Injury and migration in Sweden : Risk of death and hospitalization due to car accidents among foreign-born compared to Swedish-born individuals

Aim: To compare risk of death and hospitalization due to car accidents among foreign-born individuals to Swedish-born.Method: The study cohort (2,404,710 individuals; 11% foreign-born) established by linkage between Swedish national registers. The main exposure was migration status, and duration of residence and age at migration considered as secondary exposures. The cohort was 18-39 years old and followed from 2005-2012. Hazard ratios (HR) with 95% confidence intervals (CI) adjusted for birth year, gender, family income, area of residence, and country of birth were calculated by Cox proportional hazard model.Results: 588 death (8% among foreign-born) and 17,969 hospitalization (11% among foreign-born) due to car accidents recorded. While, adjusted risk of hospitalization was higher among foreign-born than that among Swedish-born individuals, we found lower risk (HR: 0.92; CI: 0.85-0.996) among females and higher risk (HR: 1.17; CI: 1.10-1.24) among males. Risk of hospitalization was higher among foreign-born individuals who immigrated to Sweden at ages younger than 18 years or lived in Sweden 5 years or longer.Conclusions: Gender is acting as an effect modifier for the risk of hospitalization due to car accidents. We recommend further research to examine factors underlying excess risk impact of duration of residence in host country