Der Nervenarzt

, Volume 90, Issue 11, pp 1103–1108 | Cite as

Armut, Migration und psychische Gesundheit

  • Ulrike KlugeEmail author
  • Michael A. Rapp
  • Nassim Mehran
  • Jinan Jumaa
  • Marion Christina Aichberger


Armut und soziale Ausgrenzung stehen in engem Zusammenhang mit psychischer Belastung und einem erhöhten Erkrankungsrisiko. Im Jahr 2018 waren rund 19 % der deutschen Bevölkerung von Armut und damit verbundener sozialer Ausgrenzung bedroht. Insbesondere Migrantengruppen zeigen häufig eine besondere Mehrfachbelastung durch sozioökonomische Belastungsfaktoren. Es konnte vielfach gezeigt werden, dass sich u. a. gesellschaftlicher Ausschluss, unsichere Lebensbedingungen und das Wohnumfeld auf psychische Belastungen auswirken, die nicht ausschließlich durch Prämigrationsfaktoren zu erklären sind. Im folgenden Beitrag werden Zusammenhänge zwischen psychischer Gesundheit und Armut sowie damit verbundenen Konstrukten, wie sozialer Kohäsion, sozialem Kapital und sozialer Ausgrenzung, in der Gesamtgesellschaft sowie in besonderen Risikogruppen, wie Geflüchtetenpopulationen, diskutiert.


Soziales Kapital Soziale Kohäsion Migration Ausgrenzung Wohnumfeld 

Poverty, migration and mental health


Poverty and social exclusion are closely related to an increased risk for the deterioration of mental health. In 2018 approximately 19% of the German population were threatened by poverty and the associated social ostracization. Migrant groups in particular often show an increased risk for poverty and are often exposed to multiple socioeconomic stress factors depending on the context of migration, pre-migration and post-migration social factors. Numerous studies have shown that societal exclusion, precarious living conditions and the residential environment negatively affect mental health beyond the effects of pre-migration risk factors. This article provides a review and discussion on the relationship between mental health, poverty and related constructs, such as social cohesion, social capital and social exclusion in general as well as in specific risk groups, such as migrant and refugee populations.


Social capital Social cohesion Migration Exclusion Residential environment 


Einhaltung ethischer Richtlinien


U. Kluge, M.A. Rapp, N. Mehran, J. Jumaa und M.C. Aichberger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.


  1. 1.
    Aichberger MC, Bromand Z, Heredia Montesinos A, Temur-Erman S, Mundt A, Heinz A, Rapp MA, Schouler-Ocak M (2012) Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin. Eur Psychiatry 27(Suppl 2):10–16Google Scholar
  2. 2.
    Aichberger MC, Bromand Z, Rapp MA, Yesil R, Heredia Montesinos A, Temur-Erman S, Heinz A, Schouler-Ocak M (2015) Perceived ethnic discrimination, acculturation, and psychological distress in women of Turkish origin in Germany. Soc Psychiatry Psychiatr Epidemiol 50:1691–1700PubMedGoogle Scholar
  3. 3.
    Aichberger MC, Thöle A‑M, Romero B, Schreiter S, Panneck P, Hoyer A, Heinz A, Sutej I, Kluge U (2019) Newly arrived refugees in a low threshold psychiatric facility: living conditions and mental suffering (submitted)Google Scholar
  4. 4.
    Almedom AM (2005) Social capital and mental health: an interdisciplinary review of primary evidence. Soc Sci Med 61:943–964PubMedGoogle Scholar
  5. 5.
    Artazcoz L, Benach J, Borrell C, Cortès I (2004) Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am J Public Health 94:82–88PubMedPubMedCentralGoogle Scholar
  6. 6.
    Berg AO, Melle I, Rossberg JI, Romm KL, Larsson S, Lagerberg TV, Andreassen OA, Hauff E (2011) Perceived discrimination is associated with severity of positive and depression/anxiety symptoms in immigrants with psychosis: a cross-sectional study. BMC Psychiatry 11:77PubMedPubMedCentralGoogle Scholar
  7. 7.
    Bertossi Urzua CB, Ruiz MA, Pajak A, Kozela M, Kiubinova R, Malyutina S, Peasey A, Pikhart H, Marmot M, Bobak M (2019) The prospective relationship between social cohesion and depressive symptoms among older adults from Central and Eastern Europe. J Epidemiol Community Health 73:117–122PubMedGoogle Scholar
  8. 8.
    Bogic M, Njoku A, Priebe S (2015) Long-term mental health of war-refugees: a systematic literature review. BMC Int Health Hum Rights 15:29. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Cantor-Graae E, Selten JP (2005) Schizophrenia and migration: a meta-analysis and review. Am J Psychiatry 162:12–24PubMedGoogle Scholar
  10. 10.
    Chu T, Keller AS, Rasmussen A (2013) Effects of post-migration factors on PTSD outcomes among immigrant survivors of political violence. J Immigr Minor Health 15:890–897PubMedGoogle Scholar
  11. 11.
    De Silva MJ, McKenzie K, Harpham T, Huttly SR (2005) Social capital and mental illness: a systematic review. J Community Health 59:619–627Google Scholar
  12. 12.
    DESTATIS (2019) Wirtschaftsrechnungen. Leben in Europa (EU‐SILC). Einkommen und Lebensbedingungen in Deutschland und der Europäischen UnionGoogle Scholar
  13. 13.
    Dohrenwend BP, Levav I, Shrout PE, Schwartz S, Naveh G, Link BG, Skodol AE, Stueve A (1992) Socioeconomic status and psychiatric disorders: the causation-selection issue. Science 255:946–952PubMedGoogle Scholar
  14. 14.
    Fitzsimons E, Goodman A, Kelly E, Smith JP (2017) Poverty dynamics and parental mental health: determinants of childhood mental health in the UK. Soc Sci Med 175:43–51PubMedGoogle Scholar
  15. 15.
    Fone D, Greene G, Farewell D, White J, Kelly M, Dunstan F (2013) Common mental disorders, neighbourhood income inequality and income deprivation: a small-area multilevel analysis. Br J Psychiatry 202:286–293PubMedPubMedCentralGoogle Scholar
  16. 16.
    Fone D, White J, Farewell D, Kelly M, John G, Lloyd K, Williams G, Dunstan F (2014) Effect of neighbourhood deprivation and social cohesion on mental health inequlity: a multilevel population-based longitudinal study. Psychol Med 44:2449–2460PubMedGoogle Scholar
  17. 17.
    Fryers T, Melzer D, Jenkins R (2003) Social inequalities and teh common mental disorders. Soc Psychiatry Psychiatr Epidemiol 38:229–237PubMedGoogle Scholar
  18. 18.
    Fryers T, Melzer D, Jenkins R, Brugha T (2005) The distribution of the common mental disorders: social inequalities in Europe. Clin Pract Epidemiol Ment Health 1:14PubMedPubMedCentralGoogle Scholar
  19. 19.
    Galea S, Ahern J, Nandi A, Tracy M, Beard J, Vlahov D (2007) Urban neighborhood poverty and the incidence of depression in a population-based cohort study. Ann Epidemiol 17:171–179PubMedPubMedCentralGoogle Scholar
  20. 20.
    Häfner H (1974) Der Einfluß von Umweltfaktoren auf die seelische Gesundheit. Psychopathology 7:199–225Google Scholar
  21. 21.
    Heeren M, Wittmann L, Ehlert U, Schnyder U, Maier T, Müller J (2014) Psychopathology and resident status—comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents. Compr Psychiatry 55:818–825PubMedGoogle Scholar
  22. 22.
    Heinz A, Deserno L, Reininghaus U (2013) Urbanicity, social adversity and psychosis. World Psychiatry 12:187–197PubMedPubMedCentralGoogle Scholar
  23. 23.
    Johansson SE, Sundquist J (1997) Unemployment is an important risk factor for suicide in contemporary Sweden: an 11-year follow-up study of a cross-sectional sample of 37,789 people. Public Health 111:41–45PubMedGoogle Scholar
  24. 24.
    Kessler RC (1982) A disaggregation of the relationship between socioeconomic status and psychological distress. Am Sociol Rev 47:752–764PubMedGoogle Scholar
  25. 25.
    Krieger N (1999) Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. Int J Health Serv 29:295–352PubMedGoogle Scholar
  26. 26.
    Lamkaddem M, Essink-Bot M‑L, Devillé W, Gerritsen A, Stronks K (2015) Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. Eur J Public Health 25:917–922PubMedGoogle Scholar
  27. 27.
    Laurence J (2011) The effect of ethnic diversity and community disadvantage on social cohesion: a multi-level analysis of social capital and Interethnic relations in UK communities. Eur Sociol Rev 27:70–89Google Scholar
  28. 28.
    Leary MR, Cottrell CA (2013) Evolutonary perspectives on interpersonal acceptance and rejection. In: De Wall CN (Hrsg) The oxford handbook of social exclusion. Oxford University Press, New YorkGoogle Scholar
  29. 29.
    Lelkes O (2007) European centre for social welfare policy and research. Policy brief april 2007: poverty among migrants in europe. Zugegriffen: 10. Jan. 2011Google Scholar
  30. 30.
    Lochner K, Kawachi I, Kennedy BP (1999) Social capital: a guide to its measurement. Health Place 5:259–270Google Scholar
  31. 31.
    Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M (2003) Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157:98–112PubMedGoogle Scholar
  32. 32.
    Ludwig J, Duncan GJ, Gennetian LA, Katz LF, Kessler RC, Kling JR, Sanbonmatsu L (2012) Neighborhood effects on the long-term well-being of low-income adults. Science 337:1505–1510PubMedPubMedCentralGoogle Scholar
  33. 33.
    Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, Swatz L, Patel V (2010) Poverty and common mental disorders in low and middle income countries: a systematic review. Soc Sci Med 71:517–528PubMedPubMedCentralGoogle Scholar
  34. 34.
    Lund C, Cois A (2018) Simultaneous social causation and social drift: longitudinal analysis of depression and poverty in South Africa. J Affect Disord 229:396–402PubMedGoogle Scholar
  35. 35.
    Marmot MG, Rose G, Shipley M, Hamilton PJS (1978) Employment grade and coronary heart disease in British civil servants. J Epidemiol Community Health 32:244–249PubMedPubMedCentralGoogle Scholar
  36. 36.
    Marmot MG, Stansfeld S, Patel C, North F, Head J, White I, Brunner E, Feeney A, Marmot M, Smith GD (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337:1387–1393PubMedGoogle Scholar
  37. 37.
    Massey DS, Eggers LM (1990) The ecology of inequality: minorities and the concentration of poverty, 1970–1980. Am J Sociol 95:1153–1188Google Scholar
  38. 38.
    Murali V, Oyebode F (2004) Poverty, social inequality and mental health. Adv Psychiatr Treat 10:216–224Google Scholar
  39. 39.
    Myer L, Stein DJ, Grimsrud A, Seedat S, Williams DR (2008) Social determinants of psychological distress in a nationally-representative sample of South African adults. Soc Sci Med 66:1828–1840PubMedPubMedCentralGoogle Scholar
  40. 40.
    Pascoe EA, Smart Richman L (2009) Perceived discrimination and health: a meta-analytic review. Psychol Bull 135:531–554PubMedPubMedCentralGoogle Scholar
  41. 41.
    Patel V, Kleinman A (2003) Poverty and common mental disorders in developing countries. Bull World Health Organ 81:609–615PubMedPubMedCentralGoogle Scholar
  42. 42.
    Putnam RD (2007) E pluribus unum: diversity and community in the twenty-first century. The 2006 Johan Skytte prize lecture. Scand Pol Studs 30(2):137–174Google Scholar
  43. 43.
    Rapp MA, Kluge U, Penka S, Vardar A, Aichberger MC, Mundt AP, Schouler-Ocak M, Mösko M, Butler J, Meyer-Lindenberg A, Heinz A (2015) When local poverty is more important than your income: mental health in minorities in inner cities. World Psychiatry 14:249–250PubMedPubMedCentralGoogle Scholar
  44. 44.
    Reijneveld SA, Schene AH (1998) Higher prevalence of mental disorders in socioeconomically deprived urban areas in The Netherlands: community or personal disadvantage? J Epidemiol Community Health 52:2–7PubMedPubMedCentralGoogle Scholar
  45. 45.
    Ryan L, Sales R, Tilki M, Siara B (2008) Social networks, social support and social capital: the experiences of recent polish migrants in London. Sociology 42(4):672–690Google Scholar
  46. 46.
    Stafford M, DeSilva M, Stansfeld S, Marmot M (2008a) Neighbourhood social capital and common mental disorder: testing the link in a general population sample. Health Place 14:394–405PubMedGoogle Scholar
  47. 47.
    Stafford M, Gimeno D, Marmot MG (2008b) Neighbourhood characteristics and trajectories of health functioning: a multilevel prospective analysis. Eur J Public Health 18:604–610PubMedPubMedCentralGoogle Scholar
  48. 48.
    Statistisches Bundesamt (2007) DESTATIS, 2007. Bevölkerung und Erwerbstätigkeit. Bevölkerung mit Migrationshintergrund – Ergebnisse des Mikrozensus 2005Google Scholar
  49. 49.
    United Nations Population Fund (2012) State of world population 2012. By choice, not by chance: family planning, human rights and development. United Nations Population Fund, New YorkGoogle Scholar
  50. 50.
    Vardar A, Kluge U, Penka S (2012) How to express mental health problems: Turkish immigrants in Berlin compared to native Germans in Berlin and Turks in Istanbul. Eur Psychiatry 27:50–55Google Scholar
  51. 51.
    Williams DR, Williams-Morris R (2000) Racism and mental health: the African American experience. Ethn Health 5:243–268PubMedGoogle Scholar
  52. 52.
    Wollesen B, Bischoff L, Stehr G, Niessen J (2016) „Auswirkungen der Armut auf die Gesundheit von Senioren im Bezirk Altona“ Zentrale Ergebnisse des 2. Altonaer Gesundheitsberichts. Das Gesundheitswes 78:505–509Google Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Ulrike Kluge
    • 1
    • 2
    Email author
  • Michael A. Rapp
    • 3
  • Nassim Mehran
    • 4
  • Jinan Jumaa
    • 4
  • Marion Christina Aichberger
    • 1
    • 2
  1. 1.Klinik für Psychiatrie und PsychotherapieCharité Universitätsmedizin Berlin, Campus MitteBerlinDeutschland
  2. 2.Berliner Institut für empirische Integrations- und Migrationsforschung (BIM)Humboldt Universität zu BerlinBerlinDeutschland
  3. 3.Sozial- und Präventivmedizin, Strukturbereich Kognitionswissenschaften, Department Sport- und GesundheitswissenschaftenUniversität PotsdamPotsdamDeutschland
  4. 4.Klinik für Psychiatrie und Psychotherapie, Charité Campus MitteCharité Universitätsmedizin BerlinBerlinDeutschland

Personalised recommendations