Abstract
BackgroundInadequate utilization of healthcare services by migrant populations is an important public health concern. Inadequate drug consumption and poor compliance to the therapeutic regimen are common manifestations of low health-care seeking behavior present in migrants even in the countries with well-established healthcare systems. There are few studies on the use of medicines among the different groups of migrants in Germany. The objective of this study is to investigate drug consumption patterns of ethnic German migrants (Aussiedler) and their current health status.MethodsA cross-sectional study nested into a cohort of 18,621 individuals aged 20-70 years who migrated to Germany from the former Soviet Union between 1990 and 2005 was conducted. Data on consumption of drugs, drug handling, major health risk factors, and one-year disease prevalence were obtained for 114 individuals through a self-administered questionnaire and phone interviews. Results were compared to the data on the German population derived from the Disease Analyzer database and Robert Koch Institute (RKI) annual reports. Direct age standardization, test of differences, Chi-square test, and descriptive statistics were applied as appropriate. For drug classification the Anatomical Therapeutic Chemical (ATC) system was used.ResultsOf the respondents, 97% reported to have at least one disease within a 12-month period. The one-year prevalence of asthma (6.9%), hypertension (26.7%), chronic bronchitis (8.6%), and diabetes (4.9%) in migrants was similar to the general German population. 51% regularly took either over-the-counter (OTC) medication or prescription medicines. Six ATC groups were analyzed. The highest drug consumption was reported for the ATC cardiovascular (22%), nervous (9%), and muskulo-skeletal system (8%). 30% used OTC medicines obtained in the country of origin. Difficulties with drug handling were rare. Alcohol consumption did not differ from the German population (p = 0.19 males and 0.27 females), however smoking prevalence was lower (p < 0.01) in both sexes.ConclusionEthnic German migrants seem to differ only slightly from Germans in health status, drug utilization, and disease risk factors, and if so, not in an extreme way. Country of origin remains a source of medicines for a substantial part of migrants. The study is limited by a small sample size and low response rate.
Highlights
Inadequate utilization of healthcare services by migrant populations is an important public health concern
Some studies on drug utilization in Spain have observed that immigrants consume fewer medicines and have much lower expenditures on pharmaceuticals compared to the autochthonous population [10,11]
We report results of a cross-sectional study nested into a cohort of migrants from the former Soviet Union on drug consumption, handling and administering drugs in the light of reported health status and socio-demographic characteristics of this population. This is a cross-sectional study nested into a large cohort of 18,621 migrants, who have migrated to Saarland, a federal state of Germany, from the former Soviet Union between 1990 and 2005 [21]
Summary
Inadequate utilization of healthcare services by migrant populations is an important public health concern. Even in western industrialized countries where access to health services in the general population is ensured, health care utilization rates are usually lower for knowledge about available medical services, different perception of health, disease, and sickness, disapproving attitude to the health services and personnel in the host country, personal health practices, and many more. By addressing this issue in the “Health of Migrants” report of 2007, the World Health Organization (WHO) highlights the vulnerability of migrants regardless of type and reason of migration and emphases on eliminating the differences in health status between migrants and the native population. Some studies on drug utilization in Spain have observed that immigrants consume fewer medicines and have much lower expenditures on pharmaceuticals compared to the autochthonous population [10,11]
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