Publicatie datum

Acculturation and the use of health care services in The Netherlands.

Foets, M., Uiters, E.H., Devillé, W., Groenewegen, P.P. Acculturation and the use of health care services in The Netherlands. European Journal of Public Health: 2005, 15(suppl. 1) 51. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: The purpose of this study was to examine to what extent ethnic differences in health
care utilisation can be explained by differences in acculturation. The basic premise driving our
analyses is the expectation that health care use becomes more similar to the indigenous population
as minority groups become more acculturated. Our study aimed to include acculturation, in a very
broad sense. We therefore did not only include traditional indicators of acculturation such as
length of residence and generational status. We also took into consideration proficiency in Dutch
language, social interaction with and participation in the new country, and a scale measuring the
degree of acquisition of Western cultural values and norms. Methods: * Health interview surveys in
NIVEL’s Dutch National Survey of General Practice-2 (2001). * 12 699 indigenous and 1339 ethnic
minorities from Turkey, Morocco, Surinam and the Netherlands Antilles were interviewed. *
Independent variables: ethnic background and indicators of acculturation. * Control variables:
socio-demographic variables and health status. * Outcome variables: use of health care services (GP
services and specialist care) and (non) prescription drug use. * Considering possible clustering on
GP level, multilevel analyses were performed. Results: Contrary to our expectation, ethnic
differences in health care use do not diminish as the level of acculturation increases. Preliminary
results showed that first generation migrants see their GP more often than the indigenous population
(B ¼ 0.47, se 0.09, P < 0.01), whereas second generation migrants contacted medical specialists more
often (B ¼ 1.20, se ¼ 0.21, P < 0.01). No relation is found between the use of prescription
medication and the indicators of acculturation included in this study. Conclusions: Our study showed
that the relationship between ethnic background and health care use still holds even when
differences in acculturation are taken into account. The most important indicator of acculturation
in the explanation of differences in health care use was generational status. (aut.ref.)