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1.4.2009 | Von:

Explaining The Relationship Between Migration and Health

Migration and lifecourse epidemiology

Migrants have often been exposed to different experiences during their lives than those of the non-migrant majority population, especially during childhood in their country of origin. This can lead to unexpectedly different patterns in the occurrence of chronic disease. For some chronic diseases the risk of occurrence in later life – after a long period of latency – is already determined by exposure in early or very early childhood. This makes it necessary to study the entire lifecourse of migrants in order to be able to understand the pattern of their chronic diseases and their mortality. A snapshot at a time after migration is not sufficient. What is more necessary is a lifecourse epidemiology, in other words an epidemiology that factors in exposure throughout the person´s life. [18] The Figure shows an overview of such an approach.

Variables influencing the health of migrants from the perspective of lifecourse epidemiologyVariables influencing the health of migrants from the perspective of lifecourse epidemiology Lizenz: cc by-nc-nd/2.0/de (bpb)
In studies on the health of migrants – and thus also in the development of an explanatory model – it is difficult to identify suitable control groups. The differences, for example in the mortality between male and female migrants on the one hand and the majority population on the other, result in part from factors relating to their lives in the country of origin. Anyone migrating to Germany from a southern country bordering the Mediterranean initially brings with them the cardiac mortality associated with that country – far lower than that of the German population. Due to the long latency periods between exposure to risk and disease, this advantage is retained even where there is socio-economic disadvantage. If we wish to differentiate between genetic predisposition and lifestyle influences, then comparison with the population in the country of origin is particularly meaningful. If, by contrast, we wish to make observations on access to health care, comparisons with the population in the migrants´ country of destination are sensible.

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18.
See Lynch and Davey Smith (2005); Spallek and Razum (2008).

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