The European Journal of Public Health Advance Access originally published online on February 14, 2006
The European Journal of Public Health 2006 16(4):376-382; doi:10.1093/eurpub/ckl013
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Migration and health |
Mortality from external causes among ethnic German immigrants from former Soviet Union countries, in Germany
Catherine Kyobutungi1, Ulrich Ronellenfitsch1, Oliver Razum1,2 and Heiko Becher1
1 Department of Tropical Hygiene and Public Health, University of Heidelberg, Germany
2 Department of Epidemiology and International Public Health, School of Public Health, University of Bielefeld, Germany
Correspondence: Heiko Becher, Department of Tropical Hygiene and Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany, tel: +49 6221 565031; fax: +49 6221 565948; e-mail: heiko.becher{at}urz.uni-heidelberg.de
Background: Diaspora migration flows from the former Soviet Union to Western Europe and Israel have increased since the late 1980s. Risk factors responsible for the East-West mortality gap and post-migration factors may lead to higher mortality from external causes of death like suicide amongst such Diaspora immigrants. We investigated whether ethnic German immigrants from the former Soviet Union had increased mortality from external causes compared to native Germans. Methods: We conducted a retrospective cohort study of 34 393 adults, so-called Aussiedler who arrived in Germany's largest federal state between 1990 and 2001. We ascertained vital status and causes of death from registry data. Standardized mortality ratios (SMRs) were calculated using the native German population as comparison. Multivariate effects were assessed using Poisson regression. Results: 1 657 members (4.8%) died, 88 from external causes. Overall SMR was 1.29 (95% confidence intervals 1.05–1.61). Males had a 39% higher mortality from all external causes and accidents, and a 30% higher mortality from suicide than German males. Females had slightly higher mortality from accidents but comparable mortality from all external causes. Aussiedler aged <65 years had rate ratios above one for external causes and accidents in multivariate models. SMRs for suicide and all external causes decreased with length of stay. Conclusion: While ethnic German immigrants have a mortality disadvantage compared to the NRW population, it is on a much lower scale than expected if they were representative of their source populations in former Soviet Union countries.
Keywords: cause of death, immigration, mortality, Soviet Union, suicide
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