The research at the chair focuses on the following areas:
- Trends in morbidity and mortality
- Life factors of cognitive and physical diseases in old age
- Risk factors for neurodegenerative diseases such as dementia and Parkinson's disease
- Health of migrants
- Health consequences of minimally invasive implant technolog
Within the last decade, the proportion of the population with a migration background in Germany has increased from 18.7 % (15.4 million) to 22.5 % (18.6 million). This increase is associated with a growing diversity of the population, which also raises new questions in health research. Migration (or the presence of a migration background) is considered one of the newer dimensions of health inequalities. Previous studies indicate that migrants constitute a vulnerable group within the population and differ both in their risk for diseases and spectrum of diseases as well as in the mechanisms that determine their health status. Our research aim is to identify and quantify these differences with particular focus on mapping the heterogeneity of the migrant population. This heterogeneity refers to numerous characteristics, e.g. the country of origin, the immigration period, the duration of stay, the immigrant generation, the legal status, the motive to migrate, experiences in the process of migration, selection mechanisms etc., and allows different perspectives and differentiation levels. One of the largest migrant groups in Germany are Ethnic German Immigrants ((Spät-)Aussiedler, ca. 3 million), who are characterized by their special legal status and the cultural proximity to the German majority population. Our analyses yield new insights into differences in health, but also similarities between Ethnic German Immigrants, non-migrant Germans and other migrant groups. We can prove that (comparative) health benefits and disadvantages depend on the duration of stay in Germany and the integration into the labour market and varies according to the type of residential area and household characteristics. A good integration into the labour market, living in rural areas and economically powerful regions as well as cohabitating with children has a particularly positive effect. Health disadvantages for Turks – the second large migrant group in Germany (3 million) – were discussed frequently and are mostly attributed to economic and socio-cultural differences. We also show these connections in our research, and find that – besides socio-economic characteristics – also disadvantageous lifestyle factors (obesity, smoking) lead to poorer health among Turkish migrants. Although different patterns in terms of the household and family formation of Turks compared to Germans emerge, the influence of specific household forms is similar for both groups. In the course of the current migration flows, refugee migration is also gaining importance. This acute migration of people from distant countries poses new challenges for both the migrant and the host population. With regard to health, this subgroup within the migrant population highlights the importance of integration on health outcomes. Both high economic and high socio-cultural integration are associated with better health, as our most recent research shows. Subsequent studies aim to identify further determinants of health and health inequalities among migrants, to assess the validity of our findings taking different health outcomes into account and/or to consider other subgroups within the migrant population.
Publications:
[1] Frentz-Göllnitz, M., Remund, A., Harmsen, C., Stoeldraijer, L., van der Toorn, J., Doblhammer, G., & Janssen, F. (2024): Contributions of causes of death to differentials in life expectancy by internal migrant status in the Netherlands. A population register based study, 2015-2019. SSM-Population Health, DOI: 10.1016/j.ssmph.2024.101690.
[2] Georges, D.; Doblhammer, G. (2024): Älter und diverser: Demografische Entwicklungen in Deutschland und ihre Herausforderungen für die Gesundheitsversorgung und Pflege. In: Bauer, J.; Becker, C.; Denkinger, M.; Wirth, R. (Eds.): Geriatrie: Das gesamte Spektrum der Altersmedizin für Klinik und Praxis. Stuttgart: Kohlhammer.
[3] Georges, D.; Doblhammer, G. (2023): Informal care and mental health in Germany: What are the differences between non-migrants and ethnic German immigrants? A longitudinal comparative analysis. Aging and Mental Health. DOI: 10.1080/13607863.2023.2271866
[4] Georges, D. (2022): Three Groups of Immigrants in Germany: Analysing Health Inequalities. Universität Rostock. Dissertationsschrift. DOI: 10.18453/rosdok_id00003883
[5] Georges, D. (2022): The effect of informal caregiving on physical health among non-migrants and Ethnic German Immigrants in Germany: a cohort analysis based on the GSOEP 2000–2018. BMC Public Health 22, 121. DOI: 10.1186/s12889-022-12550-0
[6] Georges D.; Buber-Ennser, I.; Rengs, B.; Kohlenberger, J.; Doblhammer, G. (2021): Health determinants among refugees in Austria and Germany: A propensity-matched comparative study for Syrian, Afghan, and Iraqi refugees. PLOS ONE 16(4): e0250821. DOI: 10.1371/journal.pone.0250821
[7] Georges, D.; Kreft, D.; Doblhammer, G. (2018): The Contextual and Household Contribution to Individual Health Status in Germany: What is the Role of Gender and Migration Background? In: Gumà, J.; Doblhammer, G. (Eds.): Family and Health from a Gender Perspective in Europe. Springer Brief.
[8] Kreft, D.; Doblhammer, G (2012): Contextual and individual determinants of health among Aussiedler and native Germans. Health & Place 18 (5): 1046–1055. DOI: 10.1016/j.healthplace.2012.05.008
Cognitive abilities determine the absorption and processing of information and thus characterise individual attention, perception and language skills as well as memory and thinking. Cognitive performance begins to decline from around the age of 25, whereby pathological processes can also occur alongside natural, age-related processes. The latter influence the individual's lifestyle and are often associated with further health-related complications, e.g. serious neurodegenerative diseases or increased mortality risks.
The initial aim of the project is to analyse in depth the factors influencing cognitive health and cognitive performance. Particular focus will be placed on socio-structural and socio-economic characteristics (including gender, age, education, marital status, employment status, income, migration background) and their interaction and mediation with lifestyle factors and associated characteristics (physical activity, sleeping habits, alcohol consumption, smoking behaviour; mental health, cardiovascular diseases, inflammatory processes, blood values). Furthermore, the influence of lifestyle and associated characteristics on mortality will be analysed.
The project therefore aims to identify risk and protective factors for cognitive performance and to derive and quantify intervention options for maintaining cognitive health. Implications for mortality are also to be derived from this.
This project focusses on the effects of the increase in neurodegenerative diseases on the care of patients. On the other hand, we identify potentially modifiable risk and protective factors, particularly for dementia syndrome and Parkinson's disease. Our research is based on the application of demographic and epidemiological approaches in interdisciplinary collaboration with working groups at the DZNE and national and international research institutions. We use billing data from health insurance companies (AOK, DaTraV) and population-based surveys (Lifelines, SHARE, BASE-II) as a data basis.
Prevalence, incidence, spatial patterns and trends of neurodegenerative diseases
Analyses of age- and gender-specific prevalences and incidences as well as their trends over time serve as a basis for future planning in the medical and healthcare sector.
Protective and risk factors of neurodegenerative diseases
Detailed analyses of causes and determinants of neurodegenerative diseases provide indications for clinical studies with regard to causal protective factors, and show options for action in the area of prevention by reducing identified risk factors.
Risk of care and mortality in neurodegenerative diseases
Dementia syndrome and Parkinson's disease are associated with an increased risk of care dependency and mortality. We analyse the transitions from illness to care and death and identify factors that are associated with the longest possible period of good quality of life, even with an existing illness.