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Institute
Inclusion of migrants and ethnic minorities in European birth cohort studies - a scoping review
(2016)
Background: Migrant and ethnic minority groups constitute substantial parts of European populations. They frequently experience health disadvantages relative to the respective majority populations. Birth cohort studies can help to disentangle social and biological factors producing these health inequalities over the life course. We investigated whether birth cohorts in European countries (i) assess migration history and ethnicity in the study design; and (ii) use this information in data analyses. Methods: A scoping review was performed in which European birth cohort studies were identified using dedicated web-based registries, MEDLINE and EMBASE. Two reviewers systematically assessed all identified birth cohorts and selected those fulfilling defined inclusion criteria (e.g. enrolment after 1980). Publications and websites were screened for information on the inclusion of migrants and ethnic minorities. To obtain more detailed information, researchers of enrolled birth cohorts were contacted individually. Results: Eighty-eight birth cohorts were identified in 20 European countries, with more than 486 250 children enrolled in total. Sixty-two studies (70.5%) reported collecting data about migration history or ethnic background. Twenty-three studies (26%) used information on migration history or ethnicity for data analyses or plan to do so in future. Conclusion: The majority of European birth cohorts assessed participants’ migration history or ethnic background; however, this information was seldom used for comparative analyses in trying to disentangle reasons for health inequalities. Also, heterogeneous indicators were used. Better use of data already available, as well as harmonization of data collection on migration history and ethnicity, could yield interesting insights into the production of health inequalities.
In diesem Kapitel wird dargestellt, warum Menschen mit Migrationshintergrund eine wichtige Zielgruppe der Forschung zu sozialer Ungleichheit und Gesundheit darstellen und es wird dokumentiert, dass diese Gruppe bislang nicht hinreichend berücksichtigt wird. Es werden gängige Erklärungsansätze für gesundheitliche Unterschiede zwischen Menschen mit Migrationshintergrund und der nicht migrierten Mehrheitsbevölkerung und ihre Grenzen erläutert. Schließlich wird aufgezeigt, dass zukünftige Modelle eine Lebenslaufperspektive enthalten und die epidemiologische Situation der Bevölkerung des Herkunftslandes berücksichtigen müssen.
Breast cancer is the most prevalent cancer among women and mammography screening programs are seen as a key strategy to reduce breast cancer mortality. In Germany, women are invited to the population-based mammography screening program between ages 50 to 69. It is still discussed whether the benefits of mammography screening outweigh its harms. Therefore, the concept of informed choice comprising knowledge, attitude and intention has gained importance. The objective of this observational study was to assess the proportion of informed choices among women invited to the German mammography screening program for the first time. A representative sample of 17,349 women aged 50 years from a sub-region of North Rhine Westphalia was invited to participate in a postal survey. Turkish immigrant women were oversampled. The effects of education level and migration status on informed choice and its components were assessed. 5,847 (33.7%) women responded to the postal questionnaire of which 4,113 were used for analyses. 31.5% of the women had sufficient knowledge. The proportion of sufficient knowledge was lower among immigrants and among women with low education levels. The proportion of women making informed choices was low (27.1%), with similar associations with education level and migration status. Women of low (OR 2.75; 95% CI 2.18–3.46) and medium education level (OR 1.49; 95% CI 1.27–1.75) were more likely to make an uninformed choice than women of high education level. Turkish immigrant women had the greatest odds for making an uninformed choice (OR 5.30, 95% CI 1.92–14.66) compared to non-immigrant women. Other immigrant women only had slightly greater odds for making an uninformed choice than non-immigrant women. As immigrant populations and women with low education level have been shown to have poor knowledge, they need special attention in measures to increase knowledge and thus informed choices.
GBE für Migranten
(2007)
Migranten bilden einen signifikant großen Teil der deutschen Bevölkerung. Jedoch gibt es in der Gesundheitsberichterstattung keine eindeutige Definition über den Status "Migrant". Somit ist die Datenerfassung in dieser Hinsicht mangelhaft. Dieser Artikel zeigt die Relevanz dieses Themas auf und liefert Vorschläge zu der sinnvollen Erfassung und Interpretation von migrantenspezifischen Gesundheitsdaten.
In diesem Artikel werden zunächst drei Konzepte von Gesundheit dargestellt. Dann geben die Autoren empirische Beispiele für unterschiedliche Krankheitsrisiken von Migrantinnen und Migranten relativ zur Mehrheitsbevölkerung. Anschließend erläutern sie theoretische Erklärungen für das Zustandekommen solcher Unterschiede. Sie schließen mit einem Modell aus der "lifecourse epidemiology" (lebenslaufbezogene Epidemiologie). Es versucht unter anderem, spezifische Expositionen zu berücksichtigen, denen Menschen vor, während und nach einer Migration ausgesetzt sind. Das Modell erleichtert es, solche Expositionen zu identifizieren, denen die nicht-migrierte Mehrheitsbevölkerung nicht oder in anderem Maße ausgesetzt sind.
Breast cancer screening among immigrant women: do we need specific approaches in risk communication?
(2012)
The aim of this chapter is to illustrate the specific Situation of Migrant women with regard to breast cancer Screening programmes. Screening uptake and determining factors among Migrant populations will be described. Furthermore, differences in breast cancer risk and ist Impact on the efficiencz of breast cancer Screening among migrants will be assessed. It will be discussed critically whether lower uptake rates among migrants should necessarily lead to measures to increase uptake. A Special Focus will be on risk communication and informed choice.
Migration und Gesundheit
(2011)
Die Datenlage zur Gesundheit von Menschen mit Migrationshintergrund ist in Deutschland bislang unzureichend. Dies hat zum Teil methodische Gründe, die in diesem Artikel dargestellt werden. Für den 2008 erschienenen Schwerpunktbericht "Migration und Gesundheit" im Auftrag des Robert Koch Instituts wurden umfangreiche Auswertungen der vorhandenen Datenquellen vorgenommen (Razum et al. 2008a). Sie zeigen, dass das Krankheitsspektrum der Menschen mit Migrationshintergrund dem der nicht migrierten Bevölkerung weitgehend ähnelt (mit Ausnahme einiger seltener erblicher hämatologischer und Stoffwechselerkrankungen bei Migranten).In vielen Bereichen bestehen aber Unterschiede hinsichtlich des Ausmaßes und der relativen Bedeutung bestimmter Krankheiten, Mutter-Kind-Gesundheit, Gesundheit am Arbeitsplatz, sowie chronische Erkrankungen und ihre Risikofaktoren zeigen, wie vielschichtig die gesundheitliche Lage von Migranten ist (Razum et al. 2008b).
In diesem Artikel wird im Speziellen auf Infektionskrankheiten, Müttersterblichkeit, Kindergesundheit, Unfall- und Schwerbehindertenquellen, Risikofaktoren für Herz-Kreislauferkrankungen und die gesundheitsbezogene Forschung zu Migranten eingegangen.