title: Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London.
abstract: OBJECTIVE
  There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants.
  
  
  METHODS
  This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used.
  
  
  RESULTS
  Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants.
  
  
  CONCLUSIONS
  The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.
authors.affiliation: Department of Family Medicine, Pamukkale University Faculty of Medicine, Denizli 20200, Turkey. ktopal9@yahoo.com
authors.forename: Kenan
authors.initials: K
authors.lastname: Topal
authors.forename: Erhan
authors.initials: E
authors.lastname: Eser
authors.forename: Ismail
authors.initials: I
authors.lastname: Sanberk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bayliss
authors.forename: Esra
authors.initials: E
authors.lastname: Saatci
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008131:London; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014421:Turkey / Q000208:ethnology; D006113:United Kingdom; D014505:Urban Population; D055815:Young Adult