Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter?

Abstract

Background: Migration background is known to be an important risk factor for a number of medical outcomes. Still, relatively little is known about the epidemiologic relevance of different definitions of migration status. Methods: Data from 5250 school entry examinations spanning three consecutive years (2015–2017) were gathered from the Public Health Department in Halle, Germany. Data were stratified according to six different migration statuses and evaluated for differences in health service utilization and developmental outcomes. Results: Compared to non-migrant children, migrant children have a lower utilization of preventative services, and higher frequencies of developmental delays. Children with first-generation migration background consistently show results worse than all others, while children with one-sided second-generation migration background show results similar to those of their non-migrant peers. These findings are not substantially altered by adjustment for social status. Conclusions: Children with first-generation migration background should receive special attention in school entry examinations, since they constitute a group with consistently higher health risks compared to other groups of preschoolers.

Utilization of preventive care among migrants and non-migrants in Germany: results from the representative cross-sectional study ‘German health interview and examination survey for adults (DEGS1)’

“…This insight is not possible when using a binary indicator for migration background. The few previous studies accounting for this factor have confirmed that people with a onesided migration background and non-migrants are similar with respect to their health care utilization [16,39].…”

Migration-related determinants of health-related quality of life of persons with direct migration background in Germany: a study based on the German Socio-Economic Panel

“…In the current study, the physical HrQoL was positively associated with the oral ability in the German language. As oral ability might be an informal facilitator to accessing health care, it might thereby also have an influence on HrQoL ( 29 , 46 , 47 ). A worse ability in the German language of parents with direct migration background was directly negatively associated with the mental health of their children ( 42 ).…”

Health service behaviors of migrants: A conceptual framework

“…Migrant-specific demographic factors, including generation, race or ethnicity, and duration at a specific destination, were associated with immigrants' and IMs' HSU. First-generation immigrants (64,(107)(108)(109) and old-generation IMs (50) had worse HSU than the others because the early generation had more barriers to becoming integrated into society. The home country of the immigrants, including Asia or developing countries (88- 91,110,111), and nationality (112) of IMs were found to be associated with HSU.…”