Uptake of vaccinations and health examinations among refugee children compared to Danish-born children - a register based cohort study

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Fältnamn	Indikatorer	Metadata
000		04025naa a2200337 4500
001		oai:DiVA.org:su-110382
003		SwePub
008		141212s2014 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-1103822 URI
024	7	a https://doi.org/10.1093/eurpub/cku163.0242 DOI
040		a (SwePub)su
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Möller, Sanne P.4 aut
245	1 0	a Uptake of vaccinations and health examinations among refugee children compared to Danish-born children - a register based cohort study
264		c 2014-10-24
264	1	b Oxford University Press (OUP),c 2014
338		a print2 rdacarrier
520		a BackgroundIn Denmark, vaccinations recommended for children include among others vaccinations against diphteria, tetanus, pertussis and polio (DTwP) and measles, mumps and rubella (MMR). Children are also offered seven child health examinations (CHE). Both are important to prevent illness and to ensure early detection of developmental progblems. It is crucial that both services are utilized by all families regardless of their socioeconomic position, ethnic background or migrant status. However, there is a paucity of studies on uptake among the potentially vulnerable group of refugees.MethodsThe study population consisted of all refugee children arriving to Denmark between 1993 and 2010, and Danish-born children matched 1:6 on age and sex to the refugee children. Those included in the study had to be eligible for vaccination or CHE, i.e. have the recommended age for an investigated outcome during the observation period, which was January 1993 - May 2012. These criteria were met by 17,701 refugees and 106,206 Danish-born children. Information on vaccinations and CHE's from the Danish National Health Service Register was used to compare uptake among the two groups. Information on refugee status, duration of residence, region of origin and equivalised family income was used to examine predictors of uptake among refugee children. Analyses were made using a Cox regression model.ResultsFor all unadjusted vaccination outcomes refugee children had lower uptake than Danish-born children. However, after adjusting for income only the DTwP remained significant (HR = 0.61; 95%CI: 0.58-0.63). All results for the CHE's remained significant after adjustment for income, with the biggest difference observed for the last CHE at age 5 (HR = 0.48; 95%CI:0.47-0.50). Both refugee status, duration of residence, region of origin and equivalised family income were identified as predictors of uptake among refugee children.ConclusionThe findings that refugee children do not have the same uptake of the investigated services as Danish-born children, suggest that refugees face barriers in the Danish health care system, and that newly arrived families are especially vulnerable. This indicates a need for improvements in the information on health services for newly arrived families.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi0 (SwePub)303022 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Public Health, Global Health, Social Medicine and Epidemiology0 (SwePub)303022 hsv//eng
700	1	a Andersen, A-M N.4 aut
700	1	a Hjern, Andersu Stockholms universitet,Centrum för forskning om ojämlikhet i hälsa (CHESS)4 aut0 (Swepub:su)ahjer
700	1	a Nörredam, M.4 aut
710	2	a Stockholms universitetb Centrum för forskning om ojämlikhet i hälsa (CHESS)4 org
773	0	t European Journal of Public Healthd : Oxford University Press (OUP)g 24:S2, s. 165-166q 24:S2<165-166x 1101-1262x 1464-360X
856	4	u https://academic.oup.com/eurpub/article-pdf/24/suppl_2/cku163-024/9124413/cku163.024.pdf
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-110382
856	4 8	u https://doi.org/10.1093/eurpub/cku163.024

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Av författaren/redakt...: Möller, Sanne P.; Andersen, A-M N.; Hjern, Anders; Nörredam, M.

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