The authors review the health situation of immigrants in Germany. They also describe the limitations of the existing evidence. Aside from a lower socioeconomic status, immigrants encounter barriers in health care that limit their access to health services and that may also affect health-care quality and outcomes. Based on the evidence assembled, it is not say definitively whether immigrants have a higher or lower mortality than non-immigrants because the evidence is often contradictory and limited. Nonetheless, computed standardized death rates do for the most part suggest an immigrant mortality advantage. Concerning morbidity, immigrants appear to have a higher incidence of certain infectious diseases and a higher prevalence of some chronic conditions. This situation is attributed to unfavorable social determinants in the immigrant population as well as access barriers to, and a limited effectiveness of, health services to migrants.
Patrick Brzoska and Oliver Razum
Jacob Spallek, Anna Reeske, Hajo Zeeb and Oliver Razum
In this chapter we discuss the ways in which the health situation of individuals with a migrant background differs from that of the autochthonous, non-migrated population. We focus on current explanatory models, using the healthy migrant effect and the model of migration as health transition as our examples. Furthermore, we present selected empirical evidence and describe further factors, notably socioeconomic status and gender, as well as methodological aspects that are important for a valid description, analysis and interpretation of the health of migrants. Importantly, we argue for a life course model of migrant health that incorporates these aspects, moving well beyond snapshot assessments of health status of migrants.