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Research project Studies of Migration and Social Determinants of Health (SMASH)

Studies of Migration and Social Determinants of Health (SMASH) is a collaborative research project based at the Department of Public Health Sciences, Stockholm University and funded by the Swedish Research Council for Health, Working Life and Welfare (Forte) for the period 2017-2022.

The research programme includes six different sub-projects which examine the impact of upstream and downstream social determinants of health among people with foreign background, while also recognizing the ways in which various background factors such as gender, country of birth, reason for migration, duration of residence and socioeconomic position may influence relationships between such determinants and health.

SMASH Sub-projects

Social policies - SMASH Sub-project 1

Contextual exposures - SMASH Sub-project 2

Working life and health - SMASH Sub-project 3

Socioeconomic conditions - SMASH Sub-project 4

Health behaviours - SMASH Sub-project 5

Trauma and post-traumatic stress - SMASH Sub-project 6

Project description

In recent years Sweden has experienced a substantial increase in the proportion of the population that is of foreign-origin. Ensuring the successful integration and positive well-being of persons of foreign-origin is of great social importance. Although Swedish research on health inequalities by country of origin is relatively extensive, most previous research is descriptive and does not thoroughly examine the causes of these inequalities. The present research programme is devoted to the investigation of the social determinants of health among individuals with foreign backgrounds in Sweden.

Utilizing the theory of fundamental causes of disease, we will consider how different social determinants of health in individuals with foreign backgrounds are causally related, and how distal factors influence the proximal factors. In six interrelated projects, ranging from upstream (distal) to downstream (proximal) social determinants, we will study the contribution for health of societal policies and processes, contextual-level exposures (i.e. characteristics of the residential area), working life factors, socioeconomic conditions, health behaviours and post-traumatic stress due to war trauma.

We have access to optimal data including total-population register data, several regional longitudinal public health surveys, and longitudinal Level-of-Living survey data including a sub-survey of the foreign-born population. We will use various methods and tools which allow us to examine causal relationships assess such as survival analysis, structural equation modelling (SEM), multilevel modelling and directed acyclic graphs (DAGs) that take advantage of the detailed covariate information available within the data.

Sweden has been at the forefront of research on migration and health. We believe that this research programme has the potential to further develop and elaborate on research on migration and health.