Ten Swedens. Examining intersecting inequalities in mortality

Background

Sweden is often seen as a model egalitarian society, known for its generous welfare state with historically low levels of inequality. However, like most European countries, Sweden faces growing challenges related to immigrant integration and socioeconomic segregation. Inspired by a series of U.S. studies, this paper aims to assess inequalities in mortality, considering key axes of spatial segregation covering the period before and after the COVID-19 pandemic.

Methods

Using individual-level register data, we divided the total Swedish population during 2011–2022, aged 16–90 years, into ten mutually exclusive population subgroups. The population was categorized by migration background (native-born Swedish, immigrants [G1], and descendants of immigrants [G2]), region of origin (Global North/ South), urbanicity (metropolitan, urban, rural), and area-level sociodemographic characteristics (migrant density and income deprivation). We constructed life tables and estimated life expectancy at age 30 for each subgroup and calendar year.

Results

Native-born Swedes and immigrants from the Global North residing in non-deprived, low–migrant-density areas consistently showed the highest life expectancy at age 30 (≈54 years) throughout the study period. Subgroups living in migrant-dense and particularly income-deprived areas had the lowest life expectancy, especially those with a Global South immigrant background: Among G1 individuals, life expectancy ranged from 44 years in 2011 to 53 years in 2022, whereas among G2 it ranged from approximately 30 to 45 years over the same period. Overall differences in life expectancy between groups narrowed over time, except for individuals living in migrant-dense areas, particularly those with a Global South immigrant background.

Conclusions

Marked life expectancy differences remain across intersecting social inequalities. While socioeconomic disparities have diminished over time, migration-related inequalities persist.

Key messages

• Life expectancy in Sweden differs substantially across intersecting social inequalities, with differences up to about 20 years between some groups.

• Intersectional socioeconomic disparities in life expectancy—temporarily disrupted by the COVID 19 pandemic—have diminished over time, whereas migration related inequalities persist.