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Immigrants’ diminished protective effects of parental education and employment on youth mood disorders in Sweden

Assari, Shervin ; Osooli, Mehdi LU orcid ; Ohlsson, Henrik LU ; Sundquist, Jan LU and Sundquist, Kristina LU (2025) In BMC Psychiatry 25(1).
Abstract

Objectives: While high socioeconomic status (SES) indicators generally protect against mental health issues such as mood disorders in overall populations, evidence suggests that these protective effects might be attenuated for marginalized groups such as immigrants, in comparison to groups who are more socially privileged. This phenomenon is referred to as Marginalization-related Diminished Returns (MDRs). Existing knowledge on diminished returns of SES indicators primarily stems from cross-sectional comparisons of racial groups of adults in the US. Therefore, there is a crucial need to investigate these dynamics using longitudinal data of youth in European countries that are host countries for migrants from many different countries.... (More)

Objectives: While high socioeconomic status (SES) indicators generally protect against mental health issues such as mood disorders in overall populations, evidence suggests that these protective effects might be attenuated for marginalized groups such as immigrants, in comparison to groups who are more socially privileged. This phenomenon is referred to as Marginalization-related Diminished Returns (MDRs). Existing knowledge on diminished returns of SES indicators primarily stems from cross-sectional comparisons of racial groups of adults in the US. Therefore, there is a crucial need to investigate these dynamics using longitudinal data of youth in European countries that are host countries for migrants from many different countries. Aims: This study aims to compare the impact of family SES indicators (parental education, parental employment, family income), and family composition on subsequent incidence of mood disorders in youth from immigrant and non-immigrant families. Methods: Utilizing a retrospective cohort design, we analyzed data from nationwide registers in Sweden from Jan 1, 2001, to Dec 31, 2020, and included immigrant and non-immigrant children 12–18 years. Independent variables included parental education, parental employment, family income, and family composition. The outcome variable was a mood disorder diagnosis based on the national patient register. Sex and study year served as covariates, while immigration background acted as a moderator. Cox regression models were employed for statistical analysis. Results: All SES indicators (higher parental education, parental employment, higher family income), and two-parent family composition were associated with a lower risk of mood disorders. However, the protective effects of parental education and employment were weaker for immigrant youth compared to native-born youth, as documented by statistically significant interaction tests. Conclusions: Our findings reveal weaker protective effects of parental education and employment for youth from immigrant families compared to youth from native-born families in Sweden. Prevention of mood disorders among immigrant families in Sweden may require two sets of policy interventions: one that supports education and employment in general and one that supports employed and educated families to harness their available human capital, with particular attention to immigrants from Africa and the Middle East.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
First-generation, Immigrant, Inequity, Mood disorders, Second-generation, Socioeconomic status, Sweden, Young adult
in
BMC Psychiatry
volume
25
issue
1
article number
800
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105013773519
  • pmid:40836277
ISSN
1471-244X
DOI
10.1186/s12888-025-07264-7
language
English
LU publication?
yes
id
cfdf48a2-64e7-44a7-9f4f-9b34e112bca8
date added to LUP
2025-10-03 12:36:28
date last changed
2025-10-17 14:29:51
@article{cfdf48a2-64e7-44a7-9f4f-9b34e112bca8,
  abstract     = {{<p>Objectives: While high socioeconomic status (SES) indicators generally protect against mental health issues such as mood disorders in overall populations, evidence suggests that these protective effects might be attenuated for marginalized groups such as immigrants, in comparison to groups who are more socially privileged. This phenomenon is referred to as Marginalization-related Diminished Returns (MDRs). Existing knowledge on diminished returns of SES indicators primarily stems from cross-sectional comparisons of racial groups of adults in the US. Therefore, there is a crucial need to investigate these dynamics using longitudinal data of youth in European countries that are host countries for migrants from many different countries. Aims: This study aims to compare the impact of family SES indicators (parental education, parental employment, family income), and family composition on subsequent incidence of mood disorders in youth from immigrant and non-immigrant families. Methods: Utilizing a retrospective cohort design, we analyzed data from nationwide registers in Sweden from Jan 1, 2001, to Dec 31, 2020, and included immigrant and non-immigrant children 12–18 years. Independent variables included parental education, parental employment, family income, and family composition. The outcome variable was a mood disorder diagnosis based on the national patient register. Sex and study year served as covariates, while immigration background acted as a moderator. Cox regression models were employed for statistical analysis. Results: All SES indicators (higher parental education, parental employment, higher family income), and two-parent family composition were associated with a lower risk of mood disorders. However, the protective effects of parental education and employment were weaker for immigrant youth compared to native-born youth, as documented by statistically significant interaction tests. Conclusions: Our findings reveal weaker protective effects of parental education and employment for youth from immigrant families compared to youth from native-born families in Sweden. Prevention of mood disorders among immigrant families in Sweden may require two sets of policy interventions: one that supports education and employment in general and one that supports employed and educated families to harness their available human capital, with particular attention to immigrants from Africa and the Middle East.</p>}},
  author       = {{Assari, Shervin and Osooli, Mehdi and Ohlsson, Henrik and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{1471-244X}},
  keywords     = {{First-generation; Immigrant; Inequity; Mood disorders; Second-generation; Socioeconomic status; Sweden; Young adult}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Psychiatry}},
  title        = {{Immigrants’ diminished protective effects of parental education and employment on youth mood disorders in Sweden}},
  url          = {{http://dx.doi.org/10.1186/s12888-025-07264-7}},
  doi          = {{10.1186/s12888-025-07264-7}},
  volume       = {{25}},
  year         = {{2025}},
}