title: Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study.
abstract: BACKGROUND
  Social environment and health status are related, and changes affecting social relations may also affect the general health state of a group. During the past few years, several events have affected the relationships between Muslim immigrants and the non-immigrant population in many countries. This study investigates whether the health status of the Moroccan and Turkish immigrants in the Netherlands has changed in four years, whether changes in health status have had any influence on primary health care use, and which socio-demographic factors might explain this relationship.
  
  
  METHODS
  A cohort of 108 Turkish and 102 Moroccan respondents were interviewed in 2001 and in 2005. The questionnaire included the SF-36 and the GP contact frequency (in the past two months). Interviews were conducted in the language preferred by the respondents. Data were analysed using multivariate linear regression.
  
  
  RESULTS
  The mental health of the Moroccan group improved between 2001 and 2005. Physical health remained unchanged for both groups. The number of GP contacts decreased with half a contact/2 months among the Turkish group. Significant predictors of physical health change were: age, educational level. For mental health change, these were: ethnicity, age, civil status, work situation in 2001, change in work situation. For change in GP contacts: ethnicity, age and change in mental and physical health.
  
  
  CONCLUSIONS
  Changes in health status concerned the mental health component. Changes in health status were paired with changes in health care utilization. Among the Turkish group, an unexpected decrease in GP contacts was noticed, whilst showing a generally unchanged health status. Further research taking perceived quality of care into account might help shedding some light on this outcome.
authors.affiliation: NIVEL (Netherlands Institute for health services Research), Utrecht, The Netherlands. m.lamkaddem@nivel.nl
authors.forename: Majda
authors.initials: M
authors.lastname: Lamkaddem
authors.forename: Peter M
authors.initials: PM
authors.lastname: Spreeuwenberg
authors.forename: Walter L
authors.initials: WL
authors.lastname: Devillé
authors.forename: Marleen
authors.initials: M
authors.lastname: Foets
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004641:Emigration and Immigration; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008603:Mental Health; D009018:Morocco / Q000208:ethnology; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data / Q000639:trends*; D014421:Turkey / Q000208:ethnology