Does Labor Market Position Explain the Differences in Self-Rated Health between Employed Immigrants and Native Swedes: a Population-Based Study from Southern Sweden

Many groups of immigrants have worse health than the native population in the host countries. One possible explanation for this is that immigrants are disadvantaged in the labor market, since it has been shown that both precarious and locked-in labor market position can be associated with health problems. However, no published study to date has analyzed the prevalence or consequences of locked-in labor market position among immigrants. The aim of the current study is to analyze the labor market using a population-based survey. More concretely to investigate to what extent immigrants are over-represented in locked-in labor market positions and to what extent this can explain the health disadvantage among immigrants. The study is based on a dataset of the 20,449 individuals, who in the year 2000 were aged 18-64, from a survey of a representative sample of the population in the Scania region with citizen or resident status of southern Sweden, the Public Health in Scania Study conducted by the Unit of Social Medicine at Lund University, Malmo University Hospital (MAS). Respondents born abroad with Swedish parents had the highest employment rate (81.5%), with 73.7% of the employed on permanent contracts followed by participants born in Western Europe excluding the Nordic countries (81.4%), with 66.4% permanently employed, followed by native Swedes (79.1%), with 76.9% permanently employed. The lowest employment rate was observed among those born in the Middle East and North Africa, 49.4%, with 36.8% permanently employed and 19.1% self-employed. Employed participants born in the Middle East or North Africa had an excess risk of poor self-rated health if they were in a double locked-in as well as not locked-in situation, compared with native Swedes in the same labor market situations (OR = 2.18 and 2.04, respectively). In conclusion, it appears that selection into less preferred occupations or workplaces cannot explain the excess risk of poor health among immigrants from outside of Western world. Further studies, including qualitative ones, should provide detailed information from immigrants about their labor market position and the reason behind it.