Abstract
Objectives
We assessed the association between acculturation and health-related quality of life (HRQoL) among persons with a Turkish migrant background in Germany.
Methods
1226 adults of Turkish origin were recruited in four German cities. Acculturation was assessed using the Frankfurt Acculturation Scale resulting in four groups (integration, assimilation, separation and marginalization). Short Form-8 physical and mental components were used to assess the HRQoL. Associations were analysed with linear regression models.
Results
Of the respondents, 20% were classified as integrated, 29% assimilated, 29% separated and 19% as marginalized. Separation was associated with poorer physical and mental health (linear regression coefficient (RC) = −2.3, 95% CI −3.9 to −0.8 and RC = −2.4, 95% CI −4.4 to −0.5, respectively; reference: integration). Marginalization was associated with poorer mental health in descendants of migrants (RC = −6.4, 95% CI −12.0 to −0.8; reference: integration).
Conclusions
Separation and marginalization are associated with a poorer HRQoL. Policies should support the integration of migrants, and health promotion interventions should target separated and marginalized migrants to improve their HRQoL.
References
Alegria M et al (2008) Prevalence of mental illness in immigrant and non-immigrant U.S. Latino groups. Am J Psychiatry 165(3):359–369. doi:10.1176/appi.ajp.2007.07040704
Avis NE, Colvin A (2007) Disentangling cultural issues in quality of life data. Menopause 14(4):708–716. doi:10.1097/gme.0b013e318030c32b
Bade KJ (1992) Deutsche im Ausland—Fremde in Deutschland: migration in Geschichte und Gegenwart. Beck, München
Berry JW (1980) Acculturation as varieties of adaptation. In: Padilla AM (ed) Acculturation: theory, models, and some new findings. Westview, Boulder, pp 9–25
Berry JW (2005) Acculturation: living successfully in two cultures. Int J Intercult Rel 29(6):697–712
Bongard S, Pogge SF, Arslaner H, Rohrmann S, Hodapp V (2002) Acculturation and cardiovascular reactivity of second-generation Turkish migrants in Germany. J Psychosom Res 53(3):795–803
Brzoska P, Voigtlander S, Spallek J, Razum O (2010) Utilization and effectiveness of medical rehabilitation in foreign nationals residing in Germany. Eur J Epidemiol 25(9):651–660. doi:10.1007/s10654-010-9468-y
Brzoska P et al (2015) Reviewing the topic of migration and health as a new national health target for Germany. Int J Public Health 60(1):13–20. doi:10.1007/s00038-014-0617-z
Dempster AP, Laird NM, Rubin DB (1977) Maximum likelihood from incomplete data via the EM algorithm. J R Stat Soc B 39(1):1–38
Ellert U, Lampert T, Ravens-Sieberer U (2005) Measuring health-related quality of life with the SF-8. Normal sample of the German population. Bundesgesundheitsbl 48(12):1330–1337. doi:10.1007/s00103-005-1168-5
Esser H (2009) Pluralization or assimilation? Effects of multiple inclusion on the integration of immigrants. Zeitschrift für Soziologie 38(5):358–378
Galobardes B, Shaw M, Lawlor DA, Lynch JW, Davey Smith G (2006) Indicators of socioeconomic position (part 2). J Epidemiol Community Health 60(2):95–101. doi:10.1136/jech.2004.028092
Gordon M (1964) Assimilation in American life. Oxford University Press, New York
Guarnaccia PJ, Hausmann-Stabile C (2016) Acculturation and its discontents: A case for bringing anthropology back into the conversation. Sociol Anthropol 4(2):114–124. doi:10.13189/sa.2016.040209
Hunt LM, Schneider S, Comer B (2004) Should “acculturation” be a variable in health research? A critical review of research on US Hispanics. Soc Sci Med 59(5):973–986. doi:10.1016/j.socscimed.2003.12.009
IOM, WHO, United Nations Human Rights (2013) International migration, health and human rights. International Organization of Migration, Geneva
Jang Y, Chiriboga DA (2010) Living in a different world: acculturative stress among Korean American elders. J Gerontol B 65B(1):14–21. doi:10.1093/geronb/gbp019
Kim J, Ashing-Giwa KT, Kagawa Singer M, Tejero JS (2006) Breast cancer among Asian Americans: is acculturation related to health-related quality of life? Oncol Nurs Forum 33(6):E90–E99. doi:10.1188/06.onf.e90-e99
Lampert T, Kroll L, Muters S, Stolzenberg H (2013) Measurement of socioeconomic status in the German Health interview and examination survey for adults (DEGS1). Bundesgesundheitsbl 56(5–6):631–636. doi:10.1007/s00103-012-1663-4
Lorenzo-Blanco EI, Cortina LM (2013) Latino/a depression and smoking: an analysis through the lenses of culture, gender, and ethnicity. Am J Community Psychol 51(3–4):332–346. doi:10.1007/s10464-012-9553-3
Morawa E, Erim Y (2014) Acculturation and depressive symptoms among Turkish immigrants in Germany. Int J Environ Res Public Health 11(9):9503–9521. doi:10.3390/ijerph110909503
Ranganathan M, Bhopal R (2006) Exclusion and inclusion of nonwhite ethnic minority groups in 72 North American and European cardiovascular cohort studies. PLoS Med 3(3):e44. doi:10.1371/journal.pmed.0030044
Reiss K, Makarova N, Spallek J, Zeeb H, Razum O (2013) Identification and sampling of people with migration background for epidemiological studies in Germany. Gesundheitswesen 75(6):e49–e58. doi:10.1055/s-0032-1321768
Reiss K et al (2014) Comparing sampling strategies to recruit migrants for an epidemiological study. Results from a German feasibility study. Eur J Public Health 24(5):721–726. doi:10.1093/eurpub/cku046
Reiss K, Breckenkamp J, Borde T, Brenne S, David M, Razum O (2015) Smoking during pregnancy among Turkish immigrants in Germany-are there associations with acculturation? Nicotine Tob Res 17(6):643–652. doi:10.1093/ntr/ntu237
Rudmin F (2003) Critical history of the acculturation psychology of assimilation, separation, integration, and marginalization. Rev Gen Psychol 7(3):3–37
Rudmin F (2009) Constructs, measurements and models of acculturation and acculturative stress. Int J Intercult Rel 33(2):106–123. doi:10.1016/j.ijintrel.2008.12.001
Rumbaut RG (2008) Reaping what you sow: immigration, youth, and reactive ethnicity. Appl Dev Sci 12(2):108–111. doi:10.1080/10888690801997341
Schwartz SJ, Unger JB, Zamboanga BL, Szapocznik J (2010) Rethinking the concept of acculturation: implications for theory and research. Am Psychol 65(4):237–251. doi:10.1037/a0019330
Spallek J, Zeeb H, Razum O (2011) What do we have to know from migrants’ past exposures to understand their health status? a life course approach. Emerg Themes Epidemiol 8(1):6. doi:10.1186/1742-7622-8-6
Statistisches Bundesamt (2015) Bevölkerung und Erwerbstätigkeit. Bevölkerung mit MIgrationshintergrund. Statistisches Bundesamt, Wiesbaden
Viruell-Fuentes EA, Miranda PY, Abdulrahim S (2012) More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med 75(12):2099–2106. doi:10.1016/j.socscimed.2011.12.037
Ware J, Kosinski M, Dewey J, Gandek B (2001) How to score and interpret single-item health status measures: A manual for users of the SF-8 health survey. QualyMetric, Lincoln
WHO (1997) WHOQOL—measuring quality of life. WHO, Geneva
Yang YM, Wang HH (2011) Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan. J Transcult Nurs 22(4):405–413. doi:10.1177/1043659611414144
Yoon E, Lee DY, Koo YR, Yoo S-K (2010) A qualitative investigation of Korean immigrant women’s lives. Couns Psychol 38(4):523–553. doi:10.1177/0011000009346993
Yoon E et al (2013) A meta-analysis of acculturation/enculturation and mental health. J Couns Psychol 60(1):15–30. doi:10.1037/a0030652
Acknowledgements
This study was part of the feasibility studies in preparation for the German National Cohort and was funded by the Federal Ministry of Education and Research (German: Bundesministerium für Bildung und Forschung) under Grant Number: 01ER1001B; Beneficiary: Freiburg University.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This study was approved by the respective ethical committees of all four recruitment centres.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Brand, T., Samkange-Zeeb, F., Ellert, U. et al. Acculturation and health-related quality of life: results from the German National Cohort migrant feasibility study. Int J Public Health 62, 521–529 (2017). https://doi.org/10.1007/s00038-017-0957-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-017-0957-6