The risks of being exposed to infection, becoming ill and suffering from severe complications were unevenly distributed and based on social and structural determinants such as living environment (overcrowding), occupation (contact-based professions), access to transport and commuting distance (public transport dependence), level of education, language skills, income and underlying health condition. People who have moved to Sweden from countries outside Europe are overrepresented among those where these factors are unfavourable in terms of the risks associated with covid-19.

Social distancing in order to protect the elderly was strongly emphasized during the beginning of the pandemic. But the special interest in protecting the elderly from covid-19 and other infectious diseases must also take into account the protection of those who care for the elderly. And in the big cities' Million Programme areas, it is common to have close contact with the elderly, both through multi-generational living and professionally through elderly care.

A group of researchers and practitioners are behind this policy brief. In two studies and an information project, they have investigated the underlying structural and social factors to excess mortality among foreign-born during the covid-19 pandemic and produced information on covid-19 in overcrowded and multigenerational housing. The policy brief summarizes results from these and other studies and recommends measures in favour of public health more in line with the national goal of good and equal health for the entire population.

Policy brief authors

Erik Hansson, Resident Physician in general medicine and doctoral student at the School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg

Lina Al-Nahar, Health Informatics and Diversity Scientist, Department of Environment, Society and Health, Division of Occupational and Environmental Medicine, Lund University

Maria Albin, Professor of Occupational and Environmental Medicine, Institute of Environmental Medicine, Karolinska Institutet, and Center for Occupational and Environmental Medicine, Region Stockholm

Eskil Jakobsson, District Nurse, Home Nursing, Health, Care and Welfare Administration, Malmö

Maria Magnusson, Medicine dr, dietician and nurse, Public Health Unit at Angered Hospital / SV Hospital Group, Region Västra Götaland

Kristina Jakobsson, Professor of Clinical Environmental Medicine, Department of Community Medicine and Public Health, Institute of Medicine, University of Gothenburg, and Occupational and Environmental Medicine at Sahlgrenska University Hospital, Region Västra Götaland.

Policy Brief 2021:2 is only available in Swedish.