divisions and wage differences on the labor market as well as the gender and social class to which female immigrants belonged. Domestic violence and gender discrimination are other factors that were found to play a part in the decline in health among female immigrants. Furthermore, ethnic discrimination, racism, experienced trauma and the lack of social support and social networks in relation to ethnicity and immigration were also deemed to be contributing factors.
The main findings show also that there is an interaction between health, work and immigration. Although people who migrate are often in good health, immigration process itself may give rise to diminished health and result in unemployment and/or the increased incidence of sick leave. Immigration may also lead to an inferior position on the labor market, which could in turn lead to poor health due to exposure effects. The influence of these factors on health is more evident among female immigrants than among male immigrants.
Furthermore, the main findings of the four studies demonstrate that the work-related health of female immigrants is strongly associated with social class. The three aspects based on class are wage, professional status and position in the hierarchical work organization. Other factors associated with work-related health factors are discrimination due to ethnicity and gender, unfavorable physical and psychosocial work environments and the absence of opportunities for skills upgrade training.
Finally, the thesis sheds new light on the subject area, particularly in Sweden. Although Sweden is one of the European countries that has a very large number of distinct ethnic minority groups, research on these issues has been extremely limited. In particular, research on the health of female immigrants in Sweden has often been focused on
“cultural differences”. This result of the studies in the thesis shows that the health of female immigrants cannot be attributed solely to “cultural differences”, but that it must also be viewed and understood within the contexts of social class, gender and ethnicity.
From the accounts of the interviewed women, two new insights about the factors that influence the health of female immigrants during the post-migration period can be put forward. Firstly, female immigrants may overcome some health-related factors such as domestic violence or traumatic experiences during the first decade of the post-migration period. However, the effects of other health determinants such as unemployment or experiences of discrimination and racism were observed even two decades after immigration. Secondly, the impact of ethnic discrimination on health is not alleviated by the length of stay in the host country or by higher socioeconomic status. The only aspect that may have changed concerns the strategies used in coping with discrimination. The length of stay, entering the labor market and a more favorable socioeconomic status seem to result in better management and better strategies for coping with ethnic discrimination. The thesis contributes new insights to the subject area by showing that ethnic and gender discrimination occurs regardless of a female immigrant’s position in the organizational hierarchy. Nevertheless, the mechanism of discrimination can be
different for those who are employed in low status occupations. This shows that class still matters and is a very important factor in public health research. As such, it should not be ignored in studies on health in relation to ethnicity.
The individual attributes that may also contribute to poor health among female immigrants are living habits, length of stay in the host country, cultural attributes, age and genetic or biological attributes. The social attributes influence the individual attributes.
The strength of the thesis is that it includes both qualitative and quantitative methods. It includes a study with a longitudinal approach, which enabled a study of the impressions and evaluations of a group of female Iranian immigrants of the various factors that have influenced their health over time, after post-migration. The thesis also includes a study with a triangulation method, which facilitated both an individual and group level perspective of the study’s aims. For example, the results obtained from group discussions were reinforced by the results of the questionnaire.
The implications of the findings in this study suggest that public health policies aimed at female immigrants should provide a good introduction and access to health information for new arrivals. Specific measures are needed to recognize female immigrants’ pre-migration work experience and academic qualifications in order to counteract the deskilling process, a process which results in unemployment, long-term social exclusion and employment in low-status occupations with low incomes. Strategies tackling ethnic discrimination/racism are needed, particularly on the labor market and in workplaces.
The recommendations of this thesis include the counteraction of discrimination due to ethnicity/gender in areas such as employment, wage setting and the provision of opportunities for skills upgrade training. Policies to stimulate an increase in the opportunities for mobility for female immigrants on the labor market are needed, especially for those who work in jobs with low status and low pay.