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Changes in self-reported health status and health care use of Moroccan and Turkish migrants in The Netherlands 2001-2005.

Lamkaddem, M., Devillé, W., Groenewegen, P.P., Foets, M. Changes in self-reported health status and health care use of Moroccan and Turkish migrants in The Netherlands 2001-2005. European Journal of Public Health: 2006, 16(Suppl. 1) 189. Abstract. 14 th Eupha conference "Politics, Policies and /or the Public's Health", Montreux, 16-18 November 2006.
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Background: Several events took place in the past 5 years that affected the relationships between what is commonly seen as the Muslim immigrant groups and the non-immigrant population in The Netherlands. Previous studies suggest a relationship between social environment and health status, implying that changes affecting the social relations may also affect the general health state of a group. This study investigates whether the health status of the Moroccan and Turkish in The Netherlands changed in the past 4 years, if supposed changes in health status had an influence on health care use, and whether this hypothesized relationship is being mediated by sociodemographic factors. Methods: A cohort of 108 Turkish and 102 Moroccan respondents were interviewed in 2001 and in 2005, in the language of their choice. The questionnaire included among others translations of the Short Form Health Survey-36 (SF-36) and several items on health care use (self-report on contact frequency with the GP, use of outpatient specialist care, prescription medication, and use of psychosocial care). Socio-demographic characteristics such as age, gender, ethnicity, and educational level were also recorded. Data were analysed by logistic and linear regressions. Results: The mean score on the mental health component of the SF-36 improved significantly among the Moroccan group (P = 0.022). Improvement in mental health was negatively associated with a decrease in frequency of contact with the GP for the Moroccan (R=-0.469) and for the Turkish (R=-0.227), and it was also the case for improvements in physical health (Moroccan R= -0.553 ; Turkish R= -0.327). Controlling for other sociodemographic characteristics, predictors of an increase in the use of GP care were as follows: a decrease in mental health scores (Beta= -0.0233, P= 0.009), a decrease in physical health scores (Beta =-0.261, P = 0.003), and Moroccan versus Turkish (Beta=0.185, P = 0.012). Conclusions: Mental health of Moroccans improved during the past 5 years despite the recent pressure on the relationships between immigrants and the Dutch population. Differences between ethnic groups can be found in the changes of health status, but also in the way changes in health status predict changes in health care use. The reasons for these differences need to be investigated, taking the cultural and access components into account. (aut. ref.)