Major Depressive Syndrome (MDS) and its Association with Time of Residence among Spanish Speaking Au-Pairs Living in Germany

Aetiological research on the health of migrants living in Germany: a systematic literature review

BACKGROUND

Germany has become an important immigration country and health services need to adopt to meet the needs of an increasingly multicultural population. For public health planning, it is essential to understand the aetiology of health problems among migrant populations. The main objective was to systematically identify, evaluate and synthesise population-based studies that investigated exposure-outcome relationships among migrant groups in Germany.

METHODS

In November 2019, we searched PubMed and LIVIVO, and updated this search in November 2020, to identify peer-reviewed publications that fulfilled our eligibility criteria: English or German language; study on disease aetiology among major migrant groups in Germany, according to the latest microcensus; publication date from inception to 01 November 2020 and observational or experimental study designs. For quality appraisal, we used the Critical Appraisal Skills Programme checklists. Outcomes under investigation were categorised according to the WHO major disease groups, and their associations with risk factors were synthesised as a heat map.

RESULTS

Out of 2407 articles retrieved, we included 68 publications with a total number of 864 518 participants. These publications reported on cross-sectional data (n=56), cohort studies (n=11) and one intervention study. The population groups most frequently studied were from the Middle East (n=28), Turkey (n=24), sub-Saharan Africa (n=24), Eastern Europe (n=15) and the former Soviet Union (n=11). The outcomes under study were population group specific. There were consistent associations of demographic and socioeconomic factors with ill health among migrants in Germany.

DISCUSSION

In this systematic review, we observed low risk of bias in two-thirds of the studies. There is an increasing body of evidence for aetiological research on migrants' health in Germany. Still, the directions of associations between a wide range of risk factors and major disease groups seem only partially understood.

PROSPERO REGISTRATION NUMBER

CRD42018085074.

Working Conditions as Risk Factors for Depressive Symptoms among Spanish-Speaking Au Pairs Living in Germany-Longitudinal Study

Previous studies have shown poor working conditions and poor mental health among au pairs. However, there are limited longitudinal approaches to these conditions. Therefore, the main objectives of this study were to assess the occurrence of depressive symptoms longitudinally and to analyze the association between sociodemographic characteristics, working conditions and violence at work with depressive symptoms over time among Spanish-speaking au pairs living in Germany. A prospective cohort study was performed with three measurement intervals, which included 189 participants. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9). Generalized Estimating Equation (GEE) models were implemented to estimate the association between predictors and depressive symptoms. Au pairs who worked >40 h per week were more than three times more likely to experience depression than those who did not (OR: 3.47; 95% CI: 1.46-8.28). In addition, those exposed to physical violence were almost five times more likely to suffer from depression (OR: 4.95; 95% CI: 2.16-9.75), and au pairs who had bad schedule adaptation to social and family commitments had twice the risk of depression than those who did not (OR: 2.24; 95% CI: 0.95-5.28). This knowledge could be of interest for future au pairs, host families, au pair agencies and policy makers. Together, they could improve awareness and monitoring of au pair working conditions.

Migrant Health Burden: Where Do We Stand?

This Special Issue of the International Journal of Environmental Research and Public Health contains a collection of extended papers that describe many important aspects of the “migrant health burden” and focus on new realities and solutions in the healthcare of migrants and refugees.