Virginia Commonwealth University School of Social Work, Richmond, Virginia, USA.
Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA.
Alcohol Clin Exp Res (Hoboken). 2023 Jan;47(1):104-115. doi: 10.1111/acer.14969. Epub 2022 Nov 22.
This study aimed to determine the robustness of the impact of immigration on risk for alcohol use disorder (AUD) using different measures, designs, and immigrant regional cohorts.
The analytic sample included all individuals born between 1950 and 1990 and registered in Sweden from 1973 to 2017. Using Cox regression models, we examined the risk for AUD from Swedish nationwide registries in immigrants to Sweden from seven geographical regions: Africa, Asia and Oceania, Eastern Europe, Finland, Latin America and the Caribbean, Middle East/North Africa, and Western countries. We assessed greater exposure to Swedish culture, which we interpreted as increasing acculturation, by (i) comparing first-generation immigrants and their children with no and one native Swedish parent and (ii) examining age at immigration. The baseline comparison group was the native Swedish population. We also examined AUD risk in first-generation sibling pairs discordant for their age at immigration.
In nearly all immigrant cohorts in Sweden, increasing degrees of acculturation, as assessed by both our variables, were associated with rates of AUD that approached those of the Swedish population. These findings occurred in both men and women and both regional cohorts whose first-generation immigrants had lower and higher levels of AUD than native-born Swedes. For most cohorts, the rates of change with acculturation were greater in women than in men. In sibling pairs from most regions, the sibling who was younger at immigration had a higher rate of AUD.
An examination of both sexes and two different proxies for acculturation provides consistent support for socio-cultural influences on AUD risk. Our co-sibling analyses suggest that a meaningful proportion of this effect is likely to be causal in nature.
本研究旨在使用不同的测量方法、设计和移民区域队列，确定移民对酒精使用障碍（AUD）风险的影响的稳健性。
分析样本包括 1950 年至 1990 年之间出生并于 1973 年至 2017 年在瑞典注册的所有个体。使用 Cox 回归模型，我们从瑞典全国登记处检查了来自七个地理区域的移民的 AUD 风险：非洲、亚洲和大洋洲、东欧、芬兰、拉丁美洲和加勒比、中东/北非和西方国家。我们通过（i）比较第一代移民及其父母均无和仅有一位瑞典籍父母的子女，以及（ii）检查移民年龄，评估了对瑞典文化的更多接触，我们将其解释为不断融入。原始比较组是瑞典本土人口。我们还检查了第一代兄弟姐妹移民年龄不一致的 AUD 风险。
在瑞典的几乎所有移民群体中，我们通过两个变量评估的融入程度越高，AUD 的发病率就越接近瑞典人口。这些发现发生在男性和女性以及第一代移民的 AUD 发病率低于和高于瑞典出生者的两个区域队列中。对于大多数队列，与融入相关的变化率在女性中比男性中更高。在大多数地区的同胞对中，移民年龄较小的同胞 AUD 发病率更高。
对两性和两种不同的融入度代理进行检查，为 AUD 风险的社会文化影响提供了一致的支持。我们的同胞对分析表明，这种影响的相当一部分可能具有因果关系。
