East—west health divide and east—west migration: Self-reported health of immigrants from Eastern Europe and the former Soviet Union in Sweden

Aim: Research on the east—west health divide has provided extensive evidence of poorer health in Eastern Europe and the former Soviet Union than in Western Europe. This study focuses on immigrants from Eastern to Western Europe and analyses whether they have an increased risk of self-reported poor health compared with the host population and what determines that. Methods: This cross-sectional study is based on 373 immigrants from Poland, other East European countries, and the former Soviet Union, aged 25—84, who arrived in Sweden after 1944 and were interviewed during 1993— 2000 along with their 35,711 Swedish counterparts. Results: Age- and sex-adjusted unconditional logistic regression showed in general a 92% higher risk of reporting poor health among immigrants than among Swedish-born respondents. The risk also persisted after adjustment for several potential confounders (living singly, having a poor social network, low socioeconomic status, and smoking) and after an additional adjustment for acculturation (language at home), and years in Sweden. Conclusions: Being born in Eastern Europe or the former Soviet Union was an independent risk factor for reporting poor health. It is therefore suggested that it is important for primary and public care services to be aware of the health status and needs of immigrants from these countries.