eprintid: 26802
rev_number: 12
eprint_status: archive
userid: 1589
dir: disk0/00/02/68/02
datestamp: 2019-08-13 09:51:44
lastmod: 2019-09-16 00:52:11
status_changed: 2019-08-13 09:51:44
type: article
metadata_visibility: show
creators_name: Biddle, Louise
creators_name: Menold, Natalja
creators_name: Bentner, Martina
creators_name: Nöst, Stefan
creators_name: Jahn, Rosa
creators_name: Ziegler, Sandra
creators_name: Bozorgmehr, Kayvan
title: Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany
subjects: ddc-610
divisions: i-910100
keywords: Health monitoring, Refugees, Asylum seekers, Survey, Healthcare access, Health status, Healthcare quality, Healthcare planning
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.
date: 2019
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1671901533
own_urn: urn:nbn:de:bsz:16-heidok-268028
language: eng
bibsort: BIDDLELOUIHEALTHMONI2019
full_text_status: public
publication: Emerging Themes in Epidemiology
volume: 16
number: 3
place_of_pub: London
pagerange: 1-21
issn: 1742-7622
citation:   Biddle, Louise ; Menold, Natalja ; Bentner, Martina ; Nöst, Stefan ; Jahn, Rosa ; Ziegler, Sandra ; Bozorgmehr, Kayvan  (2019) Health monitoring among asylum seekers and refugees: a state-wide, cross-sectional, population-based study in Germany.  Emerging Themes in Epidemiology, 16 (3).  pp. 1-21.  ISSN 1742-7622     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26802/1/12982_2019_Article_85.pdf