Proficiency in the Norwegian language and self-reported health among 12 immigrant groups in Norway: A cross-sectional study.

Background: Migration presents numerous significant changes in a person's life, physically, emotionally and socially. How health develops in the host country depends on a range of factors, including language proficiency. We aimed to investigate associations between language proficiency and health.

Methods: Statistics Norway carried out the Living Conditions Survey for Immigrants (2016), conducting telephone (82%) or face-to-face (18%) interviews with immigrants (two or more years of residence) from 12 countries. The survey collected data on self-reported proficiency in the Norwegian language, health and socio-economic variables, and included 4077 people aged 16-66 years.

Results: In logistic regression models adjusted for age, sex and duration of residence, poor or medium self-reported Norwegian proficiency, as compared to good, was associated with poorer health outcomes, including lower odds of self-rated health (odds ratio (OR)=0.46; 95% confidence interval (CI) 0.39-0.54) and higher odds of hypertension (OR=1.74; 95% CI 1.34-2.26), back or neck pain (OR=1.52; 95% CI 1.28-1.80), mental health problems (OR=1.34; 95% CI 1.09-1.65), sleep disturbances (OR=1.51; 95% CI 1.23-1.86) and being overweight (OR=1.20; 95% CI 1.03-1.40). Adjustment for socio-economic status attenuated the associations, but further adjustments for perceived discrimination and lifestyle (smoking and physical activity) did not further alter the estimates.

Conclusions: Host language proficiency has implications for health among immigrants. Equitable access to health services and quality of care requires adjustment to the language level needs of patients. Facilitating language learning for immigrants may be vital in providing access to health services and supporting newcomers in being more active participants in managing their health.