Olakivi Antero, Kouvonen Anne, Koskinen Aki, Kemppainen Laura, Kokkinen Lauri, Väänänen Ari
Faculty of Social Sciences, University of Helsinki, Finland.
Centre for Public Health, Queen's University Belfast, UK.
Scand J Public Health. 2024 Jul;52(5):539-546. doi: 10.1177/14034948231168434. Epub 2023 Apr 22.
This study aimed to compare the sickness absence (SA; over 10 days) rates of migrant and non-migrant care workers in Finland.
Two cohorts were randomly sampled from nationwide registers and analysed together in a three-year follow-up design (2011-2013, 2014-2016). The pooled data consisted of 78,476 care workers, of whom 5% had a migrant background. Statistical methods included cross-tabulations and Poisson regression modelling.
Thirty-five percent of the Finnish-born care workers had at least one SA during the follow-up. Care workers from the post-2004 EU countries (30%, at least one SA), Russia, the Former Soviet Union and the Balkan states (25%) and the Global South and East (21%) had fewer episodes of SA than the Finnish-born care workers. The two latter groups also had lower SA rates after we controlled for occupation, gender, age, income and region of residence. Care workers from Western Europe and the Global North (36%) had higher SA rates than the Finnish-born care workers.
The following explanations were discussed: population-level health differences - migrants from lower-income non-EU countries are generally healthier than the Finnish-born population (due to, e.g., the 'healthy migrant effect'); discrimination in recruitment and employment - migrants from lower-income non-EU countries need to be healthier than Finnish-born jobseekers to gain employment (in the care sector or more broadly); and sickness presenteeism - migrants from lower-income non-EU countries underuse their right to sickness allowance (due to, e.g., job insecurity). It is likely that these mechanisms affect migrants differently depending on, for example, their countries of origin and social status in Finland.
本研究旨在比较芬兰移民护理人员和非移民护理人员的病假（超过10天）率。
从全国登记册中随机抽取两个队列，并在三年随访设计（2011 - 2013年、2014 - 2016年）中进行综合分析。汇总数据包括78476名护理人员，其中5%有移民背景。统计方法包括交叉表和泊松回归建模。
在随访期间，35%出生在芬兰的护理人员至少有一次病假。来自2004年后欧盟国家（30%，至少有一次病假）、俄罗斯、前苏联和巴尔干国家（25%）以及全球南部和东部（21%）的护理人员病假次数少于出生在芬兰的护理人员。在我们控制了职业、性别、年龄、收入和居住地区后，后两组的病假率也较低。来自西欧和全球北部（36%）的护理人员病假率高于出生在芬兰的护理人员。
讨论了以下解释：人群健康差异——来自低收入非欧盟国家的移民总体上比出生在芬兰的人群更健康（例如，由于“健康移民效应”）；招聘和就业中的歧视——来自低收入非欧盟国家的移民需要比出生在芬兰的求职者更健康才能获得就业（在护理部门或更广泛的领域）；以及带病上班——来自低收入非欧盟国家的移民未充分利用他们的病假津贴权利（例如，由于工作不稳定）。这些机制可能因移民的原籍国和在芬兰的社会地位等因素对他们产生不同的影响。
