Health Determinants among Refugees and the Impact of Differences in Access to Health Service: A Propensity-Matched Comparative Study for Syrian, Afghan and Iraqi Refugees in Germany and Austria

Daniela Georges , Universität Rostock
Isabella Buber-Ennser, Wittgenstein Centre (IIASA, VID/ÖAW, WU)
Bernhard Rengs, Wittgenstein Centre (IIASA, VID/ÖAW, WU)
Judith Kohlenberger, Wittgenstein Centre (IIASA, VID/ÖAW, WU)
Gabriele Doblhammer, University of Rostock

Germany and Austria have been important receivers of asylum seekers and refugees (AS&R) in Europe in recent years. Nonetheless, relatively little is known about the characteristics and situation of these migrant populations. This study analyzes the health situation and health determinants of refugees in Germany and Austria in comparative perspective. It is hypothesized that different health policies in both countries contribute to health differences. Germany and Austria provide health care to refugees in different ways: only in Austria, refugees have unrestricted access to health services upon arrival. To evaluate a potential impact of health policies on health outcomes, we analyzed comparable survey data from both countries for Syrian, Afghan and Iraqi nationals aged 18 to 59 years who had immigrated between 2013 and 2016 (Germany: n=2,854; Austria: n=374). Refugees in Germany (72%) reported significantly less often (very) good health than their peers in Austria (89%). Compositional differences in terms of age, sex, nationality, education and partnership situation between Germany and Austria only partly contribute to this difference. Applying Propensity Score Matching to adjust for structural differences and to assess non-confounded country effects, the probability of reporting (very) good health is still 12 percentage points lower in Germany than in Austria (95% CI: 0.04; 0.20). Our results point to a negative impact of initially restricted health access on health assessments, which is discussed in the context of unobserved heterogeneity and selectivity as well as country-specific societal, normative and legal circumstances.

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 Presented in Session 86. Health and Wellbeing of Migrants