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PubMed1995

A comparison of avoidable mortality in Lithuania and Sweden 1971-1990.

BACKGROUND: In reforming the Lithuanian health care system it is important to evaluate the health status of the population and the outcome of health care by comparison to Western European countries. The aim of this study is to examine the possibility of comparing data on avoidable mortality in Lithuania with Sweden and, when realistic, to compare avoidable mortality rates between Lithuania and Sweden. METHODS: Comparisons were made for the time period 1971-1990. During this period a basic tabulation list including 200 groups of causes of death modified from WHO's International Classification of Diseases was obligatory for all Soviet Republics. This limited the opportunity for comparisons with Western European countries. However, for most of the selected avoidable death indicators comparisons with Sweden were made possible by slightly modifying the indicators. RESULTS: In the age group 5-64 years in 1971-1975 the total mortality in Lithuania was 60% higher than that in Sweden. In 1986-1990 this gap had increased to 90%. For most avoidable death indicators the difference was even greater, i.e. the death rate in Lithuania was several times higher than that in Sweden. For instance, death rates for tuberculosis were 36 times higher and for appendicitis, cholelithiasis and cholecystitis six times higher in Lithuania. For several avoidable causes of death, such as tuberculosis, appendicitis and hypertensive and cerebrovascular disease the gap widened during the study period. CONCLUSIONS: The results indicate potential fields for improvement of the health care system in Lithuania. The importance of implementing international classification systems for epidemiological surveillance of the outcome of health care is stressed.

Adolescent↗

PubMed2001

A national record linkage to study acute myocardial infarction incidence and case fatality in Sweden.

BACKGROUND: During the last decades substantial temporal changes, as well as population differences, in coronary heart disease mortality have occurred in Sweden. There is little information to what extent these changes and differences also apply to myocardial infarction incidence. The aim of this paper was to describe the methods used to identify cases in a recently developed National Acute Myocardial Infarction Register in Sweden, and to present estimates of incidence and case fatality in Sweden. MATERIAL AND METHODS: Incident cases of acute myocardial infarction (AMI) were identified by record linkage of routinely collected data on hospital discharges and deaths. Case fatality within 28 days was ascertained by linkage of incident cases to the National Cause of Death Register. RESULTS: About 40 000 new cases of AMI per year were recorded in Sweden during 1987-1995. Well-known differences in incidence with regard to age and gender were observed, as well as a decline in incidence between 1987 and 1995. A similar case fatality was seen in men and women aged 30-89 among hospitalized cases. When fatal cases outside hospital were also considered the case fatality was somewhat higher in men. Examination of medical records for a national sample of ischaemic heart disease patients suggested a high sensitivity (94%) and a high positive predictive value (86%) for ICD-9 code 410 in hospital discharge data with regard to definite AMI. CONCLUSIONS: The National Acute Myocardial Infarction Register offers a new possibility to study the incidence of AMI, as well as case fatality, in Sweden.

Acute Disease↗

PubMed1987

Epidemiology of nephropathia epidemica in Sweden.

A comprehensive study of nephropathia epidemica (NE), caused by Puumala virus, was conducted in Sweden. Human sera from residents of various regions of Sweden were examined for antibody to Puumala virus, and the incidence of NE was determined. Small mammals were captured at locations throughout Sweden and were examined for antibody to Puumala virus and for antigen. The human serosurvey found the highest prevalence rates and the highest incidence rates in northern Sweden. The bank vole was found to be the most-abundant rodent, as well as the species most frequently positive for antibody. Antibody-positive voles were restricted to the northern two-thirds of the country, an area corresponding to that where most human disease was noted. These results suggest that the bank vole is the principal host of Puumala virus in Sweden and clearly establish the region near 64 degrees N as highly endemic for NE in humans.

Animals↗

PubMed1997

Age-period-cohort effects on ischaemic heart disease mortality in Sweden from 1969 to 1993, and forecasts up to 2003.

AIMS: Mortality from ischaemic heart disease has been decreasing in most industrialized countries since the 1960s. The aim of this study was to analyse ischaemic heart disease mortality during 1969-1993 in Sweden, and to predict mortality trends until 2003. METHODS AND RESULTS: Age-period cohort models were used to analyse ischaemic heart disease mortality in Sweden between 1969 and 1993, and to predict age-specific death rates and total number of deaths for the periods 1994-1998 and 1999-2003. Mortality rates in the age group 25-89 years decreased from 719 to 487 per 100,000 for men, and from 402 to 215 per 100,000 for women over the study period (average annual decrease of 1.5% for men and 2.2% for women). The decline started earlier for women than for men. The ratio of age-adjusted mortality between men and women increased steadily over the study period. Predictions based on the full age-period cohort model for the period 1999-2003 gave mortality rates of 346 and 155 per 100,000 for men and women, respectively. Despite the ageing of the population, the total numbers of ischaemic heart disease deaths in Sweden are predicted to decline by approximately 25% in both men and women from 1989-93 to 1999-2003. CONCLUSION: A major decline in ischaemic heart disease mortality has been observed in the last 15 years in Sweden. Both factors, cohort and calendar period, contain information which helps explain the decline in ischaemic heart disease mortality trends in Sweden. Predictions indicate that the decline of both age-specific and total mortality is to continue.

Adult↗

PubMed1997

Most HIV-1 genetic subtypes have entered Sweden.

OBJECTIVE: The aim of this study was to document which genetic subtypes of HIV-1 have entered Sweden and to study transmission patterns of these virus variants. PATIENTS: All HIV-1 infected individuals at Danderyds Hospital, Stockholm, Sweden, who were suspected of carrying a virus of African origin were prospectively included in the study. The study subjects originated from 15 different African countries. METHODS: The V3 domain of the HIV-1 envelope was directly sequenced from uncultured peripheral blood mononuclear cells from 75 individuals included in the study. Phylogenetic analyses were used to determine genetic subtype and to study transmission patterns. RESULTS: The virus strains carried by the study subjects belonged to six established subtypes of HIV-1 (27A, 4B, 18C, 18D, 2G, 2H). Two individuals from Zaire carried a subtype, which had not been classified previously, provisionally named subtype 1. Eleven transmissions of non-subtype B strains in Sweden were documented. CONCLUSIONS: This study shows that most genetic HIV-1 subtypes have entered Sweden despite the relatively low prevalence of HIV infection in the country. Thus, the complete dominance of subtype-B infections which was seen during the early phase of the HIV-1 epidemic in Europe and the US has been broken in Sweden.

HIV Infections↗

PubMed2006

Breast cancer trends: opportunistic screening in Austria versus controlled screening in Finland and Sweden.

The objective of the study was to compare the trends of incidence and of mortality of breast cancer in Austria, Finland and Sweden, where different mammography screening strategies (opportunistic versus controlled) are applied. Furthermore, to find out whether a change in screening strategies would be feasible for Austria. Age-standardized incidence rates (1983-2000) and mortality rates (1980-2001/2) were analysed. Furthermore, the annual per cent change and the annual rate change (annual rate change=+/-n/100,000 per year) and the 95% confidence interval were calculated. In all three countries, incidence rates increased significantly (Austria +26.4%, Finland +86.7%, Sweden +38.8%) during the period analysed (P<0.01). The annual per cent change and the annual rate change in Austria (1.57 and 1.56, respectively) are below the annual per cent change and the annual rate change in Finland (3.38 and 3.49, respectively) and in Sweden (1.80 and 2.19, respectively) for the period analysed. Total breast cancer mortality decreased significantly in Sweden since 1980 (-20.5%, P<0.01), in Finland since 1988 (-18.3%, P<0.05) and in Austria since 1990 (-19.8%, P<0.01). The annual per cent change and the annual rate change in Austria (-1.81 and -0.59, respectively) are below the annual per cent change and the annual rate change in Finland (-0.57 and -0.16, respectively) and in Sweden (-1.02 and -0.28, respectively) for the period analysed. In conclusion, despite its unsophisticated opportunistic screening, Austria does well in comparison with countries operating organized breast cancer screenings.

Adult↗

PubMed1997

Cancer risk and mortality patterns among silicotic men in Sweden and Denmark.

Data from nationwide registry-based cohorts of patients hospitalized for silicosis in Sweden from 1965 to 1983 and Denmark from 1977 to 1989 were linked to national cancer registries in both countries and to mortality data in Sweden to evaluate the risk of cancer and other disorders among hospitalized silicotic patients. The overall cancer standardized incidence ratio (SIR) was 1.5 (95% confidence interval [CI], 1.3 to 1.7) in Sweden and 1.7 (95% CI, 1.2 to 2.3) in Denmark, primarily because of elevations in primary lung cancer in both Sweden (SIR, 3.1; CI, 2.1 to 4.2) and Denmark (SIR, 2.9; CI, 1.5 to 5.2). For Sweden, the all-causes standardized mortality ratio (SMR) was 2.0 (1.9 to 2.2). The SMR for all malignancies was 1.5 (1.2 to 1.7), primarily because of excesses of lung cancer (SMR, 2.9; CI, 2.1 to 3.9). The significant increase in mortality for all infectious and parasitic conditions (SMR, 11.2) was primarily due to tuberculosis (SMR, 21.8). Significant excesses in mortality from silicosis (SMR, 523), bronchitis (SMR, 2.6) and emphysema (SMR, 6.7) contributed to the elevation in nonmalignant respiratory deaths (SMR, 8.8), whereas excess mortality from musculoskeletal disorders (SMR, 5.9) was due to six deaths from autoimmune diseases. Despite limitations of the available data, our findings are consistent with previous reports indicating that silicotic patients are at elevated risk of lung cancer, nonmalignant respiratory diseases, tuberculosis, and certain autoimmune disorders.

Adult↗

PubMed2007

Adverse health indicators correlating with sparsely populated areas in Sweden.

Earlier studies on health characteristics in Sweden have pointed at a sudden trend change in general health indicators around 1997. The decline was worse in areas with less estimated coverage by the mobile phone system; that is, areas where the average output power from mobile phone handsets is expected to be higher. In this study, health parameters were related to the population density, which is a well defined, rather than an estimated variable. Statistics were obtained from different authorities in Sweden. Data were correlated to the population densities in the 21 different counties of Sweden as well as to estimates of average mobile phone output power. Several health quality measures showed that people in sparsely populated counties in Sweden (as well as in Denmark and Norway) have suffered more illness, and lengthier recovery than people in more densely populated areas since 1997. This is in strong contrast to the situation 20 years ago, when the countryside was the healthiest place in which to live. The indicators strongly correlated with estimated mobile phone area coverage and estimated power output. The indicator statistics suggest that the decline in health in Sweden is not a primary consequence of low population density by itself, but that other factors related to population density are causative. The two factors having the strongest correlation with decreased health quality were the estimated average power output from mobile phones (positive correlation) and the reported coverage from the global system for mobile communication base stations (negative correlation) in each county.

Alzheimer Disease↗

PubMed2006

A survey of specialist paediatric dental services in Sweden: results from 2003, and trends since 1983.

UNLABELLED: The child population in Sweden has changed dramatically during the last 20 years. Changes have also occurred within the Public Dental Service (PDS), regarding the provision of dental care to children and adolescents. All these changes may affect the referral pattern and provision of specialist dental care for children and adolescents. OBJECTIVES: The primary aim of this study was to survey the services provided by specialists in paediatric dentistry in Sweden during 2003. A secondary aim was to compare the results with previous surveys. METHODS: A Web-based survey was sent to all 34 specialist paediatric dentistry clinics and was answered by all clinics. Data were compared with results from the surveys performed in 1983, 1989, and 1996. RESULTS: The number of paediatric dentists had been relatively constant over the last 20 years, whereas the number of children referred to paediatric dentists had increased by 28% since 1983. It was estimated that 1.3% of all children in Sweden are treated at a specialist paediatric dental clinic in 2003. Dental treatment need in combination with behaviour management problems (BMP) was the main reason for referral and occurred in 37% of all referrals. The proportion of medically compromised children/children with disabilities had increased from 6% in 1983 to 22% in 2003. The number of patients treated using sedation and general anaesthesia had increased since 1983, and particularly since 1996. CONCLUSIONS: Despite improvements in dental health among children and adolescents in Sweden during the last 20 years, an increasing number of children are referred for specialist paediatric dental treatment. There is an urgent need to increase the number of specialist paediatric dentists in Sweden in order to ensure the continuation of high quality of dental care for children and adolescents.

Adolescent↗

PubMed2004

Adolescents with Turkish background in Norway and Sweden: a comparative study of their psychological adaptation.

Using a questionnaire survey, this study compared psychological adaptation (self-esteem, life satisfaction, and mental health problems) of Turkish adolescents in Norway and Sweden, and examined to what extent ethnic and majority identities, acculturation strategies, and perceived discrimination accounted for adaptation among Turkish adolescents. The samples consisted of 407 Turks (111 in Norway and 296 in Sweden) with a mean age of 15.2 years and 433 host adolescents (207 in Norway, 226 in Sweden) with a mean age of 15.6 years. Turks in Norway reported poorer psychological adaptation than Turks in Sweden. Predictors of good adaptation were Turkish identity and integration, whereas poor adaptation was related to marginalization and perceived discrimination. The results indicated that the poorer adaptation of Turks in Norway compared to that of Turks in Sweden could be due to lower degree of Turkish identity and higher degree of perceived discrimination.

Acculturation↗

PubMed1994

Infant survival in Norway and Sweden 1985-88.

In recent years, considerable attention has been attached to the disquieting fact that infant survival is much lower in Norway than in Sweden. In the present study, comprising all live single births in Norway and Sweden during 1985-88, the observed infant mortality was 1.5 times higher in Norway than in Sweden. The largest difference between Norway and Sweden was found in infants of young mothers with high birth order. Thus for the second births of mothers aged less than 20 years the observed mortality ratio of Norway to Sweden was 1.8. The infant mortality ratio decreased with increasing maternal age for all birth orders, and for the second births of mothers aged 35 years or more the mortality ratio was 1.0. The higher infant mortality in Norway was evident throughout the first year of life, with the highest mortality ratio observed at 6-8 months of life. Adjustment for maternal age, birth order and geographical region did not alter the observed infant mortality ratios. In both countries, the highest risk was found among infants of young mothers. this suggests a need for a more extensive preventive health care system directed at young mothers during their pregnancy and the infancy period.

Adolescent↗

PubMed1992

Social class differences in infant mortality in Sweden: comparison with England and Wales.

OBJECTIVES: To investigate social class differences in infant mortality in Sweden in the mid-1980s and to compare their magnitude with that of those found in England and Wales. DESIGN: Analysis of risk of infant death by social class in aggregated routine data for the mid-1980s, which included the linkage of Swedish births to the 1985 census. SETTING: Sweden and England and Wales. SUBJECTS: All live births in Sweden (1985-6) and England and Wales (1983-5) and corresponding infant deaths were analysed. The Swedish data were coded to the British registrar general's social class schema. MAIN OUTCOME MEASURES: Risk of death in the neonatal and postneonatal period. RESULTS: Taking the non-manual classes as the reference group, in the neonatal period in Sweden the manual social classes had a relative risk for mortality of 1.20 (95% confidence interval 1.02 to 1.43) and those not classified into a social class a relative risk of 1.08 (0.88 to 1.33). In the postneonatal period the equivalent relative risks were 1.38 (1.08 to 1.77) for manual classes and 2.14 (1.65 to 2.79) for the residual; these are similar to those for England and Wales (1.43 (1.36 to 1.51) for manual classes, 2.62 (2.45 to 2.81) for the residual). CONCLUSIONS: The existence of an equitable health care system and a strong social welfare policy in Sweden has not eliminated inequalities in post-neonatal mortality. Furthermore, the very low risk of infant death in the Swedish non-manual group (4.8/1000 live births) represents a target towards which public health interventions should aim. If this rate prevailed in England and Wales, 63% of postneonatal deaths would be avoided.

England↗

PubMed1994

Risk of acute childhood leukaemia in Sweden after the Chernobyl reactor accident. Swedish Child Leukaemia Group.

OBJECTIVE: To evaluate the risk of acute childhood leukaemia in areas of Sweden contaminated after the Chernobyl reactor accident in April 1986. DESIGN: Population based study of childhood leukaemia diagnosed during 1980-92. SETTING: Coordinates for places of residence of all 1.6 million children aged 0-15 years; aerial mapped areas of Sweden heavily contaminated after the Chernobyl accident. SUBJECTS: 888 children aged 0-15 years with acute leukaemia diagnosed in Sweden during 1980-92, identified with place of birth and residence at diagnosis. MAIN OUTCOME MEASURES: Risk of leukaemia in areas contaminated after the Chernobyl accident compared with the rest of Sweden and in the same areas before the accident. RESULTS: During six and a half years of follow up after the accident the odds ratio for acute leukaemia was 0.9 (95% confidence interval 0.6 to 1.4) in highly contaminated areas (> or = 10 kBq/m2) compared with the same areas before the accident. For the subgroup acute lymphoblastic leukaemia in children aged under 5 years at diagnosis the odds ratio was 1.5 (0.8 to 2.6). For all cases diagnosed after May 1986 in highly contaminated areas compared with areas of low contamination the odds ratio was 0.9 (0.7 to 1.3). For acute lymphoblastic leukaemia in children aged under 5 years at diagnosis the odds ratio was 1.2 (0.8 to 1.9) in highly contaminated areas compared with areas of low contamination. Dose-response analysis showed no correlation between the degree of contamination and the incidence of childhood leukaemia. CONCLUSION: There has been no significant increase in the incidence of acute childhood leukaemia in areas of Sweden contaminated after the Chernobyl reactor accident.

Accidents↗

PubMed2003

Trends in incidence and case fatality rates of acute myocardial infarction in Denmark and Sweden.

OBJECTIVE: To compare the incidence and case fatality of acute myocardial infarction in Denmark and Sweden. DESIGN: A cohort study, linking the national registries of hospital admissions and causes of death in the two countries. PATIENTS: All admissions and deaths with acute myocardial infarction as primary or secondary diagnosis were extracted (Denmark, 1978 to 1998; Sweden, 1987 to 1999). MAIN OUTCOME MEASURES: The incidence was estimated using the first acute myocardial infarct for each patient. Case fatality was estimated in the first 28 days after acute myocardial infarction, including prehospital deaths. All rates were adjusted for age. RESULTS: The incidence of myocardial infarction and the case fatality declined significantly among all subgroups of patients. Case fatality was higher in Denmark early in the study period (1987-1990) than in Sweden. The odds ratios (OR) ranged from 1.28 to 1.50 in the four age groups. In 1994-1999, the prognosis of patients younger than 75 years did not differ. Patients aged 75-94 years still fared worse in Denmark (OR 1.21, 95% confidence interval 1.17 to 1.27). Women aged 30-54 years had a worse prognosis than men in both Denmark and Sweden (OR associated with male sex 0.85 and 0.90, respectively). In contrast, for patients older than 65 years, women had a better prognosis than men. This difference in the effect of sex with age was significant (p < 0.0001) and did not change over time. CONCLUSIONS: Case fatality after acute myocardial infarction was notably higher in Denmark than in Sweden in 1987-1991, but in the later periods the prognosis was comparable in the two countries.

Adult↗

PubMed1996

Can regional variation in "avoidable" mortality be explained by deaths outside hospital? A study from Sweden, 1987-90.

STUDY OBJECTIVE: This study aimed to calculate the proportion of deaths outside hospital in Sweden for some conditions for which the acute medical management may be important to the outcome and to analyse whether the proportion of deaths outside hospital can explain regional variations in mortality from these causes of death. DESIGN: The place of death was registered on all death certificates in Sweden during the period 1987-90. The proportion of deaths outside hospital was calculated at the national level for selected causes of death. Variation in cause-specific mortality among the 26 administrative health areas in Sweden was analysed. Death rate ratios were calculated with standardisation for age and sex using the national rate as standard. The correlation between the proportion of deaths outside hospital in each health area and the cause specific mortality irrespective of place of death was calculated. For areas with a significantly high death rate the ratios for mortality outside hospital as well as in hospital were analysed in order to decide which component of mortality represented a high mortality risk. SETTING AND PARTICIPANTS: All death registration in Swedish citizens and other residents in Sweden aged under 70 years between 1987 and 1990 which gave diabetes, asthma, ischaemic heart disease, cerebrovascular diseases, or ulcer of the stomach or duodenum as the underlying cause of death. MAIN RESULTS: For asthma (58%) and ischaemic heart disease (54%), most deaths occurred outside hospital. For most causes of death, however, no correlation was found among the health areas between the proportion of deaths outside hospital and the SMR for mortality irrespective of the place of death. A high death rate was associated with a high proportion of deaths outside hospital, for diabetes in one area in the north of Sweden (Norrbotten) and for ulcer of the stomach and duodenum in one large municipality (Göteborg). CONCLUSIONS: The high proportion of deaths outside hospital at the national level for some of the conditions studied suggests that in-depth studies of the process preceding death and the functioning of medical care are needed. In most cases, however, no evidence was found that regional variation in mortality could be explained by death outside hospital. The results for diabetes in Norbotten and ulcer of stomach and duodenum in Göteborg indicate that in-depth studies on the quality of care are required.

Adolescent↗

PubMed1995

Reports of work related musculoskeletal injury among home care service workers compared with nursery school workers and the general population of employed women in Sweden.

OBJECTIVES: To describe the nationwide occurrence of work related musculoskeletal injuries among all home care service workers in Sweden, and to identify relative risks and risk factors of the injuries. METHODS: The study was based on work related injuries reported to the Swedish occupational injury information system in 1990-1. The work related musculoskeletal injuries were divided into overexertion accidents and musculoskeletal diseases. The incidence of the injuries in female home care service workers was compared with those in nursery school workers and all other employed women in Sweden. RESULTS: In home care service workers, the annual incidence of injury from overexertion accidents and musculoskeletal diseases were 19.2 and 15.1 per 1000 workers, respectively, which was higher than those in nursery school workers and all employed women in Sweden. For five injury locations including the back, all the age standardised relative risks (SRR) of overexertion accidents exceeded 4.0, and most of those for musculoskeletal diseases were 1.5 or more in home care service workers compared with all other employed women in Sweden. Total duration of sick leave due to overexertion accidents was 7.7 times, and musculoskeletal diseases 3.5 times, longer than in nursery school workers. National loss due to sick leave resulting from only musculoskeletal injuries in home care service workers was about 8.2% of the total work related sick leave in all employed women in Sweden, although the number of home care service workers represented only some 5% of this population. Lifting other people was most frequently reported as the main risk cause of overexertion accidents in both kinds of workers. CONCLUSIONS: The results support the hypothesis that home care service workers have higher annual injury incidence of musculoskeletal injuries than nursery school workers due to physically stressful tasks that are far less common in nursery school workers.

Accidents, Occupational↗

PubMed2002

Population-based twin study of the effects of migration from Finland to Sweden on endothelial function and intima-media thickness.

Finnish men have higher coronary heart disease (CHD) mortality than Swedish men do. To assess the impact of migration to a country with lower CHD mortality on subclinical atherosclerosis, we measured early functional and structural atherosclerotic vascular changes in twins discordant for migration from Finland to Sweden. Conventional CHD risk factors, flow-mediated dilatation (FMD) of the brachial artery, carotid intima-media thickness, and carotid artery compliance were measured in 74 male twin pairs (20 monozygous, 54 dizygous), aged 42 to 69 years, in which co-one twin had migrated more than 20 years ago permanently to Sweden. There were no significant differences in CHD risk factors except for diastolic blood pressure and body fat percentage, which were higher in Sweden. In all subjects, mean FMD was non-significantly higher in Sweden (5.7+/-4.3% vs 4.9+/-4.2%, P=0.22), but in monozygous twins the difference in FMD was highly significant (7.2+/-4.4 vs 3.7+/-2.9%, P=0.003). There was no significant difference in intima-media thickness or carotid artery compliance between Sweden and Finland. We conclude that in Finnish monozygous twins the endothelial function is better among the twins that have migrated to a country with lower CHD prevalence.

Adult↗

PubMed2004

Incidence of stroke and stroke subtypes in Malmö, Sweden, 1990-2000: marked differences between groups defined by birth country.

BACKGROUND AND PURPOSE: The proportion of immigrants has increased in Sweden markedly during the last decades, as in many other Western countries. Incidence of stroke has increased during this period. However, it is primarily unknown whether incidence of stroke and stroke subtypes in Sweden is related to country of birth. METHODS: Incidence of first-ever stroke was followed during 10 years in a cohort consisting of all 40- to 89-year-old inhabitants in the city of Malmö, Sweden (n=118,134). Immigrants from 12 different countries were compared with native-born Swedes. RESULTS: Adjusted for age, sex, marital status, and socioeconomic indicators, the incidence of stroke (all subtypes) was significantly higher among immigrants from former Yugoslavia (relative risk [RR], 1.31; 95% CI, 1.1 to 1.6) and Hungary (RR, 1.33; CI, 1.02 to 1.7). A significantly increased incidence of intracerebral hemorrhage was observed in immigrants from Peoples Republic of China or Vietnam (RR, 4.2; CI, 1.7 to 10.4) and the former Soviet Union (RR, 2.7; CI, 1.01 to 7.3). Immigrants from Finland had a significantly higher incidence of subarachnoid hemorrhage (RR, 2.8; CI, 1.1 to 6.8). A significantly lower incidence of stroke was observed in the group from Romania (RR, 0.14; CI, 0.04 to 0.6). Immigrants from Denmark, Norway, Germany, Chile, Czechoslovakia, and Poland had approximately the same risk as citizens born in Sweden. CONCLUSIONS: In this urban population from Sweden, there are substantial differences in stroke incidence and stroke subtypes between immigrants from different countries. To what extent this could be accounted for by exposure to biological risk factors remains to be explored.

Adult↗