Unit of Epidemiology and Biostatistics, Institute of Public Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Eur J Epidemiol. 2017 Apr;32(4):289-298. doi: 10.1007/s10654-017-0240-4. Epub 2017 Mar 17.
Resettlers (in German: (Spät-)Aussiedler) form one of the biggest migrant groups in Germany. It is known that migrants have different mortality patterns compared to the autochthon population. In this paper, we combined data from three resettler cohorts and examined differences in mortality from non-communicable diseases among resettlers in Germany and the German population. Furthermore, we investigated time trends of cause-specific mortality for 20 years of follow-up and compared it with the German mortality rates. To assess differences in cause-specific mortality between resettlers and the general German population, we calculated standardized mortality ratios (SMRs). To ascertain mortality trends, cause-specific age-standardized mortality rates were calculated and modeled with Poisson regression and fractional polynomials. During the observation period, the study population accumulated almost 800,000 person-years and 5572 deaths were observed. All-cause mortality among resettlers was lower (SMR = 0.91, 95% CI = 0.89-0.94) compared to the general German population, as well as cardiovascular diseases (CVD) mortality (SMR = 0.82, 95% CI = 0.79-0.86). Results for cancer mortality varied considerably by cancer site. Analyses of time trends showed that all-cause and CVD mortality were decreasing over time in resettlers, as well as in the general German population. Lower all-cause mortality among resettlers is mainly explained by lower CVD mortality. Cancer-site specific mortality showed different results. Converging mortality rates may indicate an adaption of lifestyle behavior. However, there are no data on individual risk factors in this study.
移居者（德语：（Spät-）Aussiedler）是德国最大的移民群体之一。众所周知，移民的死亡率模式与本地人口不同。在本文中，我们结合了三个移居者队列的数据，研究了德国移居者与德国本地人口之间非传染性疾病死亡率的差异。此外，我们还研究了 20 年随访期间特定原因死亡率的时间趋势，并将其与德国死亡率进行了比较。为了评估移居者与德国普通人群之间特定原因死亡率的差异，我们计算了标准化死亡率比（SMR）。为了确定死亡率趋势，我们计算了特定原因年龄标准化死亡率，并使用泊松回归和分数多项式进行建模。在观察期间，研究人群积累了近 800,000 人年，观察到 5572 例死亡。移居者的全因死亡率较低（SMR=0.91，95%CI=0.89-0.94），心血管疾病（CVD）死亡率也是如此（SMR=0.82，95%CI=0.79-0.86）。癌症死亡率的结果因癌症部位而异。时间趋势分析表明，移居者和德国普通人群的全因和 CVD 死亡率都随着时间的推移而下降。移居者全因死亡率较低主要归因于 CVD 死亡率较低。癌症部位特异性死亡率的结果不同。死亡率趋同可能表明生活方式行为的适应。然而，本研究中没有关于个体危险因素的数据。
