Migration pattern and mortality of ethnic German migrants from the former Soviet Union: a cohort study in Germany

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 Ge...

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Hauptverfasser: Kaucher, Simone (VerfasserIn) , Deckert, Andreas (VerfasserIn) , Becher, Heiko (VerfasserIn) , Winkler, Volker (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: December 19, 2017
In: BMJ open
Year: 2017, Jahrgang: 7, Heft: 12
ISSN:2044-6055
DOI:10.1136/bmjopen-2017-019213
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1136/bmjopen-2017-019213
Verlag, kostenfrei, Volltext: http://bmjopen.bmj.com/content/7/12/e019213
Volltext
Verfasserangaben:Simone Kaucher, Andreas Deckert, Heiko Becher, Volker Winkler

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520 |a 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. 
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