Psychological and Socio-Economical Determinants of Health: The Case of Inner German Migration

Abstract

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003–2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20–25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.

Social Integration as Mediator and Age as Moderator in Social Capital Affecting Mental Health of Internal Migrant Workers: A Multi-Group Structural Equation Modeling Approach

“…Generally, personal endowment, migration distance, migration pattern, and social environment are regarded as the main factors affecting migrants' mental health ( 7 ). However, in the context of social transformation in China, frequent migration and mobility have brought about the reconstruction and transformation of such social capital as social networks and social trust of migrant workers, which directly affects their perception and digestion of negative emotions ( 8 ).…”

Refugees, asylum seekers, and practitioners’ perspectives of embodied trauma: A comprehensive scoping review.

“…Bailey et al (2021) note the importance of targeting hopelessness and poor-self efficacy and promoting familial social support in improving the wellbeing of immigrants, acknowledging that those receiving higher levels of family support report lower levels of distress. Schmalbach et al (2021) also assert that while many individuals experience psychosocial issues in the migration process, more research into the impact of these factors is required.…”

“…Psychosocial support is another key theme found in this comprehensive scoping review, impacting the subjective wellbeing of individuals seeking refuge and asylum in host countries, yet which suffers from a deficit of qualitative research (Hocking, 2021). Psychosocial factors such as poor accommodation, lack of access to culturally appropriate healthcare services, family separation, loneliness, loss, unemployment, and lack of gainful activity (Hocking, 2021), can keep individuals entrenched in a fixed state of mental distress due to the nature of their environment and the inability to improve their socio-economic status (Schmalbach et al, 2021). Consistent research findings attribute the mental ill health and psychosomatic symptoms of individuals seeking refuge and asylum to psychosocial causes (Hocking, 2021;Papadopoulos et al, 2004).…”

“…This comprehensive scoping review has shown, however, that commonly used therapies include psychopharmacology (Hinton et al, 2012;Sonne et al, 2016;Strømme et al, 2020), culturally informed care or treatment for depression (Bhogal, 2020;Lee, 2015;Wolf et al, 2017), psychological therapy (Reich et al, 2015;Sambucini et al, 2020;Weber et al, 2020), inpatient care (Anderson et al, 2021;Handtke et al, 2021;Schaffrath et al, 2017), and culturally adapted CBT (Hinton & Jalal, 2019;Jalal et al, 2018;Kananian et al, 2020). The authors have noted, however, a paucity in comprehensive psychological assessment and interventions for individuals seeking refuge and asylum and highlight the need for a culturally informed psychological assessment, formulation, treatment plan and intervention for each individual who may be experiencing embodied trauma, from a humanistic, person-centered (Rogers, 1951(Rogers, , 1957a(Rogers, , 1957b(Rogers, , 1959(Rogers, , 1961(Rogers, , 1963, psychosocial (Bailey et al, 2021;Hocking, 2021;Schmalbach et al, 2021), and transcultural perspective (Charura & Lago, 2021;Zahid, 2021).…”

“…Further research into the provision of culturally informed care for working with embodied trauma is also recommended. This includes creating a culturally accurate, comprehensive psychological assessment and formulation of distress for each individual seeking refugee or asylum from a person-centered, humanistic (Rogers, 1951(Rogers, , 1957a(Rogers, , 1957b(Rogers, , 1959(Rogers, , 1961(Rogers, , 1963, psychosocial (Bailey et al, 2021;Hocking, 2021;Schmalbach et al, 2021), and transcultural perspective (Charura & Lago, 2021;Zahid, 2021). This will help to inform a culturally appropriate intervention and treatment plan, tailored to the individual's language and mental health needs.…”