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Objective: Ethnic minorities in the Netherlands experience worse (mental) health than Dutch natives. So far, socioeconomic factors, discrimination, and the migration process have been identified as underlying factors, neglecting the potential role of health-related behaviours. This study investigates the mediating effect of lack of physical activity, smoking and alcohol consumption on ethnic inequalities in (mental) health in the Netherlands. Design: Data from a municipal health survey (2012) in the four largest cities in the Netherlands, including 15,633 Dutch natives, 1,297 Surinamese, 850 Turks and 779 Moroccans were analysed. Mediation analyses were performed on the associations between ethnicity and psychological distress (range 10-50) and self-rated health (range 1-5). Results: Being from an ethnic minority was associated with higher distress and poorer self-rated health, especially for Turks (higher distress 4.69, 95%CI 4.22-5.16; poorer health 0.35, 95%CI 0.30-0.40). Moroccans and Turks were the least physically active, Turks smoked the most, and Dutch natives drank the most. Lack of physical activity partially mediated the association between Turks (6% respectively 11%) and Moroccans (13% respectively 9%) for psychological distress and self-rated health. Smoking played a mediating role (3%) in Turks. Conclusion: Lower physical activity and smoking more cigarettes partly explained ethnic health inequalities in the Netherlands. The current findings suggest that intervening and facilitating certain ethnic groups in engaging in health behaviours could contribute to improving their health and reduce ethnic health inequalities. [ABSTRACT FROM AUTHOR]

To investigate to what extent differences in prevalence and types of mental health problems between ethnic minority and majority youth can be explained by social disadvantage. Mental health problems were assessed in a sample of 1,278 schoolchildren (55 % Dutch, 32 % Moroccan and 13 % Turkish; mean age: 12.9 ± 1.8) using the Strengths and Difficulties Questionnaire self-report and teacher report. Measures of family socioeconomic status, neighbourhood deprivation, perceived discrimination, family structure, repeating a school year, housing stability and neighbourhood urbanization were used as indicators of social disadvantage, based on which a cumulative index was created. Ethnic minority youth had more externalizing and fewer internalizing problems than majority youth. Perceived discrimination and living in an unstable social environment were associated with mental health problems, independent of ethnicity. A dose-response relationship was found between social disadvantage and mental health problems. The adjusted odds ratio for mental health problems was 4.16 (95 % CI 2.49-6.94) for more than four compared with zero indicators of social disadvantage. Social disadvantage was more common in ethnic minority than in majority youth, explaining part of the differences in prevalence of mental health problems. Ethnic minority youth in the Netherlands have a different profile of mental health problems than majority youth. In all ethnic groups, the risk of mental health problems increases with the degree of social disadvantage. The higher prevalence of externalizing problems among ethnic minority youth is explained partly by their disadvantaged social position. The findings suggest that social factors associated with ethnicity are likely to explain mental health problems in ethnic groups. [ABSTRACT FROM AUTHOR]