Sundquist J, Johansson S E
Department of Community Health Sciences, Dalby/Lund, University of Lund, Sweden.
Int J Epidemiol. 1997 Apr;26(2):279-87. doi: 10.1093/ije/26.2.279.
Epidemiological data on ethnicity and health in Sweden have mostly been derived from small populations and focused on morbidity. The present study highlights the relation between country of birth, adjusted for other social variables, and total mortality and mortality from circulatory diseases and coronary heart disease (CHD).
The interviews with 21,420 males and 21,977 females aged 20-74 were conducted during a 7-year period, 1979-1985. The data consist of seven independent samples of the Swedish population. The present investigation was designed as a longitudinal follow-up study ranging from the day of the interview to 31 December 1993. Mortality data were obtained from the Cause of Death Register based on the Swedish national registration number. Person-years at risk were calculated from the date of the interview until death, or for those who survived, until the end of the follow-up period. The data were analysed by sex, using a proportional hazard model.
Men born in Finland had an increased mortality from all causes of death. Women born in Finland had an increased mortality risk for circulatory diseases with a relative risk (RR) of 2.15 (95% confidence interval [CI] : 1.45-3.20) when adjusted for age, marital status, form of housing tenure and years of education. The relationship between being a woman born in Finland or Eastern Europe and mortality for coronary heart disease (CHD) was significant with an RR of 2.18 (95% CI : 1.24-3.81) and 3.02 (95% CI : 1.24-7.34) respectively. The form of housing tenure was significantly associated with mortality in all models. Education showed a graded relation to total mortality and to mortality from circulatory diseases and CHD.
The increased mortality risk for Finnish males and females and, in addition the increased circulatory disease mortality risk for Finnish females and the strongly increased risk for CHD mortality for females born in Finland and Eastern Europe could not be explained by confounding by age, marital status or socioeconomic position.
瑞典有关种族与健康的流行病学数据大多来自小群体研究，且主要关注发病率。本研究着重探讨在对其他社会变量进行调整后，出生国与全因死亡率、循环系统疾病死亡率以及冠心病（CHD）死亡率之间的关系。
在1979年至1985年的7年期间，对21420名年龄在20 - 74岁的男性和21977名年龄在20 - 74岁的女性进行了访谈。数据由瑞典人口的七个独立样本组成。本调查设计为一项纵向随访研究，从访谈之日起至1993年12月31日。死亡率数据基于瑞典国家登记号码从死亡原因登记处获取。风险人年数从访谈日期计算至死亡日期，对于存活者则计算至随访期结束。数据按性别进行分析，采用比例风险模型。
出生在芬兰的男性全因死亡率有所增加。出生在芬兰的女性在调整年龄、婚姻状况、住房 tenure形式和教育年限后，循环系统疾病的死亡风险增加，相对风险（RR）为2.15（95%置信区间[CI]：1.45 - 3.20）。出生在芬兰或东欧的女性与冠心病（CHD）死亡率之间的关系显著，RR分别为2.18（95% CI：1.24 - 3.81）和3.02（95% CI：1.24 - 7.34）。在所有模型中，住房 tenure形式与死亡率显著相关。教育程度与全因死亡率、循环系统疾病死亡率和冠心病死亡率呈分级关系。
芬兰男性和女性增加的死亡风险，以及芬兰女性增加的循环系统疾病死亡风险，还有出生在芬兰和东欧的女性冠心病死亡风险的大幅增加，无法通过年龄、婚姻状况或社会经济地位的混杂因素来解释。
