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Helgesson M, Brendler-Lindqvist M, Johansson B, Nordquist T, Tondel M, Svartengren M. Sustainable Earnings among Immigrants, and the Role of Health Status for Self-Sufficiency: A 10-Year Follow-Up Study of Labour Immigrants and Refugees to Sweden 2000-2006. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:663. [PMID: 36612978 PMCID: PMC9819060 DOI: 10.3390/ijerph20010663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to investigate economic self-sufficiency for immigrants, and how health status affected self-sufficiency. The proportion of self-sufficiency during years 1-10 after receiving a residence permit is presented for all non-European labour immigrants (n = 1259) and refugees (n = 23,859), aged 18-54, who immigrated to Sweden 2000-2006, and compared to a control group of Swedish-born (n = 144,745). The risk of not being self-sufficient in year 10 was analysed with Cox regression models, and the results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). Moreover, the impact on the self-sufficiency of having a diagnosis from specialised health care during the first five years in Sweden was analysed. The results showed that half of the refugees and three-quarters of the labour immigrants were self-sufficient 10 years after residency. The adjusted risk of not being self-sufficient at year 10 was 80% higher among labour immigrants (HR = 1.8; CI = 1.6-2.0) and more than two-fold among refugees (HR = 2.7; CI = 2.6-2.8) compared to the Swedish-born. Having a diagnosis from specialised health care during the first five years in Sweden had an impact on self-sufficiency in all groups; however, the impact of having a diagnosis did not differ between refugees and Swedish-born. Measures must be taken to increase immigrants' work participation.
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Affiliation(s)
- Magnus Helgesson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Maria Brendler-Lindqvist
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Bo Johansson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Tobias Nordquist
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Martin Tondel
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, SE-752 37 Uppsala, Sweden
- Occupational and Environmental Medicine, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
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Barbati A, Geraci A, Niro F, Pezzi L, Sarchiapone M. Do Migration and Acculturation Impact Somatization? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16011. [PMID: 36498084 PMCID: PMC9737361 DOI: 10.3390/ijerph192316011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Somatization is a phenomenon in which the individual experiences physical symptoms attributable to mental projections. It is a widely used term in common parlance to figuratively describe a stressful situation. Syndromes directly related to the mind have been described; pathologies are influenced by somatization. However, the extent of somatization is also related to social and cultural factors. In fact, each culture expresses varying levels of somatization characteristic of the country of origin. A disease can even manifest with different symptoms in different ethnic groups. The migration process arises from the need for change on the part of those who undertake it and culminates in the integration of the person in the host country. This process induces changes in the person of a psychological nature, which also affects somatization. In fact, the most integrated subjects show levels of somatization comparable to those of the host country. These considerations support the thesis that psychological changes are an integral part of health and can affect the development of organic and somatized pathologies.
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Affiliation(s)
- Antonello Barbati
- Department of Medicine and Health Science, University of Molise, 86100 Campobasso, Italy
| | | | - Fabiana Niro
- Department of Pathology, Federico II University of Naples, 80138 Naples, Italy
| | - Letizia Pezzi
- Rehabilitation Unit, ASST Cremona-Ospedale di Cremona, 26100 Cremona, Italy
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, 86100 Campobasso, Italy
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Sim A, Georgiades K. Neighbourhood and family correlates of immigrant children's mental health: a population-based cross-sectional study in Canada. BMC Psychiatry 2022; 22:447. [PMID: 35790945 PMCID: PMC9254422 DOI: 10.1186/s12888-022-04096-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Immigrant children exhibit significant variation in their mental health outcomes despite disproportionate exposure to socio-economic adversity compared to their non-immigrant peers. Identifying aspects of neighbourhood and family contexts that are most salient for immigrant children's mental health can help to inform and target interventions to prevent mental disorder and promote mental well-being among this population. METHODS The study analyzed multi-informant data from 943 first- and second-generation immigrant caregiver and child dyads from the Hamilton Youth Study, a representative sample of immigrant and non-immigrant families in Hamilton, Ontario. Multivariate multilevel regression models examined associations between neighbourhood and family characteristics and processes, and parent and child self reports of internalizing and externalizing problems. RESULTS Positive and negative parenting behaviours were significantly associated with internalizing and externalizing problems, with negative parenting demonstrating associations with externalizing problems across both parent and child reports (b = 0.26-1.27). Neighbourhood social disorder and parental trauma exposure were associated with greater internalizing and externalizing problems, and neighbourhood immigrant concentration was associated with fewer externalizing problems for parent reports only. Adding parental distress and parenting behaviour to the models reduced the coefficients for parental trauma exposure by 37.2% for internalizing problems and 32.5% for externalizing problems and rendered the association with neighbourhood social disorder non-significant. Besides the parenting variables, there were no other significant correlates of child-reported internalizing and externalizing problems. CONCLUSIONS Results highlight the importance of parenting behaviour and parental experiences of trauma and distress for immigrant children's mental health. While not unique to immigrants, the primacy of these processes for immigrant children and families warrants particular attention given the heightened risk of exposure to migration-related adverse experiences that threaten parental and family well-being. To prevent or mitigate downstream effects on child mental health, it is imperative to invest in developing and testing trauma-informed and culturally responsive mental health and parenting interventions for immigrant families.
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Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON, Canada.
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON Canada
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African Refugee Youth's Experiences of Navigating Different Cultures in Canada: A "Push and Pull" Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042063. [PMID: 33672518 PMCID: PMC7923778 DOI: 10.3390/ijerph18042063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Abstract
Refugee youth face challenges in navigating different cultures in destination countries and require better support. However, we know little about the adaptation experiences of African refugee youth in Canada. Accordingly, this paper presents the adaptation experiences of African refugee youth and makes recommendations for ways to support youth. Twenty-eight youth took part in semi-structured interviews. Using a thematic analysis approach, qualitative data revealed four themes of: (1) ‘disruption in the family,’ where youth talked about being separated from their parent(s) and the effect on their adaptation; (2) ‘our cultures are different,’ where youth shared differences between African and mainstream Canadian culture; (3) ‘searching for identity: a cultural struggle,’ where youth narrated their struggles in finding identity; and (4) ‘learning the new culture,’ where youth narrated how they navigate African and Canadian culture. Overall, the youth presented with challenges in adapting to cultures in Canada and highlighted how these struggles were influenced by their migration journey. To promote better settlement and adaptation, youth could benefit from supports and activities that promote cultural awareness with attention to their migration experiences. Service providers could benefit from newcomer-friendly and culturally sensitive training on salient ways of how experiences of multiple cultures affect integration outcomes.
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Fang JQ, Wang YR, Du YY, Yan GL, Ma FL, Liu YQ, Sun WX, Chen SQ, Feng LP, Wei J, Liu H, Hu J, Zhang ZX. Migrant adolescents' behavioral problems compared to host adolescents and adolescents in their region of origin: a longitudinal study. BMC Psychiatry 2020; 20:472. [PMID: 32993575 PMCID: PMC7526236 DOI: 10.1186/s12888-020-02872-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Since the 1990s, families from the ecologically hostile mountainous southern areas of Ningxia Province, China, have been migrating to the northern areas of the province. This study compared the prevalence of behavioral problems among migrant adolescents to those among host adolescents (adolescents from the northern areas) and adolescents in the region of origin (adolescents from the southern areas), to determine whether ecological migration is related to adolescent behavioral problems, and possible changes in such problems over time. METHODS We used the Children and Adolescents Ecological Migration Survey on Mental Health, administered to 4805 students aged 12-16 years and their parents between 2012 and 2014 (W1), of whom 1753 students and their parents completed the follow-up between 2014 and 2017 (W2). Parents answered questions related to adolescent behavioral problems, main source of family income, parents' desire to reverse migrate, improved standard of living, and parents' educational attainment, while children completed the Eysenck Personality Questionnaire and a classroom environment questionnaire. RESULTS The prevalence of behavioral problems among the migrant adolescents (28.04%) was significantly higher than among host adolescents (21.59%) or adolescents in the region of origin (24.37%; p < 0.001) at W1. After adjusting for gender and age, parents' work outside the home was the main source of family income (OR = 1.42, 95% CI = 1.13-1.78), and adolescents' learning burden (OR = 1.04, 95% CI = 1.01-1.06) in school negatively influenced behavioral problems. Strong student-teacher relationships (OR = 0.97,95% CI = 0.94-0.99) and parents who had no intention to move back to the original residence (OR = 0.70, 95% CI = 0.52-0.94) exerted a protective effect at W1; at W2, a protective effect was associated with improved living conditions (OR = 0.39-0.55, 95% CI = 0.25-0.84). The extent of behavioral problems among migrant adolescents significantly decreased after two years. CONCLUSION Ecological migration will increase children's behavioral problems in the early stage, with various factors influencing the extent of these problems.
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Affiliation(s)
- Jian-Qun Fang
- Mental Health Center, The General Hospital of Ningxia Medical University, No. 804 South Shengli Street, Yinchuan, 750004, Ningxia, China.
| | - Yan-rong Wang
- grid.27255.370000 0004 1761 1174School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, 250012 China ,grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Yun-Yun Du
- grid.413385.8Mental Health Center, The General Hospital of Ningxia Medical University, No. 804 South Shengli Street, Yinchuan, 750004 Ningxia China
| | - Guo-Li Yan
- grid.440287.d0000 0004 1764 5550TianJin Anding Hospital, Tianjin Mental Health Institute, Tianjin, 300222 China
| | - Fu-Li Ma
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Yan-Qiu Liu
- Sozhou Guangji Hospital, NO.11, Guangqian Road, Suzhou, 215133 District of Suzhou China
| | - Wen-Xi Sun
- Sozhou Guangji Hospital, NO.11, Guangqian Road, Suzhou, 215133 District of Suzhou China
| | - Shi-Qi Chen
- grid.413385.8Mental Health Center, The General Hospital of Ningxia Medical University, No. 804 South Shengli Street, Yinchuan, 750004 Ningxia China
| | - Li-Ping Feng
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Jia Wei
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Hao Liu
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Jing Hu
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, No.1106 South Shengli Street, Yinchuan, 750004 China
| | - Zhao-Xia Zhang
- grid.413385.8Mental Health Center, The General Hospital of Ningxia Medical University, No. 804 South Shengli Street, Yinchuan, 750004 Ningxia China
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Saunders NR, Gill PJ, Holder L, Vigod S, Kurdyak P, Gandhi S, Guttmann A. Use of the emergency department as a first point of contact for mental health care by immigrant youth in Canada: a population-based study. CMAJ 2019; 190:E1183-E1191. [PMID: 30301742 DOI: 10.1503/cmaj.180277] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Emergency department visits as a first point of contact for people with mental illness may reflect poor access to timely outpatient mental health care. We sought to determine the extent to which immigrants use the emergency department as an entryway into mental health services. METHODS We used linked health and demographic administrative data sets to design a population-based cohort study. We included youth (aged 10-24 yr) with an incident mental health emergency department visit from 2010 to 2014 in Ontario, Canada (n = 118 851). The main outcome measure was an emergency department visit for mental health reasons without prior mental health care from a physician on an outpatient basis. The main predictor of interest was immigrant status (refugee, non-refugee immigrant and non-immigrant). Immigrant-specific predictors included time since migration, and region and country of origin. We used Poisson models to estimate adjusted rate ratios (aRRs) and 95% confidence intervals (CIs). RESULTS The cohort included 2194 (1.8%) refugee, 6680 (5.6%) non-refugee immigrant and 109 977 (92.5%) nonimmigrant youth. Rates of first mental health contact in the emergency department were higher among refugee (61.3%) and non-refugee immigrant youth (57.6%) than non-immigrant youth (51.3%) (refugee aRR 1.17, 95% CI 1.13-1.21; non-refugee immigrant aRR 1.10, 95% CI 1.08-1.13). Compared with non-refugee immigrants, refugees had a higher rate of first mental health contact in the emergency department (aRR 1.06, 95% CI 1.02-1.11). We also observed higher rates among recent versus longer-term immigrants (aRR 1.10, 95% CI 1.05-1.16) and immigrants from Central America (aRR 1.17, 95% CI 1.08-1.26) and Africa (aRR 1.15, 95% CI 1.06-1.24) versus from North America and Western Europe. INTERPRETATION Immigrant youth are more likely to present with a first mental health crisis to the emergency department than non-immigrants, with variability by region of origin and time since migration. Immigrants may face barriers to access and use of outpatient mental health services from a physician. Efforts are needed to reduce stigma and identify mental health problems early, before crisis, among immigrant populations.
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Affiliation(s)
- Natasha Ruth Saunders
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont.
| | - Peter J Gill
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Laura Holder
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Simone Vigod
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Paul Kurdyak
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Sima Gandhi
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Astrid Guttmann
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
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Braga Bezerra C, Martins Borges L, Pereira Cunha M. Filhos das fronteiras: revisão de literatura sobre imigração involuntária, infância e saúde mental. ACTA ACUST UNITED AC 2019. [DOI: 10.21615/cesp.12.2.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Na atualidade há um expressivo contingente de refugiados que deixam suas casas devido a conflitos –guerras, perseguições e violações dos direitos humanos– em busca de novas oportunidades. O Brasil tem se tornado um dos destinos destas pessoas, inclusive recebendo crianças refugiadas. Este estudo objetiva revisar a literatura científica disponível em bases de dados eletrônicas nos últimos treze anos a respeito dos impactos psicológicos da imigração involuntária em crianças. A pesquisa foi realizada em cinco bases de dados (BVS-PSI, Periódicos Capes, Francis, Redalyc e PsycARTICLES), a partir da interseção dos descritores “immigration”, “children” e “mental health”. Selecionou-se 48 artigos para análise, sendo constatada a ausência de publicações nacionais. Os conteúdos abordados nos trabalhos foram agrupados constituindo três categorias, a saber: 1) desafios enfrentados pelas crianças ao chegar ao país de acolhimento, 2) impactos psicológicos do processo migratório forçado na infância e 3) propostas de intervenção na saúde mental dos pequenos refugiados. A partir das informações obtidas, enfatiza-se a elaboração de políticas públicas no contexto brasileiro, sobretudo direcionadas a Atenção Básica com vistas a considerar as singularidades da criança refugiada no seu acolhimento.
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Saunders NR, Lebenbaum M, Lu H, Stukel TA, Urquia ML, Guttmann A. Trends in mental health service utilisation in immigrant youth in Ontario, Canada, 1996-2012: a population-based longitudinal cohort study. BMJ Open 2018; 8:e022647. [PMID: 30224392 PMCID: PMC6144399 DOI: 10.1136/bmjopen-2018-022647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe trends in mental health service use of youth by immigration status and characteristics. DESIGN Population-based longitudinal cohort study from 1996 to 2012 using linked health and administrative datasets. SETTING Ontario, Canada. PARTICIPANTS Youth 10-24 years, living in Ontario, Canada. EXPOSURE The main exposure was immigration status (recent immigrants vs long-term residents). Secondary exposures were region of origin and refugee status. MAIN OUTCOME MEASURE Mental health hospitalisations, emergency department (ED) visits and outpatient visits within consecutive 3-year time periods. Poisson regression models estimated rate ratios (RR). RESULTS Over 2.5 million person years per period were included. Rates of recent immigrant mental health service utilisation were at least 40% lower than long-term residents (p<0.0001).Mental health hospitalisation and ED visit rates increased in long-term residents (hospitalisations, RR 1.09 (95% CI 1.08 to 1.09); ED visits, RR 1.15 (1.14 to 1.15)) and recent immigrants (hospitalisations RR 1.05 (1.03 to 1.07); ED visits, RR 1.08 (1.05 to 1.11)). Mental health outpatient visit rates increased in long-term residents (RR 1.03 (1.03 to 1.03)) but declined in recent immigrant (RR 0.94 (0.93 to 0.95)). Comparable divergent trends in acute care and outpatient service use were observed among refugees and across most regions of origin. Recent immigrant acute care use was driven by longer-term refugees (hospitalisations RR 1.12 (1.03 to 1.21); ED visits RR 1.11 (1.02 to 1.20)). CONCLUSIONS Mental health service utilisation was lower among recent immigrants than long-term residents. While acute care use is increasing at a faster rate among long-term residents than recent immigrants, the decrease in outpatient mental health visits in immigrants highlights a potential emerging disparity in access to preventative care.
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Affiliation(s)
- Natasha Ruth Saunders
- Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Michael Lebenbaum
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Hong Lu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Therese A Stukel
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
| | - Marcelo Luis Urquia
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Astrid Guttmann
- Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada
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Emerson SD, Mâsse LC, Ark TK, Schonert-Reichl KA, Guhn M. A population-based analysis of life satisfaction and social support among children of diverse backgrounds in British Columbia, Canada. Qual Life Res 2018; 27:2595-2607. [PMID: 29926346 DOI: 10.1007/s11136-018-1922-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE The Satisfaction With Life Scale adapted for Children (SWLS-C) is a self-report measure of children's quality of life and has exhibited sound psychometric properties. In light of increasing ethno-cultural diversity, it is important to understand child life satisfaction across diverse subgroups. Employing children's language background as a proxy for cultural background among children in British Columbia, Canada, we examined (a) the cross-cultural measurement equivalence of the SWLS-C; and (b) cross-cultural relations of peer support and adult support with SWLS-C. METHODS Participants were 20,119 children (Mage 9.2; 50.2% boys) who provided data as part of a self-report child health survey (the Middle-years Development Instrument). Measurement equivalence across eight language/cultural background groups was tested via multi-group confirmatory factor analysis. Multi-level analyses were used to compare: a) SWLS-C means; and b) associations of peer support and adult support with SWLS-C scores, by language/cultural background. RESULTS Findings supported strict measurement equivalence between the English language/cultural background group and all other language/cultural background groups for the SWLS-C. Relative to the English language background group, SWLS-C means differed for several language/cultural background groups. Within every language/cultural background group, however, peer and adult support scale scores were significant positive correlates of SWLS-C scores. CONCLUSIONS This study provided evidence for measurement equivalence of a life satisfaction measure across children from diverse language/cultural backgrounds and identified between-group differences in the level of child life satisfaction that were generally consistent with prior theory and findings. Moreover, results provided evidence of promotive associations of adult support and peer support with life satisfaction among diverse groups of children.
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Affiliation(s)
- Scott D Emerson
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Tavinder K Ark
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kimberly A Schonert-Reichl
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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George MA, Bassani C. Influence of Perceived Racial Discrimination on the Health of Immigrant Children in Canada. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2018; 19:527-540. [PMID: 30996694 PMCID: PMC6434967 DOI: 10.1007/s12134-018-0539-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Racial discrimination and racism are recognized as determinants of health for adults. Less is understood regarding the influence of discrimination targeted towards parents, the family, or the cultural and children's health. Data from the New Canadian Children and Youth Study (NCCYS) are used in this paper. The NCCYS is a national, longitudinal study of children whose families settled in urban centers of Canada. We analyzed data from individuals who settled in the metropolitan Vancouver area from six ethnic communities: Mainland China, Hong Kong, the Philippines, Iran, Afghanistan, and the Punjab who were interviewed at two times, approximately 2 years apart. Data were collected on perceived parental, family, and cultural discrimination. Our dependent variable was parent-reported child health status. Over time, perceived parental discrimination and perceived family discrimination decreased; and both forms of discrimination had a positive effect on child health. In contrast, perceived cultural discrimination increased over time and had a negative effect on child health at both times. Different forms of discrimination have different effects on child health. Racial discrimination is complex. Its influence on either increasing family cohesion, and thereby leading to improved health, or increasing stress, thereby leading to poorer health needs to be explored further.
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Affiliation(s)
- M. Anne George
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia Canada
- BC Children’s Hospital Research Institute, Vancouver, British Columbia Canada
- School of Population & Public Health, University of British Columbia, Vancouver, British Columbia Canada
| | - Cherylynn Bassani
- Sociology, Kwantlen Polytechnic University, Surrey, British Columbia Canada
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Beiser M, Hou F. Predictors of positive mental health among refugees: Results from Canada's General Social Survey. Transcult Psychiatry 2017; 54:675-695. [PMID: 28854860 DOI: 10.1177/1363461517724985] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Do refugees have lower levels of positive mental health than other migrants? If so, to what extent is this attributable to post-migration experiences, including discrimination? How does gender affect the relationships between post-migration experience and positive mental health? To address these questions, the current study uses data from Statistics Canada's 2013 General Social Survey (GSS), a nationally representative household study that included 27,695 Canadians 15 years of age and older. The study compares self-reported positive mental health among 651 refugees, 309 economic immigrants, and 448 family class immigrants from 50 source countries. Immigration-related predictors of mental health were examined including sociodemographic characteristics, discrimination, acculturation variables, and experiences of reception. Separate analyses were carried out for women and men. Refugees had lower levels of positive mental health than other migrants. Affiliative feelings towards the source country jeopardized refugee, but not immigrant mental health. A sense of belonging to Canada was a significant predictor of mental health. Perceived discrimination explained refugee mental health disadvantage among men, but not women. Bridging social networks were a mental health asset, particularly for women. The implications of anti-refugee discrimination net of the effects of anti-immigrant and anti-visible minority antipathies are discussed, as well as possible reasons for gender differences in the salience of mental health predictors.
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Alonso-Fernández N, Jiménez-García R, Alonso-Fernández L, Hernández-Barrera V, Palacios-Ceña D. Mental Health and Quality of Life Among Spanish-born and Immigrant Children in Years 2006 and 2012. J Pediatr Nurs 2017; 36:103-110. [PMID: 28888489 DOI: 10.1016/j.pedn.2017.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 05/09/2017] [Accepted: 05/13/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND One of every five children and adolescents in the European Union suffers from behavioural, and emotional disturbances. OBJECTIVES To compare factors associated with the quality of life and mental health of immigrant and Spanish children aged 4-14years both during the years 2006 and 2012 and to evaluate changes over this time period. DESIGN AND METHODS An epidemiologic age and sex matched case-control study (1:2) was conducted. The study group were 677 immigrant children and 1354 matched Spanish children (controls). This study was conducted using data obtained from the Spanish National Health Surveys done in 2006 and 2012. We used the Strengths and Difficulties Questionnaire to obtain the score for variables derived from mental health and the Kidscreen-10 questionnaire to score the Health-Related Quality of Life. RESULTS Spanish girls scored higher in conduct problems (2.04±0.1) and better in problems with peers (1.21±0.08) regarding immigrant girls (1.82±0.12-1.92±0.13 respectively). Concerning total scores, immigrant children obtained significantly lower scores in quality of life (81.29±0.76) and in problems with peers (2.04±0.09) than their matched Spanish children (84.4±0.45 and 1.26±0.06) in 2006. Immigrant children had lower total scores in prosocial behaviour (8.62±0.11) compared to the matched Spanish children (8.92±0.06) in 2012. The total average scores of immigrant children in terms of quality of life, emotional symptoms, behavioural problems, hyperactivity and problems with peers were significantly better in 2012 (86.58; 1.84; 1.46; 3.77 and 1.48 respectively) than in 2006 (81.29; 2.15; 1.90; 4.58 and2.04). CONCLUSIONS Immigrant children had a poorer quality of life and mental health than matched Spanish children in 2006.
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Affiliation(s)
- Nazaret Alonso-Fernández
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Rodrigo Jiménez-García
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Leticia Alonso-Fernández
- Department of Medicine and Surgery, Psychology, Preventive Medicine and Public Health and Immunology, and Medical Microbiology, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Valentín Hernández-Barrera
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Domingo Palacios-Ceña
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain.
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Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada. J Nerv Ment Dis 2016; 204:464-70. [PMID: 27101023 DOI: 10.1097/nmd.0000000000000516] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.
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