Changes in smoking prevalence among first- and second-generation Turkish migrants in Germany – an analysis of the 2005 Microcensus

Reeske A, Spallek J, Razum O. Changes in smoking prevalence among first- and second-generation Turkish migrants in Germany: an analysis of the 2005 Microcensus. International Journal for Equity in Health. 2009;8(1):26.Background: Compared to the majority population of a host country, migrants tend to have different health risks and health behaviour. We have hypothesised that these differences diminish with time passed since migration. We tested this hypothesis by examining smoking behaviour among Turkish migrants and their children born in Germany (second-generation migrants), stratified by educational level and, for the first generation, length of residence. Methods: We estimated the prevalence of smoking based on the representative 2005 Mikrozensus, an annual survey including 1% of Germany's households. The 2005 Microcensus was the first to provide information that makes it possible to differentiate between first- and second-generation Turkish migrants. In total, 12,288 Turkish migrants and 421,635 native-born Germans were included in our study. The unit non-response is generally low (about 6% in 2005) because participation in the Microcensus is obligatory. Results: We found the prevalence of smoking in second-generation male Turkish migrants to be lower than in the first-generation group: 47.0% of first-generation Turkish migrants with a high level of education were smokers, in contrast to only 37.6% in the second generation. Within the German reference population, 29.9% were smokers. The percentage of Turkish women in our sample who smoked was generally smaller, but was not significantly lower in the second generation. In fact, the prevalence of smoking was highest among Turkish women of the second generation with a low level of education (40.9%), similar to younger second-generation German women with the same level of education. Conclusion: We present the first representative data on changes in the prevalence of a risk factor for many chronic diseases among Turkish migrants in Germany. Male Turkish migrants (with a high level of education) showed a decrease over the generations while smoking prevalences of female Turkish migrants increased. In the second generation, prevalences partly converged with those of the German reference population or were even higher. Our hypothesis – that migration can be interpreted as a ''health transition'' – was thus partly confirmed

Gesundheitliche Ungleichheit bei Schwangeren und Säuglingen mit und ohne Migrationshintergrund. Ein Fokus auf frühe Risikofaktoren für kindliche Adipositas

The aim of this PhD thesis is to analyse the extent of ethnic inequalities among pregnant women and newborns in Germany focussing on early life risk factors for childhood obesity. The empirical analyses are based on data from the German perinatal database, pregnancy-related reimbursement data of a German statutory health insurance in Berlin and primary data from a population-based German sample of children in the IDEFICS study. The results indicate that migration background is an independent risk factor for pre- and postnatal outcomes and suggest that the onset of ethnic inequalities in overweight lies in fetal life and early infancy. Prevention approaches should focus on the reduction of obesity and start in early pregnancy with a special emphasis on (young) Turkish women. The findings should also stimulate discussion about the quality and appropriateness of antenatal and perinatal care of pregnant women and newborns with a migration background. A focus might be information on gestational diabetes during routine antenatal care

Care-Related and Maternal Risk Factors Associated with the Antenatal Nondetection of Intrauterine Growth Restriction: A Case-Control Study from Bremen, Germany

Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR. Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases) to detected IUGR neonates (controls). Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni-and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors. Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally in = 77 pregnancies while in = 84 it was not detected antenatally (antenatal detection rate: 47.8%). Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background. Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR

Depressive symptoms and smoking among young Turkish and Moroccan ethnic minority groups in the Netherlands: a cross-sectional study

ABSTRACT: BACKGROUND: Although evidence indicates a strong association between depressive symptoms and smoking among host and migrant adults, less is known about this relationship among young ethnic minority groups in Europe. This paper aims to assess the relationship between depressive symptoms and smoking among young Turkish and Moroccan migrants in the Netherlands. METHODS: Multiple logistic regression analyses was used to analyze cross-sectional data from a sample of 364 Turkish and Moroccan migrants aged 15 to 24 years. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure the presence of clinically significant depressive symptoms. Smoking behavior was measured by a number of questions. RESULTS: Of the respondents, 22% were smokers and 33% had depressive symptoms. The prevalence of depressive symptoms was significantly higher in smokers (42.9%) than in nonsmokers (29.5%). Respondents with depressive symptoms had increased odds of smoking even after adjusting for socioeconomic and cultural factors (OR = 2.68, 95% CI = 1.45-4.97). CONCLUSIONS: Depressive symptoms were significantly associated with smoking behavior in young Turkish and Moroccan migrants. In addition to other acknowledged factors, depressive symptoms should also be considered in relation to the smoking behavior of this group. Intervention programs for smoking behavior should take depressive symptoms into account for young Turkish and Moroccan migrant

A concept analysis of the term migrant women in the context of pregnancy

Aim: This paper explores the concept of migrant women as used in European healthcare literature in context of pregnancy to provide a clearer understanding of the concept for use in research and service delivery. Methods: Walker and Avant's method of concept analysis. Results: The literature demonstrates ambiguity around the concept; most papers do not provide an explicit or detailed definition of the concept. They include the basic idea that women have moved from an identifiable region/country to the country in which the research is undertaken but fail to acknowledge adequately the heterogeneity of migrant women. The paper provides a definition of the concept as a descriptive theory and argues that research must include a clear definition of the migrant specific demographics of the women. This should include country/region of origin and host, status within the legal system of host country, type of migration experience, and length of residence. Conclusion: There is a need for a more systematic conceptualization of the idea of migrant women within European literature related to pregnancy experiences and outcomes to reflect the heterogeneity of this concept. To this end, the schema suggested in this paper should be adopted in future research

Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007

Reeske A, Kutschmann M, Razum O, Spallek J. Stillbirth differences according to regions of origin: an analysis of the German perinatal database, 2004-2007. BMC Pregnancy and Childbirth. 2011;11(1): 63.Background: Stillbirth is a sensitive indicator for access to, and quality of health care and social services in a society. If a particular population group e. g. migrants experiences higher rates of stillbirth, this might be an indication of social deprivation or barriers to health care. This study examines differences in risk of stillbirth for women of different regions of origin compared to women from Germany in order to identify high risk groups/target groups for prevention strategies. Methods: We used the BQS dataset routinely compiled to examine perinatal outcomes in Germany nationwide. Participation of hospitals and completeness of data has been about 98% in recent years. Data on all live births and stillbirths were obtained for the period 2004 to 2007 (N = 2,670,048). We calculated crude and stratified mortality rates as well as corresponding relative mortality risks. Results: A significantly elevated stillbirth rate was found for women from the Middle East and North Africa (incl. Turkey) (RR 1.34, CI 1.22-1.55). The risk was slightly attenuated for low SES. An elevated risk was also found for women from Asia (RR 1.18, CI 1.02-1.65) and from Mediterranean countries (RR 1.14, CI 0.93-1.28). No considerable differences either in use and timing of antenatal care or preterm birth and low birthweight were observed between migrant and non-migrant women. After stratification for light for gestational age, the relative risk of stillbirth for women from the Middle East/North Africa increased to 1.63 (95% CI 1.25-2.13). When adjusted for preterm births with low birthweight, women from Eastern Europe and the Middle East/North Africa experienced a 26% (43%) higher risk compared with women from Germany. Conclusions: We found differences in risk of stillbirth among women from Middle East/North Africa, especially in association with low SES and low birthweight for gestational age. Our findings suggest a need for developing and evaluating socially and culturally sensitive health promotion and prevention programmes for this group. The findings should also stimulate discussion about the quality and appropriateness of antenatal and perinatal care of pregnant women and newborns with migrant backgrounds

Solvation free energy profile of the SCN- ion across the water-1,2-dichloroethane liquid/liquid interface. A computer simulation study

The solvation free energy profile of a single SCN- ion is calculated across the water-1,2-dichloroethane liquid/liquid interface at 298 K by the constraint force method. The obtained results show that the free energy cost of transferring the ion from the aqueous to the organic phase is about 70 kJ/mol, The free energy profile shows a small but clear well at the aqueous side of the interface, in the subsurface region of the water phase, indicating the ability of the SCN- ion to be adsorbed in the close vicinity of the interface. Upon entrance of the SCN- ion to the organic phase a coextraction of the water molecules of its first hydration shell occurs. Accordingly, when it is located at the boundary of the two phases the SCN- ion prefers orientations in which its bulky S atom is located at the aqueous side, and the small N atom, together with its first hydration shell, at the organic side of the interface