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Aim: Analysis of barriers regarding the attendance of the health care system under consideration of cultural- and migrationrelated factors. Method: Cross-sectional survey with immigrants from Turkey (n=77), Spain (n=67), Italy (n=95) and German resettlers from the former Soviet Union (n=196), recruited on migration and addiction services of the German Caritasverband, the Arbeiterwohlfahrt and migrant organizations. Results: Spanish and Italian immigrants mainly search for help in their families and social environment. Immigrants from the former Soviet Union use home remedies and experience more linguistic difficulties as barriers for the use of health services, just like Turkish immigrants. Turkish immigrants reported feeling misunderstood regarding their cultural peculiarities by the expert staff as another main barrier. Other major influence factors were German language proficiency and the subjective wellbeing in Germany. Conclusion: The consideration of cultural-related as well as linguistic factors in health care services is an essential contribution for improving health care of immigrants. [Copyright &y& Elsevier]