However, the validity of this single-item question in subjects wi

However, the validity of this single-item question in subjects with different cultural backgrounds has been questioned (Agyemang et al. 2006). Differences in self-concepts between ethnic groups may influence the results of the single item general health question. The observation that after adjusting for the well-established socio-demographic selleck determinants of health inequalities, still systematic differences in occurrence of poor health in ethnic groups relative to the Dutch group were observed may indicate over-estimation of poor health. In the current

study similar conclusions on unemployed, ethnicity, and health were drawn when using the single question on perceived general health question and the other 35 questions on physical and mental health dimensions of the SNX-5422 clinical trial SF-36. This corroborates the opinion that the general health question provides a good summery of the mental and physical health in migrant groups and the indigenous population. This finding is, of course, also supported by the high correlations

between perceived general health and all health dimensions in the SF-36. A high proportion of persons with a poor health among ethnic groups has been observed in various studies in different countries (Bos et al. 2004; Chandola 2001; Smith et al. 2000; Nazroo 2003; Sundquist 1995). Different explanations have been put forward. A Swedish study among immigrants from Poland, Turkey, and Iran found that acculturation (defined by the knowledge of the Swedish language) was an important mediator in the pathway between ethnicity and poor health (Wiking et al. 2004). Indeed, in our study population differences in mastering the Dutch language may have influenced health. For Surinamese Cediranib (AZD2171) and Antilleans Dutch is usually a first or second language, whereas for Turks and Moroccans knowledge

of the Dutch language is often limited or absent, especially among older women. Language problems may hamper effective communication with physicians and also inhibit access to information on health and health care (Uniken Venema et al. 1995). In the current study, mastery of the Dutch language was not RAD001 included in the analyses, but the observation that the health status of homemakers with a Turkish or Moroccan background was worse than the health status of homemakers with another ethnic background may reflect a lower acculturation. Differences in migration experiences may also contribute to the differences in health between the ethnic minority groups. Refugees have a different migration history than Turks, Moroccans, Surinamese, and Antilleans. For refugees, experiences of violence, the flight to asylum and forced broken social networks may have affected health (Sundquist 1995).

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