Symptom burden in middle-aged women, the role of immigrant status.

backgroundSubjective health complaints (SHCs) are symptoms from various organs that do not have an obvious explanation. Immigrants in Western countries are often exposed to multiple stressors that may trigger SHCs. Increased symptom load may reflect subjective health and functioning in the present and in the future. We, therefore, aimed to identify symptom load and distribution of subjective health complaints among middle-aged women by immigrant status.

methodsThis is a cross-sectional study which uses 11-year follow-up data from the STORK Groruddalen Cohort Study of 823 healthy pregnant women enrolled in primary antenatal care in a multi-ethnic city district in Oslo from 2008 to 2010. 11 years later, 379 women (53% of the eligible) provided questionnaire data on subjective health complaints drawn from the Subjective Health Complaints Inventory (SHCI) and regarding demographics and health issues collected through interviews. Participants were divided into three immigrant status groups: born in Norway by Norwegian parents (reference), born in Norway with one or two foreign born parents, and born abroad. The primary outcomes were the total score and the scores for each of the five domains in the SHCI: musculoskeletal pain, pseudo-neurology and gastrointestinal problems, allergy and flu. In addition, we studied the distribution of the 29 health complaints from the SHCI.

resultsMusculoskeletal symptoms were most severe and prevalent in all three immigrant-status groups. Compared to women born in Norway with Norwegian parents (reference), women born abroad had significantly higher total scores (median: 11.0 (IQR: 14.82–21.45) vs. 7.6 (9.38–12.78) (p = 0.002)). For musculoskeletal pain, the crude median scores were 4.3 (0.92–4.36) for women born abroad and 2.1 (3.81–5.72) for women born in Norway with Norwegian parents (p < 0.001). The following health complaints, headache, migraine, dizziness, pain in feet on exertion, bloating, constipation, chest pain, breathing difficulties and asthma, were more prevalent in women born abroad than in the reference group, before and after adjusting for age and education.

conclusionSHCs were more frequent and severe among women born abroad compared to the reference group. This knowledge is essential to identify women at risk and target appropriate interventions.

trial registrationThe study (STORK G 2) was prospectively registered at ClinicalTrials.gov (registration number: NCT03870724), registration date: 08.03.2019.