Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany
Abstract Background Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient and marginalized groups such as asylum seekers and refugees (ASR). We aim to advance current health monitoring approaches and obtain reliable estim...
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doaj-396fa757530a48ffa0f9032501da9f3b2020-11-25T03:25:50ZengBMCEmerging Themes in Epidemiology1742-76222019-07-0116112110.1186/s12982-019-0085-2Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in GermanyLouise Biddle0Natalja Menold1Martina Bentner2Stefan Nöst3Rosa Jahn4Sandra Ziegler5Kayvan Bozorgmehr6Social Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergFaculty of Arts, Humanities and Social Science, Institute of Sociology, Technische Universität DresdenSocial Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergSocial Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergSocial Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergSocial Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergSocial Determinants, Equity and Migration Group, Department of General Practice and Health Services Research, University Hospital HeidelbergAbstract Background Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient and marginalized groups such as asylum seekers and refugees (ASR). We aim to advance current health monitoring approaches and obtain reliable estimates on health status and access to essential healthcare services among ASR in Germany’s third largest federal state, Baden-Württemberg. Methods We conducted a state-wide, cross-sectional, population-based health monitoring survey in nine languages among ASR and their children in collective accommodation centres in 44 districts. Questionnaire items capturing health status, access to care, and sociodemographic variables were taken from established surveys and translated using a team approach. Random sampling on the level of 1938 accommodation centres with 70,634 ASR was employed to draw a balanced sample of 65 centres with a net sample of 1% of the state’s ASR population. Multilingual field teams recruited eligible participants using a “door-to-door” approach. Parents completed an additional questionnaire on behalf of their children. Results The final sample comprised 58 centres with 1843 ASR. Of the total sample expected eligible (N = 987), 41.7% (n = 412) participated in the survey. Overall, 157 households had children and received a children’s questionnaire; 61% (n = 95) of these were returned. Age, sex, and nationality of the included sample were comparable to the total population of asylum applicants in Germany. Adults reported longstanding limitations (16%), bad/very bad general health (19%), pain (25%), chronic illness (40%), depression (46%), and anxiety (45%). 52% utilised primary and 37% specialist care services in the previous 12 months, while reporting unmet needs for primary (31%) and specialist care (32%). Younger and male participants had above-average health status and below-average utilisation compared to older and female ASR. Conclusions Our health monitoring survey yielded reliable estimates on health status and health care access among ASR, revealing relevant morbidities and patterns of care. Applying rigorous epidemiological methods in linguistically diverse, transient and marginalized populations is challenging, but feasible. Integration of this approach into state- and nation-wide health monitoring strategies is needed in order to sustain this approach as a health planning tool.http://link.springer.com/article/10.1186/s12982-019-0085-2Health monitoringRefugeesAsylum seekersSurveyHealthcare accessHealth status |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Louise Biddle Natalja Menold Martina Bentner Stefan Nöst Rosa Jahn Sandra Ziegler Kayvan Bozorgmehr |
spellingShingle |
Louise Biddle Natalja Menold Martina Bentner Stefan Nöst Rosa Jahn Sandra Ziegler Kayvan Bozorgmehr Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany Emerging Themes in Epidemiology Health monitoring Refugees Asylum seekers Survey Healthcare access Health status |
author_facet |
Louise Biddle Natalja Menold Martina Bentner Stefan Nöst Rosa Jahn Sandra Ziegler Kayvan Bozorgmehr |
author_sort |
Louise Biddle |
title |
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany |
title_short |
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany |
title_full |
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany |
title_fullStr |
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany |
title_full_unstemmed |
Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany |
title_sort |
health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in germany |
publisher |
BMC |
series |
Emerging Themes in Epidemiology |
issn |
1742-7622 |
publishDate |
2019-07-01 |
description |
Abstract Background Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient and marginalized groups such as asylum seekers and refugees (ASR). We aim to advance current health monitoring approaches and obtain reliable estimates on health status and access to essential healthcare services among ASR in Germany’s third largest federal state, Baden-Württemberg. Methods We conducted a state-wide, cross-sectional, population-based health monitoring survey in nine languages among ASR and their children in collective accommodation centres in 44 districts. Questionnaire items capturing health status, access to care, and sociodemographic variables were taken from established surveys and translated using a team approach. Random sampling on the level of 1938 accommodation centres with 70,634 ASR was employed to draw a balanced sample of 65 centres with a net sample of 1% of the state’s ASR population. Multilingual field teams recruited eligible participants using a “door-to-door” approach. Parents completed an additional questionnaire on behalf of their children. Results The final sample comprised 58 centres with 1843 ASR. Of the total sample expected eligible (N = 987), 41.7% (n = 412) participated in the survey. Overall, 157 households had children and received a children’s questionnaire; 61% (n = 95) of these were returned. Age, sex, and nationality of the included sample were comparable to the total population of asylum applicants in Germany. Adults reported longstanding limitations (16%), bad/very bad general health (19%), pain (25%), chronic illness (40%), depression (46%), and anxiety (45%). 52% utilised primary and 37% specialist care services in the previous 12 months, while reporting unmet needs for primary (31%) and specialist care (32%). Younger and male participants had above-average health status and below-average utilisation compared to older and female ASR. Conclusions Our health monitoring survey yielded reliable estimates on health status and health care access among ASR, revealing relevant morbidities and patterns of care. Applying rigorous epidemiological methods in linguistically diverse, transient and marginalized populations is challenging, but feasible. Integration of this approach into state- and nation-wide health monitoring strategies is needed in order to sustain this approach as a health planning tool. |
topic |
Health monitoring Refugees Asylum seekers Survey Healthcare access Health status |
url |
http://link.springer.com/article/10.1186/s12982-019-0085-2 |
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