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)’

Abstract

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.

Demandas e utilização de serviços de saúde entre imigrantes de uma região metropolitana do nordeste do Brasil

“…O fenômeno migratório é um determinante independente da saúde que interage com outros fatores socioeconômicos e culturais. 23,24 Revisões sistemáticas apontam que a relação entre as condições sociodemográficas e a saúde é mais acentuada para os migrantes do que para a população nativa, 26,27 visto que situações precárias de vida e trabalho, limitação no idioma do país receptor, etnia, escolaridade e falta de familiarização com o sistema de saúde, por ser recém-chegados, podem gerar limitações e diferenças no uso dos serviços de cuidados à saúde, contribuindo para o aumento de efeitos deletérios ao estado de saúde físicae mental do imigrante, [28][29][30] o que reforça o olhar quanto aos riscos de saúde do grupo IMB.…”

“…Em relação às DCNTs, não diferiram entre os grupos de países por renda per capita, exceto a gastrointestinal, mas os IAL possuem aproximadamente duas vezes mais chances de ter alguma DCNT, sendo a mais citada a hipertensão arterial sistêmica, assim como para os indivíduos mais velhos do estudo, independentemente do grupo de países.Achados do presente estudo também apontam que as mudanças de percepção em relação às condições de saúde pós-migração estão associadas à idade e ao tempo de permanência, e corroborando outros estudos, 12,22,30 inclusive para surgimento de doenças crônicas. 31,32 Saúde de imigrantes no nordeste do Brasil Aragão HT, Menezes AN, Oliveira MLL, Santana JT, Madi RR, Melo CM Os imigrantes adentram o país receptor com melhores condições de saúde do que a população não imigrante, o denominado "efeito do imigrante saudável".…”

Non-melanoma skin cancer among ethnic German immigrants (resettler) from the former Soviet Union: a cohort study from 1990 to 2007

“…The observed convergence of disease incidence over time could be partially explained by medical underuse in the country of origin and direct access to medical care in Germany after immigration. However, a survey showed that despite direct access to the German health care system, resettlers tend not to participate in offered preventive and screening examinations [ 35 , 36 ]. Studies have shown that cancer and cardiovascular disease rates of migrants adapt to rates of the host country [ 37 – 39 ].…”

Knowledge and understanding risk factors and preventive measures for osteoporosis in women: results of a survey in 502 women with and without a migration background

“…Specific frail groups in society, such as women with a migrant background seem to be confronted with significantly more impediments for taking up preventive measures and should therefore be specially considered [ 21 ]. Language barriers, poor working conditions, and low social status could increase the health risks for many migrant women [ 22 , 23 ].…”