Methods for Identification and Sampling of People with Migrant Background in Germany. Mortality Analyses The Concept of Premature and Avoidable Mortality as Differentiated Instrument for Mortality Evaluation

Migrants constitute a significant part of our society. Migrants differ from the general German population in health status, health risks and needs, health awareness and health behavior. These differences refer to inequalities in the presence of disease, health outcomes, or access to health care. Avoidable mortality is often used as a key indicator of broader health inequalities. To further investigate the health situation of migrants in Germany beyond the indicators of avoidable mortality, it is necessary to identify migrant populations in existing databases. The first aim of this work was to combine already applied methods with new methodological approaches for determining the vital status and the mortality of migrants from Turkey and the former Soviet Union. The second aim of this dissertation project was to analyze the health situation of migrants in the state of Bremen beyond the indicators of avoidable mortality using data from the Bremen Mortality Index. We calculated age-standardized death rates, standardized mortality ratios for premature deaths ( age 65) and years of potential life lost, and analyzed underlying causes of death contributing to premature mortality. Further in-depth methodological steps such as a qualitative approach and scoping review have been established to better understand different health situations of migrants and to examine the concept of avoidable mortality based on available current European literature. While the overall trends favour the migrant populations, the indicator of YPLL and cause-specific results indicate areas where the health care system s responsiveness may need to be improved, including preventive services. This dissertation project contributed to better determination of migration background. Specific areas have been indicated where the health care provision needs to be improved