Torun Österberg

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Background and Purpose— Current Swedish guidelines recommend that carotid endarterectomy should be performed within 14 days of a qualifying neurological event, but it is not clear if very urgent surgery after an event is associated with increased perioperative risk. The aim of this study was to determine how the time between the event and carotid endarterectomy affects the procedural risk of mortality and stroke. Methods— We prospectively analyzed data on all patients who underwent carotid endarterectomies for symptomatic carotid stenosis between May 12, 2008, and May 31, 2011, with records in the Swedish Vascular Registry (Swedvasc). Patients were divided according to time between the qualifying event and surgery (0–2 days, 3–7 days, 8–14 days, 15–180 days). Stroke rate and mortality at 30 days postsurgery were determined. Results— We analyzed data for 2596 patients and found that the combined mortality and stroke rate for patients treated 0 to 2 days after qualifying event was 11.5% (17 of 148) versus 3.6% (29 of 804), 4.0% (27 of 677), and 5.4% (52 of 967) for the groups treated at 3 to 7 days, 8 to 14 days, and 15 to 180 days, respectively. In a multivariate analysis, time was an independent risk factor for perioperative complications: patients treated at 0 to 2 days had a relative OR of 4.24 (CI, 2.07–8.70; P<0.001) compared with the reference 3- to 7-day group. Conclusions— In this study of patients treated for symptomatic carotid disease, it was safe to perform surgery as early as Day 3 after a qualifying neurological event in contrast to patients treated within 0 to 2 days, which has a significantly increased perioperative risk.

Immigrants and the public sector budget — accounting exercises for Sweden

Net contributions to the public sector budget in Sweden are investigated using large samples of foreign born and native born. The accounts build on various assumptions including that expenditures on public consumption are allocated according to the age of the person. The results indicate that during the period 1983 to 1992 net contributions of immigrants deteriorated. Upon arrival to Sweden, immigrants on average place a burden on the public sector budget but after a few years this no longer applies. Refugees initially put a larger burden on the public sector budget than other immigrants, but such a difference declines with years since immigration.

Immigrant Child Poverty – The Achilles Heel of the Scandinavian Welfare State

Abstract Immigrant and native child poverty in Denmark, Norway, and Sweden 1993–2001 is studied using large sets of panel data. While native children face yearly poverty risks of less than 10 percent in all three countries and for all years studied the increasing proportion of immigrant children with an origin in middle- and low-income countries have poverty risks that vary from 38 up to as much as 58 percent. At the end of the observation period, one third of the poor children in Norway and as high as about a half in Denmark and in Sweden are of immigrant origin. The strong overrepresentation of immigrant children from low- and middle-income countries when measured in yearly data is also found when applying a longer accounting period for poverty measurement. We find that child poverty rates are generally high shortly after arrival to the new country and typically decrease with years since immigration. Multivariate analysis shows that parents years since immigration and education affect risks of the number of periods in persistent poverty. While a native child is very unlikely to spend nine years in poverty, the corresponding risk for a child to a newly arrived immigrant was found to be far from negligible. Much of the pattern is similar across the three countries but there are also some notable differences.

Why Do Some Young Adults Not Graduate from Upper Secondary School? On the Importance of Signals of Labour Market Failure

ABSTRACT In high-income countries, not completing secondary school often entails a high risk of social exclusion. Using data on young adults born in 1985 who grew up in metropolitan Sweden, we study factors associated with not graduating from upper-secondary school at age 21. Our hypothesis is that if a young person sees examples of people who are not able to earn a living despite having a long education, such negative examples are influential. Results from estimated logistic models are consistent with the hypothesis.

Children in Out-of-Home Care and Adult Labor-Market Attachment: A Swedish National Register Study

Using longitudinal national register data, we investigated labor-market attachment during the years 1993–1995 in Sweden for persons aged 25–35 years who had been in out-of-home care before the age of 18 in Sweden during the 1960s, 1970s, and 1980s. We consider whether an immigrant background has an additional influence on labor-market attachment. Compared to majority population peers, young persons who had been in foster care had shorter educations. Fewer had a strong labor-market attachment and more were dependent on social assistance. Results from multinomial regression models indicated that having been in foster care during childhood reduced the probability of high attachment to the labor-market and increased the probability of social assistance dependency, even after making adjustments for education, marital status, parenthood, domicile, and birth country. Few signs of additive effects from being both an immigrant and a former foster child are found.

The increasing importance of place: neighbourhood differences in metropolitan Sweden, 1990–2006

The shift from a fairly equitably distributed economy to a more unequal one is likely to have consequences. This article investigates neighbourhood differences in three cities in Sweden between 1990 and 2006 using panel registry data for the total population. The results show increasing neighbourhood differences in the outcomes of student grades and youth unemployment. Neighbourhood differences were computed for both those belonging to the majority of the population and visible minorities, and it was determined that the differences are not the result of an increase in the number of immigrants in poorer neighbourhoods. The majority population displays the largest differences in both grades and unemployment. The increase in disparities among neighbourhoods regarding outcomes for youth is a warning sign: it could lead to low motivation, loss of aspirations and social unrest.

How are Immigrant Children in Sweden Faring? Mean Income, Affluence and Poverty Since the 1980s

This article presents new research on income-based child indicators for immigrant children from 17 different national backgrounds and children of parents born in Sweden observed during the 3-year periods 1983–85, 1995–97 and 2008–10. This research examines mean household income, representation at the top of the income distribution and relative poverty differ for immigrant children from the corresponding levels among children with native born parents. Most of the analysis is concentrated on the second generation of immigrant children. It is shown that the relative position of immigrant children deteriorated between 1983–85 and 1995–97 when the labour market situation of immigrant parents weakened more than among native born parents. Changes thereafter were more complex. Children born in Sweden to parents from Denmark, Norway or Germany were as likely as children of native born parents to be observed at the top of the income distribution in contrast to children of parents from countries with middle or low human development. Poverty rates among immigrant children were higher among all categories of immigrant children in 2008–10 than among children of native born parents. These cross origin differences in income-based child indicators can be attributed to the reasons and qualifications parents had when they entered Sweden and the number of years since their immigration. A majority of children living in Sweden that are classified as poor in 2008–10 were immigrant children of various categories.

Older People in Sweden Without Means: On the Importance of Age at Immigration for Being 'Twice Poor'

ABSTRACT This paper examines immigrant poverty at an older age in Sweden with an emphasis on late-in-life immigrants. We analyse tax data for the entire Swedish-born and non-Swedish-born population. The poverty status of a household is assessed using two criteria. First, the disposable income of the household in which the person lived in 2007 must be below 60 per cent of the median equivalent income in Sweden as a whole. Second, to be classified as ‘twice poor’ a households net assets must be below SEK 10,000. The results indicate that three out of four Swedish-born older persons were not classified as poor by either of the criteria, and only 1 per cent by both criteria. In contrast, among older persons born in low-income countries almost three out of four were classified as poor according to one of the criteria and not fewer than one in three according to both. Results of estimating logistic models indicate that the risk of being considered poor according to both criteria is strongly positively related to ones age at immigration. Our results indicate that it is crucial that migrants, particularly those who arrive after age 40, be better integrated into the Swedish labour market. To alleviate poverty among those migrants who are already of older age, increased transfers are probably the only possible alternative.