Section for Health Services Research, Department of Public Health, Danish Research Centre for Migration, Ethnicity, and Health, University of Copenhagen, Øster Farimagsgade 5, Building 10, 1014, Copenhagen K, Denmark.
Department of Social Medicine, Amsterdam Medical Centre, Amsterdam University, Amsterdam, The Netherlands.
Eur J Epidemiol. 2016 Jul;31(7):667-77. doi: 10.1007/s10654-015-0024-7. Epub 2015 May 13.
Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute myocardial infarction (AMI) and stroke. We conducted a historically prospective cohort study comprising all newly-arrived migrants to Denmark between 1.1.1993 and 31.12.2010 (n = 114,331), matched 1:6 to Danish-born by age and sex. CVD incidence was retrieved from the National Patient Registry and differences in incidence were assessed by Poisson regression and stratified by sex. Survival differences were assessed by Cox regression using all-cause and cause-specific mortality as outcome. Male refugees had significantly lower incidence of CVD (RR = 0.89; 95 % CI 0.85-0.93) and stroke (IRR = 0.62; 95 % CI 0.56-0.69) compared to Danish-born, but significantly higher incidence of AMI (IRR = 1.12; 95 % CI 1.02-1.24). Female refugees had similar rates of CVD and AMI, but significantly lower incidence of stroke (RR = 0.76; 95 % CI 0.67-0.85). Both male and female family-reunified immigrants had significantly lower incidence of CVD, AMI and stroke. All-cause and cause-specific survival after CVD, AMI and stroke was similar or significantly better for migrants compared to Danish-born, regardless of type of migrant (refugee vs. family-reunified) or country of origin. Refugees are disadvantaged in terms of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health.
心血管疾病（CVD）发病率和生存率的研究结果表明，不同种族之间存在差异。我们的目的是通过探索移民身份与族裔背景相结合对 CVD 发病率和生存率的影响，为这一领域增添新的视角，具体而言，是探讨急性心肌梗死（AMI）和中风的发病率和生存率。我们进行了一项历史性的前瞻性队列研究，纳入了 1993 年 1 月 1 日至 2010 年 12 月 31 日期间新抵达丹麦的所有移民（n=114331），按年龄和性别与丹麦出生者 1:6 匹配。CVD 的发病率从国家患者登记处获得，并通过泊松回归评估差异，按性别分层。使用全因和特定原因死亡率作为结局，通过 Cox 回归评估生存差异。男性难民的 CVD（RR=0.89；95%CI 0.85-0.93）和中风（IRR=0.62；95%CI 0.56-0.69）发病率明显低于丹麦出生者，但 AMI（IRR=1.12；95%CI 1.02-1.24）发病率明显较高。女性难民的 CVD 和 AMI 发病率相似，但中风（RR=0.76；95%CI 0.67-0.85）发病率明显较低。男性和女性家庭团聚移民的 CVD、AMI 和中风发病率均明显较低。无论移民类型（难民与家庭团聚）或原籍国如何，与丹麦出生者相比，移民的全因和特定原因死亡率均相似或明显更好。与丹麦出生者相比，难民在某些类型的心血管疾病方面处于劣势。另一方面，家庭团聚移民的 CVD 发病率较低。与丹麦出生者相比，所有移民的生存率都更好，这表明移民在健康方面并不总是处于劣势。
