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.
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a
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
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b
Health Sciences Centre, University of Lund, Sweden
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c
Health Sciences Centre, University of Lund, Sweden
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d
Health Sciences Centre, University of Lund, Sweden
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e
Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
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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.
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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