Perceptions of risk and preventative strategies with respect to cardiovascular diseases in people of Turkish migrant background in Germany: findings of a pilot study

Abstract

Cardiovascular diseases (CVDs) constitute one of the fastest-growing categories of disease in Germany, including among people with a background of migration. Although a growing number of epidemiological studies attempt to explain the course of migrants’ health, the extent to which cultural factors affect individual patients’ perception of and strategies for prevention of CVD (as a primary deterrent) remains clearly understudied. This pilot study describes the results of a qualitative research project based on content analysis that explores Turkish migrants’ understanding and perception of health and disease prevention and the degree to which they take advantage of health-related social services as they pertain to CVD. An important objective of the study was to explore the relationship between interviewees’ cultural background and their perceptions of health and prevention. Findings are first that despite an awareness of healthy living and disease prevention, formal healthcare is avoided unless acute illness/pain is experienced, and second that cultural factors are complex when it comes to perceptions and acceptance of disease prevention strategies. Avenues for much needed further qualitative research are outlined.

Keywords:

• ethnicity
• illness
• health promotion

Acknowledgements

The project has been funded by the core research group on vascular prevention at the University Medical Center at the Johannes Gutenberg-University Mainz. We wish to express deep gratitude to the women and men in this study for sharing their experiences. We also like to thank Ilhan Ilkilic, Sheriban Ababa, and Anika Mitzkat for their help at various stages of this research, and Camilla Blakeley for language editing.

Notes

1. Current research suggests that the CVD risk factors of obesity and diabetes are becoming more common within Turkish migrant groups in Europe than they are within the Western European population as whole (Ujcic-Voortman et al. 2012).

2. For a critical introduction to the multitude of positions on culture and to the application and breadth of the concepts involved, see Breidenbach and Nyíri (2009).

3. MAIFOR study, funded by Medical Centre at the Johannes Gutenberg University Mainz 2008–2009 (lead: Antje Kampf), subsequently published as Wolf (2010).

4. Approval for the research was obtained from the Ethics Commission of the Rhineland-Palatinate State Medical Association (No. 837.117.11 [7659]). The German Federal Statistical Office defines people with a migrant background as those who have migrated since 1949 to the area of today’s Federal Republic of Germany and all those who were born in Germany but have at least one parent with a foreign passport. The migration status of a person is defined by his or her migration, residency, and parents (Statistisches Bundesamt 2009, 6). An extensive discussion of the many diverse definitions and implications of the term migration in the German context goes beyond the scope of this paper, but see Knipper and Bilgin (2009).

5. Current research into individual behavioral prevention of CVD suggests that gender- and socio-specific differences might play a decisive role in the efficiency of preventative strategies (Wolf 2010). For a useful introduction to migration, health, and gender, see Borde (2010, 41–51).

6. At least one study has suggested that cultural implications can cut both ways: research suggests that culture has an impact on the increase of overweight children with a migration background (Ünal 2011).

7. Nevertheless, representative data on the participation rates of adult immigrants in screening programs are lacking in Germany.