Background
Legal situation
Coping with disease and access to health care
Health status
Subjective health of undocumented migrants
Methods
Ethics
Sampling, study design and measures
Quantitative study
Qualitative study
Data analysis
Quantitative study
Qualitative study
Results
Quantitative study
Sample description
Sample and comparison groups | n | Mean age in years | % female | Statistical comparison performed |
---|---|---|---|---|
Quantitative study sample of undocumented migrants | 96 | 37 | 72 % | - |
U.S. American norm sample, complete sample [34] | 7069 | 51 | 60 % | T-test of differences in means of 8 dimensions of health, see Fig. 1. |
U.S. American norm sample, subgroup of participants indicating one or more physical disease [34] | 2329 | n. a. | n. a. | T-test of differences in means of subjective physical and mental health summary scores, see text. |
Representative German sample, subgroup of participants indicating having visited a physician for an acute or chronic disease in the past four weeks [39] | 1955 | 51 | 56 % | T-test of differences in means of subjective physical and mental health summary score by age-group and gender, see Table 2. |
Generalized linear regression model, see Table 3. |
Eight dimensions of HRQOL of undocumented migrants
Summary scores for mental and physical HRQOL of undocumented migrants
Summary Scales | Subgroups | Undocumented migrants | German samplea | ||||||
---|---|---|---|---|---|---|---|---|---|
N | M | SD | Mdn | N | M | SD | Mdn | ||
Subjective Physical Health | 20–34 years | 31 | 43.98 | 5.10 | 43.63 | 391 | 47.68 | 8.59 | 49.66 |
35–49 years | 30 | 43.82 | 6.49 | 43.26 | 431 | 44.77 | 10.10 | 47.23 | |
50–64 years | 12 | 39.05 | 6.03 | 40.47 | 590 | 41.12 | 9.95 | 42.37 | |
Men | 23 | 43.76 | 7.02 | 43.28 | 865 | 43.90 | 10.01 | 45.95 | |
Women | 56 | 42.61 | 5.36 | 42.85 | 1090 | 42.39 | 10.45 | 43.73 | |
Total | 79 | 42.95 | 5.87 | 43.07 | 1955 | 43.06 | 10.28 | 44.79 | |
Subjective Mental Health | 20–34 years | 31 | 39.87 | 7.75 | 38.79 | 391 | 50.65 | 8.49 | 52.65 |
35–49 years | 30 | 40.58 | 9.28 | 41.28 | 431 | 50.49 | 9.59 | 53.02 | |
50–64 years | 12 | 40.58 | 10.49 | 39.74 | 590 | 50.92 | 10.21 | 53.96 | |
Men | 23 | 39.67 | 7.96 | 38.79 | 865 | 52.38 | 9.01 | 55.04 | |
Women | 56 | 40.88 | 8.82 | 41.28 | 1090 | 50.16 | 9.84 | 52.62 | |
Total | 79 | 40.52 | 8.55 | 40.19 | 1955 | 51.14 | 9.55 | 53.57 |
Subjective Physical Health | Subjective Mental Health | |||||
---|---|---|---|---|---|---|
Estimate | SD | p-value | Estimate | SD | p-value | |
Constant | 51.94 | .70 | <= .001 | 47.66 | .67 | <= .001 |
Men | 1.21 | .44 | .006 | 2.27 | .42 | <= .001 |
Women | Reference | . | . | Reference | . | . |
Undocumented migrants | −2.22 | .75 | .003 | −9.63 | 1.05 | <= .001 |
German samplea | - | Reference | . | - | . | . |
Age | -.19 | .01 | <= .001 | .05 | .01 | <= .001 |
Qualitative study
Sample description
Key results of qualitative analysis
Case example 1
“So much worries! My ears, I got an infection, blood came out of my ears. From all the stress, from the shock that I got when I needed to move out of the apartment. Look, I got sick because of that. I asked Stefan [a friend who volunteered for the Medibuero]: ‘Please, please, I need to see a doctor.’ After that, I got better, but then I got really, really sick again. It was the fear of the police, that the police would come find me. (…) A friend told me I could come live with her for a while, so I moved all my stuff, imagine, doing all that while being so sick. (…) With my ears, I was so ill, I said to myself, I want to rest, I am sick. If the police come – they come, I don’t care. I’ll go back [to Bolivia]. I couldn’t sleep. It was difficult, you know. I don’t know why I am suffering…so much stress…and with my son [starts crying], I am sick, my ears hurt… Sometimes I don’t know what to do.” (Follow-up interview, 17.10.2012)
“There is no security here. What happens to my son if I get sick again? Who takes care of him? It is too much stress, too much fear.” (Informal conversation, 13.12.2012).
Case example 2
“I was very depressed, it was a bad life. It was tearing me apart. To see your dream shattered means to see yourself shattered.”
“This [living illegally] really pushes you to the limit. It’s an emotional crisis; it’s a state of un-well-being. Bad alimentation, too much work, too much stress, sleeping badly. All of this directly affects the heart.” (Interview notes, 2.8.2009).
Case example 3
Tabea: “The situation [being illegalized] affects me, it even affects my health! Sometimes I stumble into a depression. I can’t even travel; I always have to watch out. (…) I am always scared, I have so much fear. So far, I never ran into a control. Thank God! (…) If I didn’t believe in God, I couldn’t go on here; I wouldn’t be able to bear the situation, right? Because it’s a situation… it’s a shitty situation really.”Interviewer: “And how does that affect your health?”T: “I am very depressed, every time I leave the apartment I say, my God, please protect me. That nothing bad happens to me, because I don’t know what’s going to happen. Because of that, I can’t live in tranquility. So, that [sighs]… that affects my health, because I am always nervous, I always live with this fear that something could happen to me. And I get depressed because I feel trapped, I can’t do anything, everything has to stay secret, I have to lie, when somebody asks me if I have a student visa, or when I met a guy, I can’t tell him the truth because I am scared that he might think something else [that she only wants to be in a relationship to get married and be legalized]… So, I have my limits, I have met people who have lived here illegally for 10 years, and I tell them: How do you live?? Tell me, how do you live?? (…) I have been here for 7 months. I can’t do it, I can’t!! I always have this fear, I always cry, I am not doing well.” (Interview, 6.6.2008)