Migration, acculturation and utilization of primary health care.

This study explored the roles of acculturation, urban-rural provenance and length of residence as determinants of the utilization pattern of first line health services by Moroccan, Turkish and Italian migrants in Belgium. Concurrently, utilization characteristics were recorded in Belgian reference patients. With increasing acculturation the demand for preventive care decreased, vague complaints became more prevalent, the delay before consulting for a curative problem shortened and the prognosis improved. There was no correlation between the occurrence of psychological problems and acculturation but, except for 15-44 year old female migrants, the rate of social problems was negatively associated with this study factor. Migrants with an urban background consulted earlier and presented more frequently vague complaints than migrants from rural provenance. We observed no significant influence of length of residence on utilization characteristics and only a marginal influence on morbidity pattern. Although acculturation seems to be a strong determinant of the migrant's utilization pattern of primary health care services, it does not consistently lead to a decrease of utilization differentials with the Belgian reference population. This may imply that there is a need for public health interventions targeted at ethnic minorities.