Recommendations for collecting and analysing migration-related determinants in public health research

Abstract

Background According to the definition of the German Federal Statistical Office, about every fourth person living in Germany has a so-called migration background (MB), i.e., the person or at least one of their parents was born without German citizenship. However, MB has been defined differently in many studies. Also, the MB summarises people in different living situations, making differentiated analysis in health science more difficult. This article formulates recommendations for the collection and analysis of migration-related, as well as social and structural, determinants of health. Indicators for capturing relevant determinants of health As part of the Improving Health Monitoring in Migrant Populations project (IMIRA), the previous approaches to operationalise and measure migration-related determinants were revised based on literature research and exchange formats, such as workshops, meetings, congress contributions, etc. Instead of MB, the country of birth of the respondents and their parents, duration of residence, citizenship(s), residence status, and German language proficiency should be recorded as minimum indicators and analysed as individual variables. Further social and structural determinants, such as socioeconomic position, working and housing conditions, or self-reported discrimination, should be included. Conclusions In order to describe health inequalities and to specifically identify the needs of people with a history of migration, a mutual and differentiated consideration of migration-related and social determinants of health is essential.

Associations of Migration, Socioeconomic Position and Social Relations With Depressive Symptoms – Analyses of the German National Cohort Baseline Data

“…Brydsten et al [14] found that experiences of discrimination were an explanatory factor regarding the mental health gap especially for non-European migrants. Additional relevant migration-related indicators have recently been proposed for future research on migration and health in Germany, including reasons for migration, self-reported discrimination, social support and sense of belonging to society [24]. Therefore, the neglect of subjective experiences of discrimination and racism remains a blind spot in the NAKO study.…”

“…People with migration background are not a homogenous group but instead consist of a broad range of nationalities, cultures, origins, languages, experiences and socioeconomic determinants [23,24]. The concept and definition of migration background in Germany has been described in detail by Will [25].…”

“…Various historical, social and political peculiarities need to be considered in the history of migration in Germany. A general comparison of migrant versus nonmigrant populations neglects these differences [23,24,26]. Most of the studies mentioned above regarding mental health gaps and the social disadvantage of migrant populations have rarely addressed the heterogeneity of persons with migration background [26][27][28].…”

The Migration and Health Teaching Network: consolidating and developing education and training

“…Alle Menschen haben aus menschenrechtlicher Sicht dasselbe Recht auf medizinische Versorgung und bestmögliche Gesundheit [9]. Aus diesem zunächst abstrakten Recht auf Gesundheit ergeben sich konkrete, operationalisierbare Maßnahmen und Rahmenbedingungen für Gesundheitssysteme [10], die die Gesundheit aller in einem Land lebenden Menschen adressieren und nicht aussen die Migrationserfahrung strukturierende biografische, soziale, migrationsbezogene und strukturelle Faktoren separat zu erheben [8]. Im Folgenden sprechen wir von Personen mit eigener oder familiärer Migrationsgeschichte,um auf Personen zu verweisen, deren Biografie durch Migrationserfahrung mitgeprägt ist.…”

“I don´t put people into boxes, but…” A free-listing exercise exploring social categorisation of asylum seekers by professionals in two German reception centres

“…"Immigration" itself has been introduced as social determinant of health [42]. In practice this category gets broken down into ever more internal distinctions, but the (super-)diversity [43,44] of migrant populations is barely reflected in statistical categories, calling for a more nuanced approach of considering differences by legal status and other characteristics [45]. Societies differentiate "types of migrants [.…”