International Journal of Public Health

, Volume 62, Issue 5, pp 521–529 | Cite as

Acculturation and health-related quality of life: results from the German National Cohort migrant feasibility study

  • Tilman Brand
  • Florence Samkange-Zeeb
  • Ute Ellert
  • Thomas Keil
  • Lilian Krist
  • Nico Dragano
  • Karl-Heinz Jöckel
  • Oliver Razum
  • Katharina Reiss
  • Karin Halina Greiser
  • Heiko Zimmermann
  • Heiko Becher
  • Hajo Zeeb
Original Article



We assessed the association between acculturation and health-related quality of life (HRQoL) among persons with a Turkish migrant background in Germany.


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.


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).


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.


Health-related quality of life Immigrants Acculturation Turkey Germany 



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.

Compliance with ethical standards

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.

Supplementary material

38_2017_957_MOESM1_ESM.pdf (68 kb)
Supplementary material 1 (PDF 67 KB)


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Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Tilman Brand
    • 1
  • Florence Samkange-Zeeb
    • 1
  • Ute Ellert
    • 2
  • Thomas Keil
    • 3
  • Lilian Krist
    • 3
  • Nico Dragano
    • 4
  • Karl-Heinz Jöckel
    • 5
  • Oliver Razum
    • 6
  • Katharina Reiss
    • 6
    • 7
  • Karin Halina Greiser
    • 8
  • Heiko Zimmermann
    • 9
  • Heiko Becher
    • 10
  • Hajo Zeeb
    • 1
    • 11
  1. 1.Department of Prevention and EvaluationLeibniz Institute for Prevention Research and Epidemiology—BIPSBremenGermany
  2. 2.Robert Koch InstituteBerlinGermany
  3. 3.Institute of Social Medicine, Epidemiology and Health EconomicsCharité UniversitätsmedizinBerlinGermany
  4. 4.Institute for Medical Sociology, Centre for Health and Society, Medical FacultyUniversity of DuesseldorfDuesseldorfGermany
  5. 5.Institute for Medical Informatics, Biometry and Epidemiology (IMIBE)University Hospital EssenEssenGermany
  6. 6.Department of Epidemiology and International Public Health, Bielefeld School of Public Health (BiSPH)Bielefeld UniversityBielefeldGermany
  7. 7.AID Information Service: Food, Agriculture, Consumer ProtectionBonnGermany
  8. 8.German Cancer Research Center (DKFZ)HeidelbergGermany
  9. 9.Institute of Public HealthUniversity Hospital HeidelbergHeidelbergGermany
  10. 10.Institute of Medical Biometry and EpidemiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  11. 11.Health Sciences BremenUniversity of BremenBremenGermany

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