gms | German Medical Science

50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Cardiovascular mortality among ethnic German immigrants from the Former Soviet Union

Meeting Abstract

  • Ulrich Ronellenfitsch - Universitätsklinikum Heidelberg, Heidelberg
  • Catherine Kyobutungi - Universitätsklinikum Heidelberg, Heidelberg
  • Heiko Becher - Universitätsklinikum Heidelberg, Heidelberg
  • Oliver Razum - Universität Bielefeld, Bielefeld

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds129

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Veröffentlicht: 8. September 2005

© 2005 Ronellenfitsch et al.
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Introduction and research question

Migration is a phenomenon of particular Public Health importance. Migrants frequently differ in their health status from the population in the country they migrate to [1]. Since 1990, almost 2 million ethnic Germans (Aussiedler) have migrated from countries of the former Soviet Union (FSU) to Germany [2]. This study compares their cardiovascular disease (CVD) mortality to that of Germany’s general population. Because of high CVD mortality in the FSU [3] and low socio-economic status (SES) of Aussiedler in Germany [4], we hypothesize that their CVD mortality is higher than that of autochthonous Germans.

Material and methods

We conducted a retrospective cohort study for the period 1990-2002 with data of 34,393 Aussiedler from the FSU who had migrated to North-Rhine Westphalia, Germany’s most populous federal state, and were at least 15 years old upon arrival. Through record linkage procedures at municipal population registries and the state statistical office, we assessed their vital status, and, for deceased persons, causes of death [5]. Using publicly available cause-specific mortality figures for Germany’s entire resident population, we calculated SMRs for the whole cohort and for substrata of sex, age, calendar period, year of arrival, duration of stay in Germany, population size of the first city of residence and family size upon arrival. To assess multivariate effects, we used Poisson regression with the logarithm of expected deaths as offset term.


During follow-up, 242,000 person years were accrued. Vital status was successfully ascertained for 91% of the cohort at the end of follow-up. 680 cohort members (2.0%) died of CVD before December 31, 2002. The SMR for the whole cohort was 0.79 (95%-CI 0.73-0.85). The SMR was higher than one for younger Aussiedler and lower for older ones. There was no appreciable effect of sex, year of arrival and duration of stay on SMRs. For the calendar period 1990-93, SMRs were significantly lower than in subsequent years. In families comprising at least five members upon arrival in Germany, SMRs were significantly lower than in smaller families.


To our knowledge, this study was the first which looked at CVD mortality of the large Aussiedler population in Germany. In contrast to our hypothesis, CVD mortality among Aussiedler was found to be lower than in Germany’s general population. Possible explanations are a substantially better health status of Aussiedler in the FSU as compared to the local average, a higher “subjective” SES [6] of Aussiedler in Germany associated with a mortality advantage or selection effects during the process of migration [7]. SMR differences between substrata, such as age groups or families of different size, need further exploration. CVD risk factor data, which we could not collect in this study, are needed in order to draw valid conclusions on the cardiovascular health status of Aussiedler in Germany.


We thank the Landesaufnahmestelle für Spätaussiedler Nordrhein-Westfalen, the Statistische Landesamt Nordrhein-Westfalen, the Datenschutzbeauftragte Nordrhein-Westfalen and all municipalities involved in our study for their valuable support and collaboration. The study was funded by the Deutsche Forschungsgemeinschaft (German Research Foundation), Graduiertenkolleg 793 “Epidemiology of communicable and chronic non-communicable diseases and their interrelationships”.


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