Medication use in migrant and non-migrant populations in the Northern part of the Netherlands

In 2018, 23.1% of the Dutch population had a migration background [1], of which half was a first-generation migrant, i.e. was born in another country than the Netherlands, and the other half concerned second generation migrants. According to the Dutch CBS, this might even increase to one third of the population by 2060 [2]. Almost half of the migrant population has a non-western background [3]. In 2015, most people migrated to the Netherlands for family reunion (CBS, 2015). Other stated reasons for migration to the Netherlands were employment, study, and asylum [3].

Social, economic, genetic, and cultural factors influence the health and health practices of migrants both before departure from their country of origin and after arrival to their destination [4], which is also likely for the migrant population in the Netherlands. Migrants are at risk for different communicable and non-communicable diseases as compared to the host population [5]. These differences in health might lead to migrants opting for, or needing, different kinds of medication.

Globally, the use of antibiotics has increased considerably over the last years [6]. Overuse and misuse are directly related to resistance of bacteria to these antibiotics [7]. This development of resistance to antibiotics is a global problem [8] and has multiple adverse consequences. Among these are higher morbidity and higher health care costs for societies, and possibly higher rates of mortality [9]. Globally, there are large differences in the quantity and type of antibiotics used [10], also reflected in differences in antibiotic consumption between countries in Europe. The Netherlands has one of the lowest rates of antibiotic consumption in Europe [11]. In the migrant population, a different demand for antibiotics based on experiences in their country of origin combined with a different epidemiology of infectious diseases, may lead to an increased consumption of antibiotics, although currently there is limited data to test this hypothesis. This leads to our first research question. We set out to determine if there is a difference in antibiotic use between the migrant and non-migrant populations in the Netherlands. Furthermore, we would like to further investigate this possible association by different risk factors for antibiotic use and time of residence in the Netherlands.