Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter?
Abstract
1. Introduction
1.1. Question
1.2. Theoretical Framework
2. Materials and Methods
2.1. Dataset
2.2. Variables
2.3. Definitions of Migration Status
2.4. Statistical Analysis
3. Results
3.1. Socio-Demographic Characteristics
3.2. Health Service Utilization
3.3. Health Outcomes
3.4. Multivariate Analyses
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Migration Status 1 | Migration Status 2 | Migration Status 3 | Migration Status 4 | Migration Status 5 | Migration Status 6 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No | Yes | No | Yes | No | Yes | No | Yes | No | Yes | No | Yes | |
Sex | ||||||||||||
Male | 50.5% | 49.8% | 50.7% | 48.2% | 50.4% | 50.7% | 50.5% | 49.3% | 50.4% | 50.2% | 50.5% | 48.5% |
Female | 49.5% | 50.2% | 49.3% | 51.9% | 49.6% | 49.3% | 49.5% | 50.7% | 49.6% | 49.8% | 49.5% | 51.5% |
Age (years) | ||||||||||||
4 | 7.7% | 6.6% | 7.6% | 6.9% | 7.6% | 6.7% | 7.7% | 6.5% | 7.7% | 4.8% | 7.6% | 7.8% |
5 | 84.8% | 85.8% | 84.8% | 86.2% | 85.0% | 84.7% | 84.9% | 86.3% | 84.8% | 89.9% | 84.8% | 83.6% |
6 | 7.4% | 7.6% | 7.5% | 6.9% | 7.4% | 8.6% | 7.4% | 7.2% | 7.5% | 5.3% | 7.5% | 8.6% |
Socio-Economic Status * | ||||||||||||
High | 46.4% | 38.5% | 46.7% | 35.4% | 46.2% | 24.9% | 46.4% | 44.6% | 45.5% | 38.7% | 45.3% | 49.3% |
Medium | 34.9% | 28.3% | 34.7% | 29.3% | 34.4% | 25.4% | 34.9% | 29.7% | 34.3% | 28.0% | 34.5% | 31.0% |
Low | 18.7% | 33.1% | 18.7% | 35.4% | 19.5% | 49.8% | 18.7% | 25.7% | 20.2% | 33.3% | 20.3% | 19.8% |
Type of Child Care | ||||||||||||
Kindergarten | 96.8% | 85.1% | 96.6% | 84.9% | 96.8% | 60.3% | 96.8% | 96.0% | 95.2% | 94.7% | 95.0% | 97.0% |
At home | 3.0% | 14.7% | 3.2% | 15.0% | 3.1% | 39.2% | 3.0% | 4.0% | 4.7% | 5.3% | 4.8% | 3.0% |
Nanny | 0.2% | 0.2% | 0.2% | 0.2% | 0.1% | 0.5% | 0.2% | . | 0.2% | . | 0.2% | . |
Parents’ Marital Status | ||||||||||||
No information | 0.2% | 0.3% | 0.2% | 0.3% | 0.2% | 0.2% | 0.4% | 0.2% | 1.0% | 0.2% | . | |
Single mother | 22.4% | 18.4% | 22.2% | 19.0% | 22.3% | 10.5% | 22.3% | 21.9% | 22.2% | 12.1% | 21.8% | 29.5% |
Mother and new partner | 6.3% | 3.2% | 6.2% | 3.0% | 6.0% | 1.9% | 6.3% | 3.8% | 6.0% | 1.5% | 6.0% | 5.6% |
Both parents | 68.6% | 76.8% | 68.9% | 76.3% | 67.0% | 87.6% | 68.6% | 72.0% | 69.1% | 85.0% | 69.5% | 61.9% |
other | 2.6% | 1.3% | 2.6% | 1.4% | 2.6% | 2.6% | 1.9% | 2.5% | 0.5% | 2.5% | 3.0% | |
Number of Siblings | ||||||||||||
<3 | 88.3% | 80.2% | 88.2% | 79.5% | 87.7% | 75.1% | 87.7% | 82.3% | 87.3% | 83.1% | 87.4% | 81.7% |
≥3 | 11.7% | 19.9% | 11.8% | 20.5% | 12.3% | 24.9% | 12.4% | 17.7% | 12.7% | 16.9% | 12.6% | 18.3% |
Mother’s Country of Origin | Migration Status 1 | Migration Status 2 | Migration Status 3 | Migration Status 4 | Migration Status 5 | Migration Status 6 |
---|---|---|---|---|---|---|
Germany | 206 (24.8%) | 159 (21.8%) | 16 (5.8%) | 190 (34.4%) | 1 (0.4%) | 189 (65.6%) |
Syria | 150 (18.0%) | 144 (19.7%) | 119 (42.8%) | 31 (5.6%) | 31 (11.7%) | 0 |
Russia | 48 (5.8%) | 42 (5.8%) | 6 (2.2%) | 42 (7.6%) | 27 (10.2%) | 15 (5.2%) |
Turkey | 42 (5.1%) | 39 (5.3%) | 2 (0.7%) | 40 (7.2%) | 40 (15.1%) | 0 |
Vietnam | 41 (4.9%) | 41 (5.6%) | 2 (0.7%) | 39 (7%) | 33 (12.5%) | 6 (2.1%) |
Poland | 24 (2.9%) | 21 (2.9%) | 11 (4%) | 13 (2.4%) | 3 (1.1%) | 10 (3.5%) |
Ukraine | 22 (2.6%) | 20 (2.7%) | 6 (2.2%) | 16 (2.9%) | 13 (4.9%) | 3 (1%) |
Iraq | 19 (2.3%) | 16 (2.2%) | 1 (0.4%) | 18 (3.3%) | 17 (6.4%) | 1 (0.4%) |
Kosovo | 18 (2.2%) | 18 (2.5%) | 2 (0.7%) | 16 (2.9%) | 15 (5.7%) | 1 (0.4%) |
Kazakhstan | 15 (1.8%) | 11 (1.5%) | 1 (0.4%) | 14 (2.5%) | 11 (4.2%) | 3 (1%) |
Father’s Country of Origin | ||||||
Syria | 158 (19%) | 149 (20.5%) | 120 (43.3%) | 38 (6.9%) | 32 (12.1%) | 6 (2.1%) |
Germany | 110 (13.3%) | 85 (11.7%) | 22 (7.9%) | 88 (16%) | 1 (0.4%) | 87 (30.4%) |
Nigeria | 56 (6.8%) | 51 (7%) | 3 (1.1%) | 53 (9.6%) | 8 (3%) | 45 (15.7%) |
Turkey | 54 (6.5%) | 51 (7%) | 4 (1.4%) | 50 (9%) | 41 (15.5%) | 9 (3.2%) |
Russia | 35 (4.2%) | 26 (3.6%) | 3 (1.1%) | 32 (5.8%) | 23 (8.7%) | 9 (3.2%) |
Vietnam | 34 (4.1%) | 34 (4.7%) | 1 (0.4%) | 33 (6%) | 33 (12.5%) | 0 |
Iraq | 32 (3.9%) | 29 (4%) | 1 (0.4%) | 31 (5.6%) | 17 (6.4%) | 14 (4.9%) |
Kosovo | 19 (2.3%) | 19 (2.6%) | 1 (0.4%) | 18 (3.3%) | 16 (6%) | 2 (0.7%) |
Ukraine | 17 (2.1%) | 16 (2.2%) | 1 (0.4%) | 16 (2.9%) | 12 (4.5%) | 4 (1.4%) |
India | 16 (1.9%) | 15 (2.1%) | 10 (3.6%) | 6 (1.1%) | 2 (0.8%) | 4 (1.4%) |
No Preventative Checkup U8 | Incomplete Tetanus Vaccination | Severe Developmental Delay | Special Educational Care Recommended | Referral for Early Intervention | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Crude PR * (95%-CI) | Adjusted PR *,† (95%-CI) | Crude PR * (95%-CI) | Adjusted PR *,† (95%-CI) | Crude PR * (95%-CI) | Adjusted PR *,† (95%-CI) | Crude PR * (95%-CI) | Adjusted PR *,† (95%-CI) | Crude PR * (95%-CI) | Adjusted PR *,† (95%-CI) | |
Migration status 1 | 1.57 (1.30–1.88) | 1.57 (1.29–1.90) | 2.14 (1.93–2.37) | 2.02 (1.81–2.26) | 2.22 (1.86–2.65) | 1.57 (1.29–1.90) | 0.76 (0.55–1.03) | 0.59 (0.42–0.82) | 0.96 (0.64–1.45) | 0.74 (0.47–1.17) |
Migration status 2 | 1.66 (1.38–2.01) | 1.61 (1.31–1.98) | 2.25 (2.03–2.49) | 2.13 (1.9–2.38) | 2.32 (1.93–2.77) | 1.58 (1.30–1.93) | 0.72 (0.51–1.01) | 0.56 (0.39–0.79) | 0.93 (0.6–1.44) | 0.69 (0.43–1.13) |
Migration status 3 | 2.35 (1.51–3.65) | 3.05 (1.97–4.73) | 3.83 (3.49–4.21) | 3.56 (3.2–3.96) | 3.69 (3.01–4.54) | 2.16 (1.73–2.69) | 0.75 (0.45– 1.27) | 0.44 (0.25–0.79) | 0.78 (0.37–1.64) | 0.42 (0.18–1.02) |
Migration status 4 | 1.49 (1.23–1.82) | 1.47 (1.2–1.81) | 1.28 (1.09–1.5) | 1.31 (1.1–1.55) | 1.47 (1.15–1.89) | 1.14 (0.87–1.51) | 0.76 (0.52–1.1) | 0.68 (0.46–1.00) | 1.06 (0.66–1.7) | 0.95 (0.58–1.58) |
Migration status 5 | 1.85 (1.45–2.35) | 1.77 (1.36–2.3) | 1.25 (0.99–1.56) | 1.28 (0.99–1.64) | 2.05 (1.54–2.74) | 1.41 (1.02–1.95) | 0.62 (0.35–1.12) | 0.52 (0.29–0.96) | 1.17 (0.62–2.19) | 0.80 (0.38–1.68) |
Migration status 6 | 1.19 (0.89–1.59) | 1.22 (0.91–1.65) | 1.31 (1.06–1.61) | 1.34 (1.08–1.66) | 0.94 (0.62–1.42) | 0.85 (0.54–1.34) | 0.88 (0.55–1.42) | 0.85 (0.52–1.38) | 0.96 (0.5–1.87) | 1.1 (0.57–2.1) |
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Führer, A.; Tiller, D.; Brzoska, P.; Korn, M.; Gröger, C.; Wienke, A. Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter? Int. J. Environ. Res. Public Health 2020, 17, 212. https://doi.org/10.3390/ijerph17010212
Führer A, Tiller D, Brzoska P, Korn M, Gröger C, Wienke A. Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter? International Journal of Environmental Research and Public Health. 2020; 17(1):212. https://doi.org/10.3390/ijerph17010212
Chicago/Turabian StyleFührer, Amand, Daniel Tiller, Patrick Brzoska, Marie Korn, Christine Gröger, and Andreas Wienke. 2020. "Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter?" International Journal of Environmental Research and Public Health 17, no. 1: 212. https://doi.org/10.3390/ijerph17010212
APA StyleFührer, A., Tiller, D., Brzoska, P., Korn, M., Gröger, C., & Wienke, A. (2020). Health-Related Disparities among Migrant Children at School Entry in Germany. How does the Definition of Migration Status Matter? International Journal of Environmental Research and Public Health, 17(1), 212. https://doi.org/10.3390/ijerph17010212