[Health Literacy of People with Former Soviet Union and Turkish Migration Background in Germany]. / Gesundheitskompetenz von Personen mit ex-sowjetischem und türkischem Migrationshintergrund in Deutschland.

AIM: So far, there are hardly any data on the health literacy of persons with a migration background in Germany. The aim of the article was to analyse the health literacy of this population group - particularly persons who originate in Turkey and the former Soviet Union (FSU). METHODOLOGY: In summer 2020, face-to-face interviews with 525 persons with FSU and 512 persons with Turkish migration background above the age of 18 were carried out across Germany. The interviews were conducted in German, Russian or Turkish. Health literacy was assessed using the internationally developed HLS19-Q47 instrument. Bivariate and multivariate analyses were carried out for each immigration group separately considering demographic, socioeconomic, linguistic and migration-specific variables. RESULTS: Overall, around half of the respondents had low health literacy, with no differences between the immigration groups. In both groups, low educational levels, socioeconomic disadvantages, limited German literacy skills, older age, multiple chronic illnesses and personal experience of immigration were linked with lower health literacy. In multivariate analyses, associations between health literacy and literacy skills, social status, financial deprivation, and chronic illness remained; however, after adjustment, no significant difference persisted by immigration generation. CONCLUSION: While a significant proportion of persons with Turkish or FSU migration background in Germany have difficulty dealing with health information, compared with existing studies, they do not have a lower health literacy than the population without a migration background. People with a migration background are therefore not to be regarded as vulnerable to low health literacy in general. Particularly socioeconomically disadvantaged subgroups display low health literacy. Interventions should therefore target these subgroups specifically and consider their living conditions. In addition, people with low literacy skills and German proficiency have greater difficulties in processing health information. This highlights the need for multilingual information, but also for multimedia materials in plain language. Structural measures are necessary for a health-literate health system and for reducing health inequalities.

Children's awareness of ethnic outgroup symbols: Piloting a task in the Republic of Ireland.

Exploring children's awareness of social categories could uncover the foundation of intergroup attitudes and behaviours. Indigenous to Ireland, Travellers are an ethnic minority marked by a tradition of nomadism, only formally recognised as a distinct ethnic group in 2017. This brief report analyses data from 148 children aged 6-12 (55% female) in the Republic of Ireland. A quantitative task was adapted and applied to assess children's awareness of symbols associated with the Traveller community. We found that primary school children could accurately categorise the symbols which relied on perceptually obvious markers of Traveller identity, and that this remained stable across middle childhood. However, children did not correctly categorise symbols related to less observable elements (e.g., language, trade, religion). To the best of our knowledge, these findings are the first to identify specific symbols which are salient in children's awareness about this marginalised group. Implications for school-based interventions are discussed.

COVID-19 booster prioritization in the West Bank: a survey experiment among Bedouins, refugees, and the majority group.

Introduction: Our main aim is to understand to what extent Bedouins, internally displaced Palestinians (refugees) and majority-group members (non-refugees, non-Bedouins, settled) in the West Bank prioritize COVID-19 booster shots for their own group over other groups. Methods: We conducted a survey experiment (face-to-face) among 678 Palestinians living in the West Bank. Participants randomly received a description of an older man (Bedouin, refugee, settled) and were asked to indicate to what extent this person should be prioritized for the booster shot. Respondents belonging to a minority saw the profile of an in-group member or a majority-group member, whereas majority-group members would see the profile of an in-group or one out-group member (Bedouin, Palestinian refugee). Results: We found slightly higher in-group preferences for Palestinian refugees when it came to vaccination, whereas majority-group members were less inclined to support a prioritization of Palestinian refugees but equally prioritized their group and Bedouins. For Bedouins, we did not find strong in-group preferences. Discussion: Our study reveals the salience of group boundaries during the COVID-19 pandemic with potentially adverse effects on the health care of minorities.

Differences in health literacy domains among migrants and their descendants in Germany.

Background: Health literacy (HL) is considered to be an important precondition for health. HL research often identifies migrants as vulnerable for low HL. However, in-depth data on HL among migrants especially in its domains of health care, disease prevention and health promotion and its determinants are still scarce. Objective: The aim of this study was therefore to analyse the current status of HL among migrants and their descendants from Turkey and from the former Soviet Union (FSU) in Germany and factors associated with it. This has not been studied using large-scale data and bilingual interviews. We differentiate between dimensions of HL, namely the domains of health care, disease prevention and health promotion which goes beyond many previous studies. In addition, we explore new mechanisms by testing the explanatory power of self-efficacy and interethnic contacts for migrants' HL. Methods: The study includes 825 first- and second-generation adult migrants from two of the largest immigration groups in Germany, from Turkey and FSU, who were interviewed face-to-face in German, Turkish or Russian in late summer 2020. HL was measured using the HLS19-Q47 instrument. Age, gender, educational level, social status and financial deprivation, chronic illness, health-related literacy skills, self-efficacy, interethnic contacts, migration generation, duration of stay and region of origin were considered as possible determinants. Ordinary least square regressions were estimated. Results: The average general HL score was 65.5. HL in health promotion and disease prevention was lower than in health care. Low financial deprivation, health-related literacy skills, and self-efficacy were positively correlated with each HL domain. Educational level, social status, age, gender, duration of stay and interethnic contacts were positively correlated with HL in some domains. Region of origin was only correlated with the domain of disease prevention until interethnic contact was accounted for. Conclusion: Our study contributes to the existing knowledge by analyzing different domains of HL and testing its correlations with self-efficacy and interethnic contact among migrants. We reveal that migrants cannot generally be considered as vulnerable for low HL, as oftentimes outlined. There is a need for interventions e.g. to enhance the understanding of health information among subgroups with lower HL.

Natives' and Immigrants' Gender Preferences for Children in Germany.

Little research has been conducted yet investigating gender preferences among immigrant parents in Western host countries. We add further empirical evidence to this sparse literature by analyzing pooled micro-census data for the years 2005-2013 from Germany. Next to updating earlier findings on the native population, we assess parental gender preferences in two large and culturally distinct groups of immigrants in Germany, namely those with Turkish and Polish origins. Our analysis indicates both daughter and son preferences in contemporary Germany and supports the notion of potentially changing gender preferences within ethnic groups over time as well as continuous differences between ethnic groups of natives and immigrants in Western societies. Whereas the observed differences between natives and immigrants suggest incomplete cultural assimilation with regard to gender- and family-related attitudes and values, they barely contribute to explaining differential fertility behaviors, as effects sizes tend to be fairly similar across groups.