Ulla Wittig

Migration und Gesundheit

ZusammenfassungDieser Artikel gibt eine Übersicht über die aktuelle Literatur zu sozialen und psychologischen Faktoren der Migration. Aus gehend von einer Begriffsbestimmung „Migration“ und methodischen Besonderheiten in der Migrationsforschung wird ein Stressmodell der Migration vorgestellt, und anschließend werden mögliche Stress auslösende Migrationsfolgen wie berufliche Belastungen, soziale Isolation oder familiäre Probleme analysiert und ihre Auswirkungen auf den psychischen Gesundheitszustand der Migranten untersucht. Zur psychischen Gesundheit von Migranten gibt es jedoch widersprüchliche Befunde, die mit dem healthy migrant effect, der Aufenthaltsdauer oder der Kulturspezifität erklärt werden können. Danach wird der Frage nachgegangen, wie sich diese teilweise belasteten Migranten im Gesundheitswesen wiederfinden. Schließlich wird diskutiert, welche Konsequenzen die dargestellten Ergebnisse für die weitere Forschung und für oziale und gesundheitspolitische Entscheidungen haben können.SummaryThe article provides an overview of the contemporary literature on the social and psychological factors which are associated with migration. Derived from the operationalisation of “migration” and an examination of the methodological peculiarities of migration research, a (transactional) stress model of migration is proposed incorporating potentially stress-eliciting influences of migration including occupational pressures, social isolation and/or family-related problems and their impact on psychological and physical health. There are inconsistencies in the findings regarding psychological health, which can in part be explained through the phenomena of the “healthy migrant effect”, duration of stay in the host culture or the culture-specificity. Moreover, a discussion is provided of the extent that disorders associated with differentially stressed migrants will be manifested in the health care system. Finally, concluding remarks are offered together with a short discussion of the implication of these findings for future research and social and health policy decision- making.

Sind Migranten häufiger von psychischen Störungen betroffen

OBJECTIVES There are few, methodically heterogeneous and unsatisfactory studies about the mental health of immigrants. Commonly, these studies refer to a single group of immigrants and in consequence general statements about the mental health of immigrants are impossible. METHODS In a representative population survey in Germany (N = 2 510) depressive and somatoform symptoms were screened with the Patients Health Questionnaire, Post Traumatic Stress Disorder was screened with the PTDS. If at least one parent was born abroad, people are classified as immigrants. RESULTS 11.1 % of the sample are immigrants, which are mostly better integrated ones. There are no significant differences in the prevalence of the investigated mental disorders of immigrants compared to the native population. CONCLUSION The sample includes a large variety of immigrants living in Germany and does not refer to a single group. Asylum seekers and undocumented migrants are not included, those immigrants with low language skills might be underrepresented because of the methodology. Against our expectations, no differences in the mental health between imigrants and native Germans could be proven. This finding stands in a marked contrast to the well established deficit-oriented point of view on the health of immigrants.

Health and migration. Psychosocial determinants

ZusammenfassungDieser Artikel gibt eine Übersicht über die aktuelle Literatur zu sozialen und psychologischen Faktoren der Migration. Aus gehend von einer Begriffsbestimmung „Migration“ und methodischen Besonderheiten in der Migrationsforschung wird ein Stressmodell der Migration vorgestellt, und anschließend werden mögliche Stress auslösende Migrationsfolgen wie berufliche Belastungen, soziale Isolation oder familiäre Probleme analysiert und ihre Auswirkungen auf den psychischen Gesundheitszustand der Migranten untersucht. Zur psychischen Gesundheit von Migranten gibt es jedoch widersprüchliche Befunde, die mit dem healthy migrant effect, der Aufenthaltsdauer oder der Kulturspezifität erklärt werden können. Danach wird der Frage nachgegangen, wie sich diese teilweise belasteten Migranten im Gesundheitswesen wiederfinden. Schließlich wird diskutiert, welche Konsequenzen die dargestellten Ergebnisse für die weitere Forschung und für oziale und gesundheitspolitische Entscheidungen haben können.SummaryThe article provides an overview of the contemporary literature on the social and psychological factors which are associated with migration. Derived from the operationalisation of “migration” and an examination of the methodological peculiarities of migration research, a (transactional) stress model of migration is proposed incorporating potentially stress-eliciting influences of migration including occupational pressures, social isolation and/or family-related problems and their impact on psychological and physical health. There are inconsistencies in the findings regarding psychological health, which can in part be explained through the phenomena of the “healthy migrant effect”, duration of stay in the host culture or the culture-specificity. Moreover, a discussion is provided of the extent that disorders associated with differentially stressed migrants will be manifested in the health care system. Finally, concluding remarks are offered together with a short discussion of the implication of these findings for future research and social and health policy decision- making.

Angst und Depression polnischer und vietnamesischer MigrantInnen in Leipzig unter besonderer Berücksichtigung ihres Eingliederungsprozesses

Although the fact that migrants show a lower psychological health status than non-migrants is clearly demonstrated by a lot of studies, the connection between migration conditions and psychological health status is seldom analyzed. To close this lack of research 140 Polish and 82 Vietnamese migrants in Leipzig were examined by the anxiety- and depression scale of the HADS and more over asked questions about their cognitive, social, occupational, identificative assimilation status and their perceived discrimination. Both migrant groups showed a higher level of depressive and anxious symptoms than Germans. In regression analyzes only social assimilation and perceived discrimination had a significant influence, language skills and structural (occupational) assimilation could not explain depression or anxiety, but there were differences in regression models between both groups. Beside problems in operationalization, different migrant biographies and structural conditions have to be discussed as reason for these results.

A comparison of general and illness-related locus of control in Russians, ethnic German migrants and Germans

Abstract General and illness-related locus of control play an immensely important role in the adherence and cooperation of patients in their therapy. Until now, culture-specific aspects of these subjective theories have rarely been investigated. However, in view of the growing proportion of migrants in the German population, they are becoming increasingly significant. In a project supported by the Volkswagenstiftung (Volkswagen Foundation), a total of 607 healthy people were surveyed. The sample includes 307 ethnic German migrants from the successor states of the former Soviet Union (descendents of German origin who had emigrated to Russia during the 18th and 19th centuries) and 300 native Russians in Russia. They were compared with 100 Germans (matched from a previous study). The data were collected using questionnaires entitled “Multidimensional Health Locus of Control (MHLC)” and “Illness-related Locus of Control”. The ethnic German migrants differed from the Russian sample in their health beliefs and attitudes towards medicine. However, in the first 18 months after migration, hardly any changes were observed. Fatalistic factors played only a minor role. Locus of health control was associated with beliefs about recovery from myocardial infarcts and tumours. Socio-demographic variables were of varying significance in the individual cultures. Gender influences on health beliefs were different in the subsamples. The level of education had only a minor influence on health attitudes. For those individuals who were acquainted with an ill person, internal factors in treatment of myocardial infarct and external psychosocial factors in cure of cancer played a larger role.