasselstrom Jan, Johansson Sven-Erik, Sundquist Jan. The influences of place of birth and socioeconomic factors on attempted suicide in a defined population of 4.5 million people. Arch Gen Psychiatry. 2003 Apr;60(4):409–414. [PubMed]
  • Reijneveld SA. Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position? J Epidemiol Community Health. 1998 May;52(5):298–304. [PMC free article] [PubMed]
  • Lillie-Blanton M, Laveist T. Race/ethnicity, the social environment, and health. Soc Sci Med. 1996 Jul;43(1):83–91. [PubMed]
  • Muntaner C, Nieto FJ, O'Campo P. The Bell Curve: on race, social class, and epidemiologic research. Am J Epidemiol. 1996 Sep 15;144(6):531–536. [PubMed]
  • Lindström M, Sundquist J, Ostergren PO. Ethnic differences in self reported health in Malmö in southern Sweden. J Epidemiol Community Health. 2001 Feb;55(2):97–103. [PMC free article] [PubMed]
  • Baron-Epel O, Kaplan G. Self-reported health status of immigrants from the former Soviet Union in Israel. Isr Med Assoc J. 2001 Dec;3(12):940–946. [PubMed]
  • Ren XS, Amick BC., 3rd Race and self assessed health status: the role of socioeconomic factors in the USA. J Epidemiol Community Health. 1996 Jun;50(3):269–273. [PMC free article] [PubMed]
  • Sundquist J, Winkleby MA. Cardiovascular risk factors in Mexican American adults: a transcultural analysis of NHANES III, 1988-1994. Am J Public Health. 1999 May;89(5):723–730. [PMC free article] [PubMed]
  • Williams R. Health and length of residence among south Asians in Glasgow: a study controlling for age. J Public Health Med. 1993 Mar;15(1):52–60. [PubMed]
  • Heistaro S, Vartiainen E, Puska P. Trends in self-rated health in Finland 1972-1992. Prev Med. 1996 Sep-Oct;25(5):625–632. [PubMed]
  • Power C, Matthews S, Manor O. Inequalities in self-rated health: explanations from different stages of life. Lancet. 1998 Apr 4;351(9108):1009–1014. [PubMed]
  • Krause NM, Jay GM. What do global self-rated health items measure? Med Care. 1994 Sep;32(9):930–942. [PubMed]
  • Fernández de la Hoz K, Leon DA. Self-perceived health status and inequalities in use of health services in Spain. Int J Epidemiol. 1996 Jun;25(3):593–603. [PubMed]
  • Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983 Mar;117(3):292–304. [PubMed]
  • Grant MD, Piotrowski ZH, Chappell R. Self-reported health and survival in the Longitudinal Study of Aging, 1984-1986. J Clin Epidemiol. 1995 Mar;48(3):375–387. [PubMed]
  • Miilunpalo S, Vuori I, Oja P, Pasanen M, Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997 May;50(5):517–528. [PubMed]
  • Kington R, Lillard L, Rogowski J. Reproductive history, socioeconomic status, and self-reported health status of women aged 50 years or older. Am J Public Health. 1997 Jan;87(1):33–37. [PMC free article] [PubMed]
  • Shetterly SM, Baxter J, Mason LD, Hamman RF. Self-rated health among Hispanic vs non-Hispanic white adults: the San Luis Valley Health and Aging Study. Am J Public Health. 1996 Dec;86(12):1798–1801. [PMC free article] [PubMed]
  • McCallum J, Shadbolt B, Wang D. Self-rated health and survival: a 7-year follow-up study of Australian elderly. Am J Public Health. 1994 Jul;84(7):1100–1105. [PMC free article] [PubMed]
  • McGee DL, Liao Y, Cao G, Cooper RS. Self-reported health status and mortality in a multiethnic US cohort. Am J Epidemiol. 1999 Jan 1;149(1):41–46. [PubMed]

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