Migration und Gesundheit - von Defizitanalysen zum Diversity-Ansatz?

Abstract

In times of globalization the subjects migration and health are gaining more and more in importance. At the same time, one can observe a discrepancy between published opinions, politically intended messages and scientifically proved evidence. With approximately 15.4 million people with a migration background (this is equivalent to approximately 19% of the German population), migrants perform as an important "customer group" for health care and social security. In 2005, the category migrant background was introduced for the first time by the Federal Statistical Office. This category suggests homogeneity, which in fact is not given. Persons with migration background (including active immigrants, their children and grandchildren, repatriates, foreigners), have to be examined in a differentiated way concerning the consequences that the migration process has on health. Apart from potentially pathogenic influences associated with migration (e. g., ethnicity, national origin, cultural/religious characteristics, migration-related stressors), for example, education, social status, life-style and participation in work and society have to be taken into consideration as important "confounders". In this, a recent sociological approach (sinus migrant milieu) could be useful for socio-medical research and practice. Health-relevant information on migrants results on the one hand from scientific studies primarily designed for this purpose and, on the other hand, from routine data from official health reports. In the interpretation of secondary data, the problem arises that the definition of the target group (migrants) is different in the diverse data sources (for example, Germans, non-Germans, foreigners, migration background) and that important confounders (for example, from socio-cultural milieu) are not included. This may result in, among other things, an under- or overestimation of health risks or even incorrect conclusions. In consideration of these limitations, by means of data sets from official statistics (among others, Federal Statistical Office, social insurance agencies) and recent scientific research the present article analyses chosen aspects of migrant health (for example, health behaviour, morbidity, sickness absence, early retirement, health-care system, rehabilitation and mortality). Finally, possible implications for a more intensive discussion and further development of health care practice are pointed out.