TY - JOUR

T1 - Association of common mental disorders and related multimorbidity with subsequent labor market marginalization among refugee and Swedish-born young adults

AU - Chen, Jiaying

AU - Mittendorfer-Rutz, Ellenor

AU - Berg, Lisa

AU - Norredam, Marie

AU - Sijbrandij, Marit

AU - Klimek, Peter

PY - 2023

Y1 - 2023

N2 - BackgroundCommon mental disorders (CMDs), multimorbidity, and refugee status are associated with poor labor market outcome. Little is known about how these factors interact in young adults. ObjectiveWe aimed to i) investigate whether the association of CMDs and multimorbidity with labor market marginalization (LMM) differs between refugee and Swedish-born young adults and ii) identify diagnostic groups with particularly high risk for LMM. MethodsThis longitudinal registry-based study included individuals aged 20-25 years followed from 2012 to 2016 in Sweden (41,516 refugees and 207,729 age and sex-matched Swedish-born individuals). LMM was defined as granted disability pension (DP) or > 180 days of unemployment (UE). A disease co-occurrence network was constructed for all diagnostic groups from 2009 to 2011 to derive a personalized multimorbidity score for LMM. Multivariate logistic regression was used to estimate odds ratios of LMM in refugee and Swedish-born youth as a function of their multimorbidity score. The relative risk (RR, 95% CI) of LMM for refugees with CMDs compared to Swedish-born with CMDs was computed in each diagnostic group. ResultsIn total, 5.5% of refugees and 7.2% of Swedish-born with CMDs were granted DP; 22.2 and 9.4%, respectively received UE benefit during follow-up. While both CMDs and multimorbidity independently elevated the risk of DP considerably in Swedish-born, CMDs but not multimorbidity elevated the risk of UE. Regarding UE in refugees, multimorbidity with the presence of CMDs showed stronger estimates. Multimorbidity interacted with refugee status toward UE (p < 0.0001) and with CMDs toward DP (p = 0.0049). Two diagnostic groups that demonstrated particularly high RR of UE were schizophrenia, schizotypal and delusional disorders (RR [95% CI]: 3.46 [1.77, 6.75]), and behavioral syndromes (RR [95% CI]: 3.41 [1.90, 6.10]). ConclusionTo combat LMM, public health measures and intervention strategies need to be tailored to young adults based on their CMDs, multimorbidity, and refugee status.

AB - BackgroundCommon mental disorders (CMDs), multimorbidity, and refugee status are associated with poor labor market outcome. Little is known about how these factors interact in young adults. ObjectiveWe aimed to i) investigate whether the association of CMDs and multimorbidity with labor market marginalization (LMM) differs between refugee and Swedish-born young adults and ii) identify diagnostic groups with particularly high risk for LMM. MethodsThis longitudinal registry-based study included individuals aged 20-25 years followed from 2012 to 2016 in Sweden (41,516 refugees and 207,729 age and sex-matched Swedish-born individuals). LMM was defined as granted disability pension (DP) or > 180 days of unemployment (UE). A disease co-occurrence network was constructed for all diagnostic groups from 2009 to 2011 to derive a personalized multimorbidity score for LMM. Multivariate logistic regression was used to estimate odds ratios of LMM in refugee and Swedish-born youth as a function of their multimorbidity score. The relative risk (RR, 95% CI) of LMM for refugees with CMDs compared to Swedish-born with CMDs was computed in each diagnostic group. ResultsIn total, 5.5% of refugees and 7.2% of Swedish-born with CMDs were granted DP; 22.2 and 9.4%, respectively received UE benefit during follow-up. While both CMDs and multimorbidity independently elevated the risk of DP considerably in Swedish-born, CMDs but not multimorbidity elevated the risk of UE. Regarding UE in refugees, multimorbidity with the presence of CMDs showed stronger estimates. Multimorbidity interacted with refugee status toward UE (p < 0.0001) and with CMDs toward DP (p = 0.0049). Two diagnostic groups that demonstrated particularly high RR of UE were schizophrenia, schizotypal and delusional disorders (RR [95% CI]: 3.46 [1.77, 6.75]), and behavioral syndromes (RR [95% CI]: 3.41 [1.90, 6.10]). ConclusionTo combat LMM, public health measures and intervention strategies need to be tailored to young adults based on their CMDs, multimorbidity, and refugee status.

KW - common mental disorders

KW - disability pension

KW - unemployment

KW - refugee

KW - disease network

KW - multimorbidity

KW - DISABILITY PENSION

KW - HEALTH-CARE

KW - COMORBIDITY

KW - NATIONWIDE

U2 - 10.3389/fpubh.2023.1054261

DO - 10.3389/fpubh.2023.1054261

M3 - Journal article

C2 - 37006549

VL - 11

JO - Frontiers in Public Health

JF - Frontiers in Public Health

SN - 2296-2565

M1 - 1054261

ER -