Mortality and causes of death among asylum seekers in the Netherlands, 2002–2005

• Published in: Journal of epidemiology and community health (1979) 2011-04, Vol.65 (4), p.376-383
• Main Authors: van Oostrum, I E A, Goosen, S, Uitenbroek, D G, Koppenaal, H, Stronks, K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Africa - ethnology; Age; Age groups; Aged; Asia - ethnology; Asylum seekers; Biological and medical sciences; Cardiovascular diseases; Cause of Death - trends; Causes of death; Censuses; Child; Child, Preschool; Chronic diseases; Chronic illnesses; Classification; Community health; Community health care; Congenital defects; Death; Epidemiology; Female; Females; General aspects; Health risks; Health services; Humans; Infant; infectious DI; Infectious diseases; Male; Maternal mortality; Medical sciences; Middle Aged; migrants; migration & health; Miscellaneous; Mortality; Mortality - trends; mortality SI; Netherlands - epidemiology; preventive health services; preventive medicine; Public health. Hygiene; Public health. Hygiene-occupational medicine; Refugees; Regions; reproductive health; Research reports; Risk factors; Subpopulations; Young Adult
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.2009.087064

BackgroundThe world's growing population of asylum seekers faces different health risks from the populations of their host countries because of risk factors before and after migration. There is a current lack of insight into their health status.MethodsA unique notification system was designed to monitor mortality in Dutch asylum seeker centres (2002–2005).ResultsStandardised for age and sex, overall mortality among asylum seekers shows no difference from the Dutch population. However, it differs between subpopulations by sex, age and region of origin and by cause of death. Mortality among asylum seekers is higher than among the Dutch reference population at younger ages and lower at ages above 40. The most common causes of death among asylum seekers are cancer, cardiovascular diseases and external causes. Increased mortality was found from infectious diseases (males, standardised mortality ratio (SMR)=5.44 (95% CI 3.22 to 8.59); females, SMR=7.53 (95% CI 4.22 to 12.43)), external causes (males, SMR=1.95 (95% CI 0.52 to 2.46); females SMR=1.60 (95% CI 0.87 to 2.68)) and congenital anomalies in females (SMR 2.42; 95% CI 1.16 to 4.45). Considerable differences were found between regions of origin. Maternal mortality was increased (rate ratio 10.08; 95% CI 8.02 to 12.83) as a result of deaths among African women.ConclusionCertain subgroups of asylum seekers (classified by age, sex and region of origin) are at increased risk of certain causes of death compared with the host population. Policies and services for asylum seekers should address both causes for which asylum seekers are at increased risk and causes with large absolute mortality, taking into account differences between subgroups.