Eleonora MussinoResearcher, Docent
Eleonora Mussino is a Docent at the Stockholm University Demography Unit (SUDA). She studies the interrelation between the demographic behaviors and the determinants of integration among migrants in Italy and Sweden.
A selection from Stockholm University publication database
How Assad changed population growth in Sweden and Norway
2021. Marianne Tønnessen, Siddartha Aradhya, Eleonora Mussino. PLOS ONE 16 (1)Article
In an increasingly interconnected world, the demographic effects of wars are not confined only to war zones and neighbouring areas; wars and conflicts may also change populations far away. Without the war in Syria under President Assad and the associated mass exodus of Syrian refugees, the population trends in distant countries like Sweden and Norway over the last few years would have been different. We create hypothetical scenarios of the population developments in Sweden and Norway without a war in Syria from 2011 onwards, where excess immigration due to the war and associated excess births are removed. The results indicate that population growth in 2016 would have been roughly 36% lower in Sweden and 26% lower in Norway without the Syrian war. The number of births in 2017 would have been about 3% lower in Sweden and 1% lower in Norway. One in ten municipalities would have had a population decline in 2016 instead of a population increase, and the largest immigrant group in Sweden by January 2019 would still be of Finnish origin.
Preterm disparities between foreign and Swedish born mothers depend on the method used to estimate gestational age. A Swedish population-based register study
2021. Sol P. Juárez (et al.). PLOS ONE 16 (2)Article
This study aims to examine whether disparities in gestational age outcomes between foreign and Swedish-born mothers are contingent on the measure used to estimate gestational age and, if so, to identify which maternal factors are associated with the discrepancy. Using population register data, we studied all singleton live births in Sweden from 1992-2012 (n = 1,317,265). Multinomial logistic regression was performed to compare gestational age outcomes classified into very (<32 weeks) and late preterm (32-36 weeks), term and post-term derived from the last menstrual period (LMP) and ultrasound estimates in foreign- and Swedish-born women. Compared to Swedish-born women, foreign-born women had similar odds of very preterm birth (OR: 0.98 [95% CI: 0.98, 1.01]) and lower odds of moderately preterm birth (OR: 0.95 [95% CI: 0.92, 0.98]) based on ultrasound, while higher risks based on LMP (respectively, OR: 1.10 [95% CI: 1.07, 1.14] and 1.09 [95% CI: 1.06, 1.13]). Conclusions on disparities in gestational age-related outcomes by mother's country of origin depend on the method used to estimate gestational age. Except for very preterm, foreign-born women had a health advantage when gestational age is based on ultrasound, but a health disadvantage when based on LMP. Studies assessing disparities in very preterm birth by migration status are not affected by the estimation method but caution should be taken when interpreting disparities in moderately preterm and preterm birth rates.
Similar Negotiations over Childcare? A Comparative Study of Fathers' Parental Leave Use in Finland and Sweden
2021. Ann-Zofie Duvander, Eleonora Mussino, Jussi Tervola. Societies 11 (3)Article
Fathers' leave use is promoted in many countries, but so far with different success. Major explanations of different usage revolve around economic bargaining between parents and economic constraints in the household. By using extensive register data from 1999-2009 in Finland and Sweden, this study asks whether fathers' use of parental leave in the two countries is determined by the same socioeconomic characteristics on the individual and the household level once we control for sociodemographic factors. Striking similarities in what influences fathers' use of leave in the two contexts are found, even though leave is used at very different levels and the policy design differs remarkably. Generally, fathers with a similar income level to the mother use leave the most, but in high-income households the mother's higher income leads to the highest propensity of fathers' leave take-up. The results indicate that equal bargaining positions are associated with fathers' leave use but also that mothers' stronger position often facilitates fathers' leave. We conclude that the role of gendered bargaining positions should be studied in interaction with the level of resources in the household.
A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden
2020. Sven Drefahl (et al.). Nature Communications 11 (1)Article
As global deaths from COVID-19 continue to rise, the world's governments, institutions, and agencies are still working toward an understanding of who is most at risk of death. In this study, data on all recorded COVID-19 deaths in Sweden up to May 7, 2020 are linked to high-quality and accurate individual-level background data from administrative registers of the total population. By means of individual-level survival analysis we demonstrate that being male, having less individual income, lower education, not being married all independently predict a higher risk of death from COVID-19 and from all other causes of death. Being an immigrant from a low- or middle-income country predicts higher risk of death from COVID-19 but not for all other causes of death. The main message of this work is that the interaction of the virus causing COVID-19 and its social environment exerts an unequal burden on the most disadvantaged members of society. Better understanding of who is at highest risk of death from COVID-19 is important for public health planning. Here, the authors demonstrate an unequal mortality burden associated with socially disadvantaged groups in Sweden.
Residential context and COVID-19 mortality among adults aged 70 years and older in Stockholm
2020. Maria Brandén (et al.). The Lancet. Healthy Longevity 1 (2), e80-e88Article
Fertility patterns of migrants from low-fertility countries in Norway
2020. Marianne Tønnessen, Eleonora Mussino. Demographic Research 42, 859-873Article
BACKGROUND Most research on migrant fertility focuses on immigrants from high-fertility countries who have moved to countries with lower fertility. Little is known about the fertility of immigrant women from countries where fertility is lower than in the destination country. OBJECTIVE This study investigates fertility rates among women from low-fertility countries who have moved to a country where fertility is comparatively higher (Norway). METHODS Register data on immigrant women from Poland, Lithuania, and Germany are used to calculate total fertility rates by duration of stay and to explore differences between family migrants and women who migrate for other reasons, between women of different ages at arrival, and between those who emigrated again and those who remained in Norway. RESULTS Among immigrants from low-fertility countries, total fertility rates are elevated in the first years after migration. This is particularly true for women from Poland and Lithuania, who often arrive as family migrants and at peak fertility age (25 to 34 years). CONTRIBUTION The fertility among migrants from low-fertility settings is often highest right after migration, particularly if they arrive as family migrants. Women with nonfamily reasons for migration have a time lag between immigration and peak fertility. The results underscore the usefulness of taking reason for and age at migration into account when studying immigrant fertility.
Spousal order of migration, gender, and hospitalization among immigrants in Denmark
2020. Jennifer Caputo (et al.). Scandinavian Journal of Public HealthArticle
Background: Certain migration contexts that may help clarify immigrants’ health needs are understudied, including the order in which married individuals migrate. Research shows that men, who are healthier than women across most populations, often migrate to a host country before women. Using Danish register data, we investigate descriptive patterns in the order that married men and women arrive in Denmark, as well as whether migration order is related to overnight hospitalizations. Methods: The study base includes married immigrants who lived in Denmark between January 1, 1980 and December 31, 2014 (N = 13,680). We use event history models to examine the influence of spousal migration order on hospitalizations. Results: The order that married individuals arrive in Denmark is indeed highly gendered, with men tending to arrive first, and varies by country of origin. Risk of hospitalization after age 50 does not depend on whether an individual migrated before, after, or at the same time as their spouse among either men or women. However, among those aged 18+, men migrating before their wives are more likely to experience hospitalizations within the first 5 years of arrival. Conclusions: These findings provide the first key insights about gendered migration patterns in Denmark. Although spousal order of migration is not related to overnight hospitalization among women, our findings provide preliminary evidence that men age 18+ who are first to arrive experience more hospitalization events in the following 5 years. Future research should explore additional outcomes and whether other gendered migration contexts are related to immigrants’ health.
Over-coverage in population registers leads to bias in demographic estimates
2019. Andrea Monti (et al.). Population StudiesArticle
Estimating the number of individuals living in a country is an essential task for demographers. This study assesses the potential bias in estimating the size of different migrant populations due to over-coverage in population registers. Over-coverage-individuals registered but not living in a country-is an increasingly pressing phenomenon; however, there is no common understanding of how to deal with over-coverage in demographic research. This study examines different approaches to and improvements in over-coverage estimation using Swedish total population register data. We assess over-coverage levels across migrant groups, test how estimates of age-specific death and fertility rates are affected when adjusting for over-coverage, and examine whether over-coverage can explain part of the healthy migrant paradox. Our results confirm the existence of over-coverage and we find substantial changes in mortality and fertility rates, when adjusted, for people of migrating age. Accounting for over-coverage is particularly important for correctly estimating migrant fertility.
Transition to third birth among immigrant mothers in Sweden
2019. Eleonora Mussino, Vitor Miranda, Li Ma. Journal of Population Research 36 (2), 81-109Article
In this study, we investigate whether immigrant parents hold sex preferences for children in Sweden, a country that promotes gender equality and where parental preference for having a girl prevails. By applying event-history models to Swedish register data, we investigate the transition to third birth by the sex composition of children born among immigrants. In particular, we examine whether women who come from countries with strong son-preference cultures accelerate their process of having a third child if their prior children are both girls. We pay particular attention to immigrants from China, Korea, India and the former Yugoslavia, where son preference culture has been well documented in the literature. Our results show that women from China, Korea, India and the former Yugoslavia are more likely to have a third child if they have two girls than if they have two boys or a boy and a girl. Interestingly, mothers from China, Korea and India tends to accelerate their process to get a son, whereas mothers from the former Yugoslavia do not hasten. Furthermore, the 1.5 generation and the immigrant mothers with a Swedish partner from China, Korea and India demonstrate a girl preference, as the native Swedes do, whereas the 1.5 generation immigrant mothers from the former Yugoslavia do not show any sign of adaptation.
Decomposing the determinants of fathers' parental leave use
2019. Eleonora Mussino, Jussi Tervola, Ann-Zofie Duvander. Journal of European Social Policy 29 (2), 197-212Article
The use of parental leave by fathers varies notably between countries. However, the underlying reasons for cross-country differences have not been explicitly studied. We use migration between Finland and Sweden as an instrument to decompose the roles of policy design and social norms in the differences in take-up rates between these two countries. First, we inferred the role of policy by looking at fathers from the same country of origin in various policy contexts. Second, we deduced the role of norms by examining fathers who migrated at different ages and fathers with spouses of different origins. We find that the large cross-country differences in fathers' use of parental leave between Finland and Sweden mainly stem from differences in policy design. Norms seem to play a smaller but still significant role.
Sex differences in mortality in migrants and the Swedish-born population
2019. Anna Oksuzyan, Eleonora Mussino, Sven Drefahl. International Journal of Public Health 64 (3), 377-386Article
ObjectivesIn the present study, we examine whether the relationships between country of origin or reason for migration and mortality differ between men and women.MethodsWe apply hazard regression models on high-quality Swedish register data with nationwide coverage.ResultsRelative to their Swedish counterparts, migrants from Nordic and East European (EU) countries and former Yugoslavia have higher mortality. This excess mortality among migrants relative to Swedes is more pronounced in men than in women. Migrants from Western and Southern European countries; Iran, Iraq, and Turkey; Central and South America; and Asia, have lower mortality than Swedes, and the size of the mortality reduction is similar in both sexes. The predictive effects of the reason for migration for mortality are also similar in migrant men and women.ConclusionsThis study provides little support for the hypothesis of a double survival advantage among immigrant women in Sweden. However, it does show that the excess mortality in migrants from Nordic and EU countries and former Yugoslavia relative to the Swedish-born population is more pronounced in men than in women.
The Same Fertility Ideals as in the Country of Origin? A Study of the Personal Ideal Family Size among Immigrant Women in Italy
2018. Eleonora Mussino, Livia Elisa Ortensi. Comparative Population Studies 43, 243-274Article
The role of the personal ideal family size for international migrants has rarely been studied in the current debate on fertility and migration in the European context. It is not known to which extent the reduction of fertility observed among immigrants who settle in a country where fertility is lower than in their country of origin is the result of a change in fertility norms among those immigrants. The study of migrants' ideals family size has the potential to shed light on fertility norms without the interference of economic conditions and migration-related disruptive phenomena. Due to the complexity of its migration context, Italy is an interesting destination country for studying changes in migrants' ideal family sizes. This paper uses data from the survey of the Italian National Institute of Statistics (ISTAT) on immigrant families conducted in 2011-12. We compare the personal ideal family size of women of reproductive age with the prevalent norm in their country of origin, applying a multinomial logistic regression analysis. Results show that the country of origin has an important role in the determination of immigrants' ideal family sizes. Women from countries where large families are the ideal are more likely to show a lower personal ideal family size compared to their non-migrant co-nationals, while women from countries where two children are considered ideal mostly share the same norm. The occurrence of fertility preferences expressed in a non-numeric form (e.g. Up to God) changes between women with different countries of origin. This study confirms that conformity with the ideal of the country of origin is more likely among women who migrated as adults. At the same time, the number of years spent in the destination country is not significantly associated with a shift away from the norms prevalent in the country of origin. Finally, female empowerment and gender equity show their effects mainly on the reduction of non-numeric responses.
Being a refugee or having a refugee status? Birthweight and gestational age outcomes among offspring of immigrant mothers in Sweden
2018. Sol Juárez, Eleonora Mussino, Anders Hjern. Scandinavian Journal of Public HealthArticle
Aims: to evaluate whether the information on refugee status based on the residence permit is a useful source of information for perinatal health surveillance. Methods: using the Swedish population registers (1997-2012), we use multinomial regression models to assess the associations between migration status (refugee and non-refugee) and birth outcomes derived from birthweight and gestational age: low birthweight (lBW) (<2500 g), macrosomia (≥4000 g); preterm: (<37 w) and post-term (≥42 w). The Swedish-born population was used as a reference group. Results: Compared to the Swedish-born population, an increased OR (odds ratio) of lBW and post-term was found among migrants with and without refugee status (respectively: OR for refugees: 1.47 [95% CI: 1.33-1.63] and non-refugees:1.27 [95% CI: 1.18-1.38], for refugees: 1.41 [95% CI: 1.35-1.49] and non-refugees:1.04 [95% CI: 1.00-1.08]) with statistically significant differences between these two migrant categories. However, when looking at specific regions of origin, few regions show differences by refugee status. Compared to Swedes, lower or equal ORs of preterm and macrosomia are observed regardless of migratory status. Conclusions: Small or no differences were observed in birth outcomes among offspring of women coming from the same origin with different migratory status, compared to their Swedish counterparts. This suggests that information on migration status is not a relevant piece of information to identify immigrant women at higher risk of experiencing adverse reproductive outcomes. Our results however might be explained by the large proportion of women coming to Sweden for family reunification who are classified as non-refugee migrants.
Use It or Save It? Migration Background and Parental Leave Uptake in Sweden
2016. Eleonora Mussino, Ann-Zofie Duvander. European Journal of Population 32 (2), 189-210Article
Sweden is a welfare state with a family policy that strongly emphasizes equality without distinction by place of birth or gender. In this study, we investigate the differences in uptake of parental leave between native and immigrant mothers, and the connection to labour-market attachment. Sweden represents a unique case study, not only because of the strong effort to combine work and family for all women and men, the high level of fertility and the large presence of immigrants in the country; it also enables a detailed and sophisticated analysis based on the high-quality data derived from its population registers. We find that immigrant mothers use more parental leave benefit the first year after their child's birth, but then fewer in the second year compared with native mothers. The differences diminish when labour-market activity is controlled for. Additionally, after a time in Sweden, immigrant mothers use leave more similarly to how native mothers do.
Show all publications by Eleonora Mussino at Stockholm University