Koffer

1.4.2009 | Von:
Oliver Razum and Jacob Spallek

The Health Status of Migrants - Selected Empirical Results

The range of illnesses suffered by people with a migration background in Germany resembles to a large extent that of the non-migrant majority population (with the exception of some rare hereditary metabolic disorders suffered by migrants). Certain health risks, however, occur more frequently among migrants or lead to more marked symptoms.
Die Rumänin Cornelia und ihr Sohn David Emanuel warten am 14.06.2013 im Wartezimmer der Malteser Migranten Medizin in Berlin.A Romanian woman and her son at a walk-in-clinic for illegal migrants in Berlin. (© picture-alliance/dpa)

For many diseases this results in a different frequency distribution than in the non-migrant majority population. A current focus report offered by the Federal Health Monitoring information system offers differentiated information in this regard. [1] The health situation of migrants in Germany presented below is based on selected examples from this report. Age differences in the demographic structure have been adjusted where applicable; data sources derived from the report are shown in brackets. Publications with additional data are also quoted in individual cases.

The health report clearly indicates the distinctly heterogeneous situation among people with a migration background as regards their health. There are also certain results regarding their state of health that are not so easily explained. The following section discusses possible explanatory models to support the interpretation of the empirical findings.

Infectious diseases

Many migrants originate from poorer countries or were in an unfavourable socio-economic position in their country of origin. For this reason, infectious diseases common in their country of origin may be more prevalent amongst them than amongst the population in the country to which they are migrating. At the time of immigration, therefore, communicable diseases in migrants reflect the epidemiological situation in the country of origin. Taking the example of HIV, immigrants from so-called high-prevalence countries, predominantly sub-Saharan African countries, have a higher incidence of HIV than the majority population in Germany. [2] Over the course of time, the incidence of newly diagnosed cases and the prevalence of infectious diseases will increasingly be determined by the living conditions in the host country and access to medical care. With 24.4 new cases of tuberculosis per 100,000 inhabitants and year, the incidence among foreign citizens is five times greater than among Germans. Cases also occur at a significantly younger age (the median age of migrant tuberculosis patients is 34 years, compared to 56 years for non-migrants). [3] On the one hand, this is attributable to migrants who have been resident for a short time and who bring the disease with them from their countries of origin. On the other hand, migrants with a low socio-economic status, similar to Germans in the same position, have an increased risk of tuberculosis.

Maternal mortality

The term maternal mortality refers to cases of death associated with pregnancy, childbirth and postpartum complications. Maternal mortality is calculated on the basis of the number of maternal deaths for every 100,000 live births. Since maternal deaths are essentially avoidable, maternal mortality is a sensitive indicator of inequalities with regard to access to and the use of health services. Until the mid-1990s, maternal mortality among foreign women was about 1.5 times greater than among German women. Since then, the figures, which show an overall decline, have become similar. [4] Maternal mortality among Turkish women in Germany is substantially lower than that in Turkey, their country of origin, evidently a consequence of differences in access to and the quality of obstetric services.

Child health

The health of children is determined in particular by the lifestyle of their family, their socio-economic status, and also in part by genetic factors. The fact that the characteristics of these determinants vary from one population group to another results in variations in the incidence of certain diseases and risk factors. Access to and making use of health services and preventive measures can likewise play a major role.Thus, for example, according to the results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) the uptake of vaccinations against diphtheria and tetanus for children aged between 11 and 17 with a migration background is lower than that for children with no migration background. [5] According to the KiGGS results, participation in early detection examinations for children is also lower for children with a migration background. Thus 14% of children with a migration background did not take advantage of the standard early detection examinations (in German, the so-called U3 to U6) compared with 2% of children with no migration background. [6]

Growing up in less favourable hygiene conditions may be associated with a lower prevalence of allergies. Certainly, children below 18 with a migration background are less often affected by allergies than children with no migration background (27.4% v. 40.4%). [7]

The issue of child obesity is attracting increasing attention. Nutrition and physical activity influence the prevalence of obesity. Migrants from poorer countries benefit on the one hand from the adequate and secure provision of food in Germany. On the other hand, malnutrition and a lack of exercise lead to the development of obesity in people with a migration background just as they do in Germans. According to KiGGS statistics, children with a migration background aged 3-17 are more often overweight than children of the same age from the non-migrant majority population (19.5% v. 14.1%). [8]

Fußnoten

1.
See Robert Koch Institut (2008).
2.
See Robert Koch Institut (2008).
3.
See Robert Koch Institut (2008).
4.
Source: Federal Statistical Office.
5.
See Poethko-Müller et al. (2007).
6.
See Kamtsiuris et al. (2007).
7.
See WHO adolescent health survey.
8.
See Kurth et al. (2007).

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