SEO for Health Industry

It's deffinitely because English market is more competitive, I would recommend focusing on hyper-local SEO, optimizing for local search terms, using Google My Business effectively, and asking patiens to leave reviews, this will be very efficient for SEO

In English, specially, there's a huge competition and mostly paid advertising is done in English which is responsible for the huge competition. But the competition is relative less and there are quite a rare of SEOs in German, so due to less competition they gain quick rankings.

The Health Industry is a competitive niche and also needs higher authority of site to compete with the other competitors. E-EAT framework of google is also responsible for ensuring only reputed and genuine sites ranked on SERP. People also need to understand the YMYL (Your Money Your Life) websites

Search engines prioritize localized content, making it easier for German-language pages to rank. User preferences for content in their native language and proper multilingual SEO implementation also play significant roles in these differences.

well now days too much competition in almost all categories.

More than likely due more competition within the english market.

Collified,

It may also have something to do with how these sites are structured for the different languages. You may get different results depending on the site TLD and how you have the subfolders setup for the different languages.

Do the pages have the correct Lang tags in place?

Also, there are some adjustments you might be able to make to inform Google about the different variations of the page. Here's a helpful guide directly from Google Search Central that may give you some things to look for:

Tell Google about localized versions of your page

You may already have the language settings correct for these pages, but this is something definitely to look into.

You could also compare the search results between the languages, and see if there is a significant difference in backlinks to any of these pages. I imagine it is easier to get backlinks to English pages than German or Turkish ones, just due to the sheer volume of English pages to link from.

One thing you can try, if you haven't already, is to perform a site specific search for the English keywords, then internally link from #2-#6 most relevant pages back to the #1 page. Then see if that page increases in rank for that English keyword/city combination.

All the best,
Jack Duncan

the E market higher competition compared to German

Ranking in the German market might be easier due to less competition or more niche-specific queries compared to English markets, where the volume of content and competition is higher. German users might have more localized search intent, making it simpler to target specific keywords effectively.

It might be because there is more competition for English keywords, even in local markets. More businesses target English, so it can be harder to rank. In German, there could be fewer competitors, making it easier to rank.

It's all about competition.

German keywords face less competition and are often part of a more localized market, which can make ranking easier.

For English rankings, focus on targeting highly localized keywords and building internal/external links that improve relevance and authority for the region you're targeting​.