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'Secrets From Sweden'

Herman A. Hein, MD
JAMA. 1982;247(7):985-986. doi:10.1001/jama.1982.03320320021023.
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SWEDEN has reported remarkably low perinatal mortality rates for many years. The Swedes' apparent superiority in perinatal health has generally been ascribed to their relatively advantaged economic status and healthy, homogeneous "stock." However, little attention has been directed to the Swedish system of providing perinatal health care.

Immigration to Sweden in recent years has been substantial, and during the period 1973 to 1976, 8.8% of all births in Sweden occurred to immigrant mothers. These women constituted 6.8% of all women of reproductive age during the years noted.1 Since, in Sweden, immigrants are less advantaged with regard to income, occupation, and living quarters,2 one might suspect that these conditions would lead to higher perinatal mortality. Interestingly, the immigrant mothers experienced a slightly lower perinatal mortality than their Swedish counterparts.1

One conceivable explanation is that foreign mothers constitute a favorably selected group and that this counterbalances the socioeconomic factors


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