Younger adults are not alright, but older adults are? Examining mortality disparities among the children of migrants aged 15–44 and 45–64 in Sweden, 1990–2023: a total-population cohort study

Introduction Younger working age children of migrants have higher mortality risks relative to younger working age non-migrants in Europe. Yet, these are unique ages of mortality where the absolute risk of death is low and driven by external causes (ie, accidents, injuries and suicides). It remains unclear whether this higher mortality risk presents among older working age children of migrants—ages at which the absolute risk of death begins to increase exponentially and becomes dictated by chronic morbidities. We aim to fill this gap. Methods We fit survival models on Swedish total population register data using an extended, competing risks approach. We investigate all-cause and mortality from natural causes and external causes, drugs and alcohol among the children of migrants, migrants and non-migrants aged 15–44 and 45–64 from 1990 to 2023. We report both HRs and regression-standardised cumulative probabilities of death. Results Younger working age children of migrants from an array of origins exhibit higher external, drug and alcohol mortality relative to non-migrants that drives their higher all-cause mortality risk. Older working age children of migrants from multiple origins also present with a higher risk of external, drug and alcohol mortality, but only exhibit comparable all-cause mortality to non-migrants, owing to their similar to lower mortality from natural causes. Disparities in socioeconomic background largely attenuate these risks. A diverse range of younger and older working age migrants exhibit lower all-cause, natural, and external, drug and alcohol mortality than non-migrants do. Conclusions Interventions should be made to address the elevated avoidable and preventable external, drugs and alcohol mortality that presents among both older and younger working age children of migrants. Doing so will generate reductions in their all-cause mortality risk.