BMJ Open
Volume 6, Issue 3, 2016

Comparative analysis of premature mortality among urban immigrants in Bremen, Germany: A retrospective register-based linkage study (Article) (Open Access)

Makarova N.* , Brand T. , Brünings-Kuppe C. , Pohlabeln H. , Luttmann S.
  • a Unit of Social Epidemiology, Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany, Department of General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf (UKE), University Heart Center (UHZ), Hamburg, Germany
  • b Unit of Social Epidemiology, Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  • c Unit of IT, Data Management and Medical Documentation, Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  • d Unit of Statistical Modelling of Primary Data, Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
  • e Unit of Translational Cancer Epidemiology, Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany

Abstract

Objectives: The main objective of this study was to explore differences in mortality patterns among two large immigrant groups in Germany: one from Turkey and the other from the former Soviet Union (FSU). To this end, we investigated indicators of premature mortality. Design: This study was conducted as a retrospective population-based study based on mortality register linkage. Using mortality data for the period 2004-2010, we calculated age-standardised death rates (SDR) and standardised mortality ratios (SMR) for premature deaths (<age 65 years). We computed years of potential life lost (YPLL) and analysed the underlying causes of death contributing to premature mortality. Setting and participants: In this study, we made use of the unique possibilities of register-based research in relation to migration and health. Analyses were performed in three population groups in the federal state of Bremen, Germany: immigrants from Turkey, those from the FSU and the general population. Results: The SDRs for premature deaths of the two immigrant groups were lower compared to those of the general population. The SMRs remained under 1. Using the indicator of YPLL, we observed higher age-standardised YPLL rates among immigrant populations, particularly among males from the FSU compared to females and population groups 4238/100 000, 95% CI (4119 to 4358). Regarding main causes of premature death, we found larger contributions of infant mortality and diseases of the respiratory system among Turkish immigrants, and of injuries and poisonings, and mental and behavioural disorders among immigrants from the FSU. Conclusions: While the overall trends favour the immigrant populations, the indicator of YPLL and cause-specific results indicate areas where the healthcare systems responsiveness may need to be improved, including preventive services. Further work with broader databases providing a similar level of differentiation is necessary to substantiate these findings.

Author Keywords

[No Keywords available]

Index Keywords

urban area Germany immigrant Death Certificates death certificate health survey Population Surveillance register sex ratio human epidemiology injury middle aged trends statistics and numerical data Turkey (republic) intoxication comparative study Aged USSR respiratory tract disease ethnology mental disease Young Adult Humans migrant Adolescent Infant, Newborn male Emigrants and Immigrants preschool child female Infant preventive health service groups by age and sex Child, Preschool newborn Article Retrospective Studies behavior disorder adult mortality rate premature mortality Turkey Sex Distribution Mortality, Premature age distribution Infant Mortality retrospective study cause of death standardized mortality ratio Child

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84962245235&doi=10.1136%2fbmjopen-2015-007875&partnerID=40&md5=fa71b421b075b2c6696f9297d2826556

DOI: 10.1136/bmjopen-2015-007875
ISSN: 20446055
Cited by: 2
Original Language: English