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Patrick Brzoska and Oliver Razum

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.