Migrants have special requirements in terms of preventive measures and health precautions. This is due on the one hand to their partly differing health risks and the group's behaviour patterns with regard to health matters. On the other hand, many preventive measures are less accessible to migrants than to the majority population.
Such barriers to participation may be due on an individual level to a lack of knowledge of the language or of knowledge about what is available; on an institutional level it may be due to a failure to gear what is offered towards the heterogeneous nature of the target groups and thus also towards the specific situation of migrants.
Opportunities offered by preventive programmes are still not taken up often enough by migrants. That can be gauged from the limited data available on migrant participation in existing services such as early cancer detection in adults or health examinations for children. According to the current state of debate, however, no specific preventive or precautionary programmes for migrants are necessary; instead, existing systems should be better-geared towards the heterogeneity that has evolved within the population and thus also towards those with a migration background. For the most part, the burden of disease among migrants is similar to that among the majority population, making it appear more meaningful to improve the accessibility of existing programmes, for instance by means of a linguistic and, if applicable, cultural translation of informational materials. It would hardly be possible, by contrast, to offer new, comprehensive and quality-assured programmes or facilities especially geared towards migrants.
The priority of preventive measures is to reduce risks such as those associated with infant mortality or the, in part, very high prevalence of smoking among male migrants. In addition to this, however, the aim should also be to safeguard any existing health advantages such as the lower prevalence of smoking among many female migrants.
Barriers to Accessing Health Care
People with a migration background are increasingly important as users of health services in Germany. Precisely in the area of research into health services we find a lack of data broken down according to migration background. Better data could, in the future, help people in this target group to look after their health and, should they become ill, ensure that they have the same opportunity to access health care as the majority population.
Until now it has been assumed that language and cultural characteristics in particular prevent migrants from making use of health services and affect communication and interaction during treatment. Language barriers may prevent patients from understanding their doctors. Often, help is sought from lay interpreters such as family members, but this is not always successful, due to the lack of specialist medical knowledge, or due to feelings of shame and respect that lead to information not being translated correctly. Cultural differences can be expressed through a different perception of what illness is about, such as when the cause of the illness is attributed to the "evil eye" or illness is understood as fate willed by God. These differences, or also a different sense of what is shameful, can lead to people not accessing care or to the wrong care being provided.
People in an unfavourable social situation do not avail themselves sufficiently of health care. They are faced with barriers regardless as to whether they have a migration background or not. These include being less well-equipped with financial resources for paying mandatory personal contributions towards their health care (practice fees, dentures etc.) and a lack of education and knowledge about such matters as pathogenesis and health behaviour.