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    • In terms of chronic health profiles and epidemiological regi

    2018-10-26

    In terms of chronic health profiles and epidemiological regimes, the population in eastern Finland is similar to the forced migrants (Norio, 2003; Saarela and Finnäs, 2006). Cultural differences, which may affect health behaviours and diet, are also much less pronounced across Finnish regions than is typically the case when individuals move across international borders (Saarela and Finnäs, 2010). Because it was not possible to move back to the ceded areas after 1944, the forced migrants were encouraged to accustom themselves for permanent residence in their new surroundings, with the expectation that they would participate in all facets of economic, social and political life (Ahonen, 2005). There is consequently no reason to expect that the migrants would have suffered from limited access to services, experienced discrimination or poor working conditions, or to have been sorted into more dangerous or strenuous occupations as compared to non-migrants.
    Data and methods Each person’s socioeconomic and demographic characteristics, together with the region of birth, come from the population register, which makes it possible to distinguish forced migrants. We study people born in Ceded Karelia in 1927–1944, and compare them with non-displaced people born on the adjacent side of the new border in Eastern Finland. In addition, we compare them to people born elsewhere in Finland (Figs. 1 and 2). This regional categorisation is the same as that used by Saarela and Finnäs (2009a) who studied mortality at ages 55–79 years of those born in 1895–1944. The last male cohort that was mobilised for army service during the war transcription factor consists of people born in 1926 (Saarela and Finnäs, 2012). Thus none of our study subjects had participated in combat during the war. People with mother tongue other than Finnish were excluded from the analyses. This group accounted for only two percent of all individuals born in Ceded Karelia. Most of them were Swedish speakers and thus had a different sociodemographic profile, because Swedish speakers in the area at that time had a non-agrarian background and lived in the city of Viipuri. Our analytic sample consists of 4146 individuals who were forced to migrate as children, 12,390 individuals born in Eastern Finland, and 30,452 individuals born elsewhere in Finland. Each group contributes 87,953, 269,005, and 669,382 person years of follow-up, respectively (Table 1). The control variables are age, period, educational attainment, homeownership, income quintile, region of residence, and family type. Family type combines information about marital status and whether or not a person lives alone. The distribution of the control variables by region of birth is shown in Table 2.
    Results As seen from the unstandardised numbers in Table 1, people born in Ceded Karelia were less likely to receive a sickness benefit (6.2 percent of the men and 6.5 per cent of the women) than people born in Eastern Finland (7.2 percent of the men and 7.3 per cent of the women) or elsewhere in Finland (6.7 percent of the men and 7.0 per cent of the women). The percentage receiving disability pension was similar among the forced migrants and those born in Eastern Finland (approximately 27 per cent of the men and 23 per cent of the women), but lower among those born in other parts of the country (approximately 23 percent of the men and 21 per cent of the women). The unstandardised death rate was highest for the group of people born in Ceded Karelia. With regard to socioeconomic and demographic characteristics, the three groups were highly similar, although the large dataset implies that there were differences in a strict statistical sense (Table 2). Given this similarity by region of birth, we would expect that their inclusion explains only a modest part of the small variation in health outcomes by region of birth. Some differences are nevertheless notable. People who were forced to migrate as children were less likely to live in Eastern Finland than those who were born there, but still more likely to live in Eastern Finland than those who were born elsewhere in the country. Also, the forced migrants were more likely to have some tertiary-level education compared to those born in Eastern Finland, and more similar in this respect to those born elsewhere in Finland.