Project description

In recent years Sweden has experienced a substantial increase in the proportion of the population that is of foreign-origin. Ensuring the successful integration and positive well-being of persons of foreign-origin is of great social importance. Although Swedish research on health inequalities by country of origin is relatively extensive, most previous research is descriptive and does not thoroughly examine the causes of these inequalities. The present research programme is devoted to the investigation of the social determinants of health among individuals with foreign backgrounds in Sweden.

Utilizing the theory of fundamental causes of disease, we will consider how different social determinants of health in individuals with foreign backgrounds are causally related, and how distal factors influence the proximal factors. In six interrelated projects, ranging from upstream (distal) to downstream (proximal) social determinants, we will study the contribution for health of societal policies and processes, contextual-level exposures (i.e. characteristics of the residential area), working life factors, socioeconomic conditions, health behaviours and post-traumatic stress due to war trauma.

We have access to optimal data including total-population register data, several regional longitudinal public health surveys, and longitudinal Level-of-Living survey data including a sub-survey of the foreign-born population. We will use various methods and tools which allow us to examine causal relationships assess such as survival analysis, structural equation modelling (SEM), multilevel modelling and directed acyclic graphs (DAGs) that take advantage of the detailed covariate information available within the data. Sweden has been at the forefront of research on migration and health. We believe that this research programme has the potential to further develop and elaborate on research on migration and health.

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The SMASH team

Program manager  
Mikael Rostila, Professor (PI) CHESS
Project managers  
Sol Pía JuárezAssociate Professor CHESS
Andrea Dunlavy, PhD CHESS
Susanna ToivanenAssociate Professor CHESS
Alexander Miething, PostDoc Stockholm University
Lisa Berg, PhD CHESS
Anders Hjern, Professor CHESS
Project members  
Hélio Manhica, Doctoral Student CHESS
Agneta Cederström, PhD CHESS
Denny VågeröProfessor CHESS
Jenny Eklund, PhD CHESS
Gabriella Olsson, PhD CHESS
Helena Honkaniemi, Research assistant CHESS
Petra Lindfors, Professor Stockholm University
Göran Henriksson, PhD Region Västra Götaland
Karin Engström, Associate Professor Karolinska Institutet
Per-Olof Östergren, Professor Lund University
Jens Rydgren, Professor Stockholm University
Srinivasa Katikireddi, Professor University of Glasgow



Miething, A., Rostila, M. and Rydgren, J., 2017. Access to occupational networks and ethnic variation of depressive symptoms in young adults in Sweden. Social Science & Medicine.

Manhica, H., Gauffin, K., Almquist, Y.B., Rostila, M., Berg, L., de Cortázar, A.R.G. and Hjern, A., 2017. Hospital admissions due to alcohol related disorders among young adult refugees who arrived in Sweden as teenagers – a national cohort study. BMC Public Health, 17(1), p. 644.

Steel, J.L., Dunlavy, A.C., Harding, C.E. and Theorell, T., 2017. The Psychological Consequences of Pre-Emigration Trauma and Post-Migration Stress in Refugees and Immigrants from Africa. Journal of Immigrant and Minority Health, 19(3), pp. 523-532.

Honkaniemi, H., Bacchus-Hertzman, J., Fritzell, J. and Rostila, M., 2017. Mortality by country of birth in the Nordic countries – a systematic review of the literature. BMC Public Health, 17(1), p. 511.

Juárez, S.P. and Hjern, A., 2017. The weight of inequalities: Duration of residence and offspring's birthweight among migrant mothers in Sweden. Social Science & Medicine, 175, pp. 81-90.

Johnson, C.M., Rostila, M., Svensson, A.C. and Engström, K., 2017. The role of social capital in explaining mental health inequalities between immigrants and Swedish-born: a population-based cross-sectional study. BMC Public Health, 17(1), p. 117.


Jon-Ivar Elstad, Jan SaarelaIchiro KawachiS.V. SubramanianSpencer MooreRosane Härter GriepRoger Keller-Celeste, Jussi Vahtera