Judith Wenner1, Oliver Razum2, Liane Schenk3, Ute Ellert4, Kayvan Bozorgmehr5. 1. Abteilung Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland. judith.wenner@uni-bielefeld.de. 2. Abteilung Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland. 3. Institut für Medizinische Soziologie und Rehabilitationswissenschaft an der Charité, Universitätsmedizin Berlin, Berlin, Deutschland. 4. Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland. 5. Abteilung für Allgemeinmedizin und Versorgungsforschung, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
Abstract
BACKGROUND: The health of children and adolescents from families with insecure residence status could be poorer compared to other children with permanent residence permits in Germany due to exposure before and during flight. Their insecure residence status and their comparably low social status in the destination country may contribute towards access barriers to health care. However, selection effects might also lead to better health compared to other children in the destination country. This study compares the health status of children and adolescents with insecure residence status to that of other children with and without migration background in Germany. METHODS: We use data from the Health Interview and Examination Survey for Children and Adolescents (KiGGS). In multivariable logistic regression models we analyze the associations between children's residence status and their subjective and mental health, as well as their utilization of emergency services and vaccination status while adjusting for the children's social status and migration background. RESULTS AND CONCLUSION: Among 17,245 children, 197 (1.1 %) had an insecure residence status. Adjusting only for age and sex, an insecure residence status is associated with poorer subjective health (OR=3.12 (2.07-4.94)), mental problems (OR=1.83 (1.16-2.87)), an incomplete vaccination status (OR=2.0 (1.33-3.0)) and the use of emergency health services (OR=2.28 (1.2-4.36)). After adjusting also for social and migration status, only the association with the use of emergency care remains significant (OR=2.53 (1.18-5.43)). This association possibly indicates barriers to the use of regular primary care services, which requires further research.
BACKGROUND: The health of children and adolescents from families with insecure residence status could be poorer compared to other children with permanent residence permits in Germany due to exposure before and during flight. Their insecure residence status and their comparably low social status in the destination country may contribute towards access barriers to health care. However, selection effects might also lead to better health compared to other children in the destination country. This study compares the health status of children and adolescents with insecure residence status to that of other children with and without migration background in Germany. METHODS: We use data from the Health Interview and Examination Survey for Children and Adolescents (KiGGS). In multivariable logistic regression models we analyze the associations between children's residence status and their subjective and mental health, as well as their utilization of emergency services and vaccination status while adjusting for the children's social status and migration background. RESULTS AND CONCLUSION: Among 17,245 children, 197 (1.1 %) had an insecure residence status. Adjusting only for age and sex, an insecure residence status is associated with poorer subjective health (OR=3.12 (2.07-4.94)), mental problems (OR=1.83 (1.16-2.87)), an incomplete vaccination status (OR=2.0 (1.33-3.0)) and the use of emergency health services (OR=2.28 (1.2-4.36)). After adjusting also for social and migration status, only the association with the use of emergency care remains significant (OR=2.53 (1.18-5.43)). This association possibly indicates barriers to the use of regular primary care services, which requires further research.
Entities:
Keywords:
Access barriers; Asylum seeker; Child health; Health inequalities; Minors with insecure residence status
Authors: Andreas Niedermaier; Anna Freiberg; Daniel Tiller; Andreas Wienke; Amand Führer Journal: BMC Health Serv Res Date: 2020-10-20 Impact factor: 2.655