Migration und Gesundheit in Deutschland – eine Bestandsaufnahme der Datenquellen

Dyck, Maria Van; Wenner, Judith; Wengler, Annelene; Bartig, Susanne; Fischer, Florian; Wandschneider, Lisa; Santos-Hövener, Claudia; Razum, Oliver

doi:10.1007/s00103-019-02973-3

Cited by 22 publications

(10 citation statements)

References 12 publications

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“…Due to the heterogeneity of the migrant population general statements are therefore of limited applicability. For this reason in epidemiologic studies and databases, an exact definition and operationalization of migration background is required [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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)’

2021

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Background In Germany, different health checks for adults are offered for primary and secondary prevention. Previous findings indicate that preventive care utilization varies according to social determinants, especially migration background. This study examined the extent to which migration background is associated with preventive care utilization, independent of factors like age and socioeconomic status and whether length of stay in Germany has a positive effect on the use of preventive care. Methods The first wave of the ‘German Health Interview and Examination Survey for Adults’ (DEGS1) is a comprehensive data collection facilitating the description of the utilization of general health checks, dental check-ups, skin cancer screening, and cervical cancer screening among people aged 18–79 years with and without migration background. Migration background was differentiated in first-generation migrants having immigrated to Germany themselves or second-generation migrants born in Germany. First-generation migrants were further differentiated by length of stay in Germany, and second-generation migrants as having one or two parents who were born abroad. Multivariate binary logistic regression models with average marginal effects were calculated to analyse the associations between preventive care utilization and migration background. Results The sample comprised 7987 participants, 1091 of whom had a migration background. Compared with non-migrants, women and men with migration background— particularly first-generation migrants with length of stay <=20 years in Germany — make less use of preventive care. This association was observed statistically independent from sociodemographic factors. For dental check-ups a significantly lower use was also found for first-generation migrants who have lived in Germany for more than 20 years and second-generation of migrants with two parents born abroad. Post-model predictions showed that the utilization rates of first-generation migrants are gradually converging to the average values for non-migrants. Conclusions Our findings suggest inequalities in realized access to preventive care for first-generation migrants particularly for those who have lived in Germany for 20 years or less. Barriers to the utilization of preventive care may be addressed by informing migrant communities about preventive health care services at an early stage after immigration using migrant-sensitive information strategies.

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Section: Introductionmentioning

confidence: 99%

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)’

2021

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“…Nationality is the common characteristic for migrant background registered in German routine data [71]. Insufficient differentiation in routine data of persons with a migrant background is evident throughout Europe [66].…”

Section: Discussionmentioning

confidence: 99%

“…Insufficient differentiation in routine data of persons with a migrant background is evident throughout Europe [66]. There is not yet a routine data basis that allows to differentiate between PMB of German and foreign nationality or to compare persons with and without a migrant background by recorded migration characteristics [71,66]. However, there are also positive examples, such as the Netherlands and Finland, which record information on the country of birth in addition to nationality.…”

Section: Discussionmentioning

confidence: 99%

Utilisation of medical rehabilitation services by persons of working age with a migrant background, in comparison to non-migrants: a scoping review

et al. 2020

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In Germany, an ageing population is affected by societal and political changes due to demographic transition, e.g. by a prolonged working life for older employees. Demographic change also influences persons of higher working age with a migrant background. In 2018, 25% of all employees in Germany had a migrant background. Those affected by poor health at a higher working age can benefit from medical rehabilitation services, which aim to prevent early retirement and disabilities. So far, the utilisation of medical rehabilitation has been lower among persons of foreign nationality (often the only available proxy for migrant background), compared to that of Germans. The aim of this scoping review is to assess the utilisation of medical rehabilitation services by those with migrant background (PMB) and those without (non-PMB) and to identify the differences between these groups. We included 25 studies in our analysis, which were mainly secondary analyses of routine data and also a small number of primary studies. The results were inconsistent: studies published before 2018 showed a lower use of rehabilitation services for persons of foreign nationality compared to Germans. However, no differences were found between PMB and non-PMB in studies published in 2018 or later. PMB, as well as foreign nationals, showed poorer health before medical rehabilitation utilisation and had a higher chance of occupational disease and a lower education level. We identified a lower work-related performance, as well as barriers (e.g. information deficits) in the utilisation of rehabilitation services for groups of PMB. Our review is limited in that we cannot generalise our results to all PMB living in Germany. This is because of the heterogeneity, the limited number of studies and lack of representativeness in some studies. In many cases, studies only analyse the nationality, but they lack information about the second generation PMB. Future studies should survey the utilisation of medical rehabilitation services by migrant background rather than by nationality and focus on changes in the provision of rehabilitation measures following diversity-centred strategies.

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“…Furthermore, bias of selection could be found within the database due to the access path of refugees into the Public Health Department. Nevertheless, not only one type of patient group could have been examined like it was often the case in other studies [41]. Through the different types of linkages to the Dep.RM like accommodation staff or persons from the health care sector a broad range of clinical pictures and age groups of refugees was included.…”

Section: Limitationsmentioning

confidence: 99%

Gaps in Health Care Services for Refugees in Cologne, Germany – a Mixed Methods Analysis

Warmbein¹,

Beiersmann²,

Eulgem³

et al. 2020

Preprint

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Background: Ever since the peak in the number of refugees arriving in Germany in 2015, existing health care structures have faced major challenges. The city of Cologne developed ad-hoc new structures: a separate department for refugee medicine was set up. In the context of this study, the actual gaps in the health care of refugees in the city of Cologne were examined. The study provides lessons learnt for the health care of refugees. Methods: The present study used an embedded mixed-methods approach using 20 semi-structured interviews and a database including 353 datasets with socio-demographic, health-related and resource-related information to cross-check the results of qualitative data. Results: The qualitative data revealed gaps in providing health care to refugees. These gaps were found concerning approving health care services and medical aids by the municipality, communication and cooperation between the actors in care of refugees, undersupplies in mental health care and addictive disorders as well as improper housing situations for vulnerable groups of refugees with mental health issues, psychiatric disorders or elderly persons. Quantitative data confirmed the gap in approving health care services and medical aids, whilst no valid statement could be made about communication and cooperation. Undersupplies for mental health issues were confirmed, the gap for treatment of addictive disorders shows a divergence within the database. Improper housing situations for mentally ill persons were reflected, for elderly persons this did not appear in data. Conclusion: Analysing the gaps can stimulate necessary changes to improve health services for refugees locally, while others are beyond the control of the local authority and require legislative and political action.

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Migration und Gesundheit in Deutschland – eine Bestandsaufnahme der Datenquellen

Cited by 22 publications

References 12 publications

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)’

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)’

Utilisation of medical rehabilitation services by persons of working age with a migrant background, in comparison to non-migrants: a scoping review

Gaps in Health Care Services for Refugees in Cologne, Germany – a Mixed Methods Analysis

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