Drug and Alcohol Dependence
Volume 205, 2019

Immigrant enclaves and risk of drug involvement among asylum-seeking immigrants in Sweden: A quasi-experimental study (Article)

Mezuk B.* , Ohlsson H. , Cederin K. , Sundquist J. , Kendler K.S. , Sundquist K.
  • a Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
  • b Health Sciences Centre, University of Lund, Sweden
  • c Health Sciences Centre, University of Lund, Sweden
  • d Health Sciences Centre, University of Lund, Sweden
  • e Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
  • f Health Sciences Centre, University of Lund, Sweden

Abstract

Background: Sweden is a major host nation for asylum-seeking immigrants, and residential placement of these immigrants is an important policy concern. This quasi-experimental study estimated of the impact of being placed into an “immigrant enclave” on risk of officially-recognized drug involvement (ORDI) among asylum-seeking immigrants over a 15-year period. Methods: All data come from Swedish registries. The sample consisted of (a) asylum-seeking immigrants aged 5–35 years old at arrival (N = 51,017) that were subject to a nationwide policy (enforced 1987–1991) that dispersed asylum-seeking immigrants across municipalities, and (b) native-born Swedes aged 15 and older during this same period (N = 1,040,311). Neighborhood immigrant composition was quantified using the Reardon Index; residents of “immigrant enclave” neighborhoods (n = 960) were compared to residents of all other neighborhoods (n = 2,471). Cox proportional hazards models assessed the relationship between living in an enclave and risk of ORDI, identified by national registries, through 2015. Results: Overall, 29.7% of immigrants were assigned to, and 25.5% of Swedes lived in, an enclave. Cumulative incidence of ORDI in enclaves was 6.34% as compared to 6.89% in other neighborhoods. Immigrants living in an enclave had lower risk of ORDI (Hazard ratio (HR): 0.86, 95% Confidence Interval (CI): 0.77 – 0.96). This protective association was marginally stronger in lower poverty areas. Native-born Swedes living in an enclave had higher risk of ORDI (HR: 1.05, 95% CI: 1.03–1.08), a relationship that was exacerbated by neighborhood poverty. Conclusions: Neighborhood immigrant composition is associated with risk of ORDI, with differential associations for immigrants and native-born populations. © 2019 Elsevier B.V.

Author Keywords

Neighborhood Immigration segregation Substance abuse

Index Keywords

social segregation immigrant quasi experimental study register human controlled study priority journal policy neighborhood asylum seeker Sweden Adolescent male female substance use Article adult quantitative analysis Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074496531&doi=10.1016%2fj.drugalcdep.2019.107666&partnerID=40&md5=fcc47b5d766f9bdcb7a21c71a50feb3c

DOI: 10.1016/j.drugalcdep.2019.107666
ISSN: 03768716
Original Language: English