Abstract
BackgroundMigration is a phenomenon of particular Public Health importance. Since 1990, almost 2 million ethnic Germans (Aussiedler) have migrated from the former Soviet Union (FSU) to Germany. This study compares their overall and cardiovascular disease (CVD) mortality to that of Germany's general population. Because of high overall and CVD mortality in the FSU and low socio-economic status of Aussiedler in Germany, we hypothesize that their mortality is higher.MethodsWe conducted a retrospective cohort study for 1990–2002 with data of 34,393 Aussiedler. We assessed vital status at population registries and causes of death at the state statistical office. We calculated standardized mortality ratios (SMRs) for the whole cohort and substrata of covariables such as age, sex and family size. To assess multivariate effects, we used Poisson regression.Results1657 cohort members died before December 31, 2002, and 680 deaths (41.03%) were due to CVD. The SMR for the whole cohort was 0.85 (95%-CI 0.81–0.89) for all causes of death and 0.79 (95%-CI 0.73–0.85) for CVD. SMRs were higher than one for younger Aussiedler and lower for older ones. There was no clear effect of duration of stay on SMRs. For 1990–93, SMRs were significantly lower than in subsequent years. In families comprising at least five members upon arrival in Germany, SMRs were significantly lower than in smaller families.ConclusionIn contrast to our hypothesis on migrants' health, overall and CVD mortality among Aussiedler is lower than in Germany's general population. Possible explanations are a substantially better health status of Aussiedler in the FSU as compared to the local average, a higher perceived socio-economic status of Aussiedler in Germany, or selection effects. SMR differences between substrata need further exploration, and risk factor data are needed.
Highlights
IntroductionSince 1990, almost 2 million ethnic Germans (Aussiedler) have migrated from the former Soviet Union (FSU) to Germany
Migration is a phenomenon of particular Public Health importance
In contrast with the postulated hypothesis on the health status of migrants, the findings show that this migrant group has a significantly lower overall and cardiovascular disease (CVD) mortality than Germany's general population
Summary
Since 1990, almost 2 million ethnic Germans (Aussiedler) have migrated from the former Soviet Union (FSU) to Germany. Migration is a phenomenon reshaping society structure in numerous countries [1] It is of particular Public Health importance because the health status of migrants frequently differs from that of the general population of the country these people come to, the "host country", as well as from that of the population of the country they come from, the "country of origin" [2,3]. In the aftermath of the collapse of the Soviet Union, they began to migrate to Germany in large numbers German legislation favours these migrants through social benefits and by giving them German nationality upon arrival in the country. This distinguishes them from other migrants, such as labour migrants, who receive much less support from the state [5]
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