According to a number of previous studies, several large immigrant groups in Sweden have a significantly higher risk of diseases such as cardiovascular disease than people born in Sweden. But researchers know little about the degree to which this is associated with migration. For her dissertation Elderly Iranians in Sweden – The impact of migration on risk factors for cardiovascular disease, Dietician Afsaneh Koochek of the Center for Family and Community Medicine (CeFAM) in Stockholm investigated this association.
She compared risk factors for cardiovascular disease in older Iranians who had immigrated to Sweden with risk factors in Iranians in Iran. Today, Iranians are the largest group of non-European elderly immigrants in Sweden. A total of 1,200 men and women aged 60–84 years participated in four studies. Participants in both Sweden and Iran were interviewed in detail about topics such as exercise and food habits, smoking, health, and quality of life. The researchers also measured participants’ height, weight, waist circumference and blood pressure.
The dissertation shows, that migration to Sweden results in a raised risk of cardiovascular disease. Iranian men in Sweden have more than three times the risk of high blood pressure than Iranian men in Iran. Among women, the risk is twice as high in Sweden as in Iran. The proportion of smokers is fully six times higher in Sweden. Iranians in Sweden eat more fruit and vegetables, but on the other hand, they eat more fat.
“This indicates that immigrants have adopted a more western lifestyle, including both advantageous and disadvantageous habits that affect health”, says Afsane Koochek.
Contrary to expectations, Afsane Koochek’s dissertation shows that quality of life did not get worse after the move to Sweden. The older Iranians in Sweden rate their quality of life as high as those in Iran. This is particularly true of women who have lived in Sweden for more than 15 years.
“It’s not easy to adapt to a new set of norms, values, and habits in a new country, so it was surprising to find that migration affects the older Iranians physically more than mentally” she says.
There are also no large differences in the prevalence of obesity and diabetes between the immigrants and those who live in Iran. It is worth noting, however, that four of five Iranian women in both places are abdominally obese, and approximately half of the Iranian women in Sweden report that they are almost never physically active.
“They may be unaccustomed to exercising, and cultural factors may also play a role. For many of the older Iranians, a large body is a sign of health and prosperity.”
Afsane Koocheck urges her colleagues in community care and health care to become better at noticing, preventing, and treating well-known risk factors for cardiovascular disease, especially overweight and abdominal obesity.
“This applies especially to Iranians, but the problem is also growing among older Swedes”, she says. “We are flooded with alarming reports about underweight, but there is actually a large group of elderly people with a body mass index of more thirty. Above all, we need better guidelines on how to provide the best possible treatment for this group. Current guidelines are geared to people up to 60 years old.”
Dissertation: Elderly Iranians in Sweden – The impact of migration on risk factors for cardiovascular disease, Afsaneh Koochek. Main advisor was Professor Jan Sundquist, Karolinska Institutet. Secondary advisors included Professor Sven-Erik Johansson of the Karolinska Institutet and Associate Professor Brita Karlström of Uppsala University. Center for Family and Community Medicine (CeFAM) is a collaboration between Karolinska Institutet and the Stockholm County Council.
For further information, please contact:
Afsaneh Koochek, Dietician, CeFAM
Tel: +46 (0)70-484 83 29
Daphne Macris, Information Officer, CeFAM
Tel: +46 (0)73-91 45 245