Migration pattern and mortality of ethnic German migrants from the former Soviet Union: a cohort study in Germany. Issue 12 (19th December 2017)

• Record Type: Journal Article
• Authors: Kaucher, Simone; Deckert, Andreas; Becher, Heiko; Winkler, Volker
• Is Part Of: BMJ open. Volume 7:Issue 12(2017)
• Publication Date: 2017-12-19
• Subjects: epidemiology -- public health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2017-019213
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: We aimed to investigate all-cause and cause-specific mortality among ethnic German migrants from the former Soviet Union by different immigration periods to describe associations with migration pattern and mortality. Design: We used pooled data from three retrospective cohort studies in Germany. Participants: Ethnic German migrants from the former Soviet Union (called resettlers), who immigrated to Germany since 1990 to the federal states North Rhine-Westphalia and Saarland and to the region of Augsburg (n=59 390). Outcome: All-cause and cause-specific mortality among resettlers in comparison to the general German population, separated by immigration period. Methods: Immigration periods were defined following legislative changes in German immigration policy (1990–1992, 1993–1995, 1996+). Resettlers' characteristics were described accordingly. To investigate mortality differences by immigration period, we calculated age-standardised mortality rates (ASRs) and standardised mortality ratios (SMRs) of resettlers in comparison to the general German population. Additionally, we modelled sex-specific ASRs with Poisson regression, using age, year and immigration period as independent variables. Results: The composition of resettlers differed by immigration period. Since 1993, the percentage of resettlers from the Russian Federation and non-German spouses increased. Higher all-cause mortality was found among resettlers who immigrated in 1996 and after (ASR 628.1, 95% CI 595.3 to 660.8), compared with resettlers who immigrated before 1993 (ASR 561.8, 95% CI 537.2 to 586.4). SMR analysis showed higher all-cause mortality among resettler men from the last immigration period compared with German men (SMR 1.11, 95% CI 1.04 to 1.19), whereas resettlers who immigrated earlier showed lower all-cause mortality. Results from Poisson regression, adjusted for age and year, corroborated those findings. Conclusions: Mortality differences by immigration period suggest different risk-factor patterns and possibly deteriorated integration opportunities. Health policy should guard the consequences of immigration law alterations with respect to changing compositions of migrant groups and their health status.