In 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.
The 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.
For 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.
The 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.
2014. Vol. 24, no S2, 165-166 p.