When Health Professionals Leave: The Hidden Costs of Cross-Border Wage Gaps
A new study from NHH and Lund University uncovers how physician migration to Norway had fatal consequences in Sweden.
A recent research collaboration between the Norwegian School of Economics (NHH) and Lund University reveals that the emigration of Swedish general practitioners (GPs) to Norway during the mid-2000s contributed to increased mortality rates in Sweden—particularly among vulnerable populations. The findings underscore how economic incentives and cross-border labor mobility can have unintended public health consequences.
Migration Driven by Wage Differentials
Between 2005 and 2009, Norway experienced strong economic growth and offered significantly higher wages for physicians. As a result, the number of Swedes working in Norway more than doubled during this period. Among those who moved were many young and well-qualified GPs who left positions in Swedish municipalities for better compensation abroad.
The study shows that municipalities in Sweden that offered comparatively lower physician salaries before 2005 saw the highest outflow of doctors. These departures left some communities critically understaffed, particularly in primary care settings.
Consequences for Public Health
The researchers found a statistically significant increase in mortality rates in Swedish municipalities that lost the most doctors. The deaths were especially pronounced in patient groups that rely on timely and continuous medical attention, such as the elderly and those with chronic conditions or acute infections.
Notably, the rise in mortality was not matched by a similar improvement in health outcomes in Norwegian municipalities that received the influx of Swedish doctors. This suggests that the additional capacity was absorbed into an already well-functioning system and did not lead to substantial health gains on the receiving side.
Economic and Systemic Strain
In an attempt to stem the loss of medical personnel, Swedish municipalities increased local wages for doctors. However, these efforts were often insufficient to compete with Norwegian salary levels. Hospitals and clinics were forced to operate with higher wage bills and fewer staff, placing strain on local healthcare systems and reducing the quality of care.
Policy Implications
The researchers argue that their findings offer a cautionary tale about the unintended effects of regional labor mobility and market-driven wage competition in essential public services. They call for greater attention to workforce planning, particularly in healthcare systems where regional disparities in wages and working conditions can lead to damaging talent drains.
The study serves as a reminder that labor markets do not operate in isolation—and that the movement of skilled professionals across borders can have far-reaching impacts on the communities they leave behind.