Racial variations in major depressive disorder onset among immigrant populations in the United States

Nepalese migrants in Japan: What is holding them back in getting access to healthcare?

Introduction

Migrants are one of the most deprived and vulnerable groups who receive the least health services in the society. Only a few studies have been conducted on access to healthcare among migrants in Asia, despite hosting 75 million migrants. In Japan, Nepalese migrants constitute the largest South Asian community. Their number increased by three folds from 2011 to 2016. However, little is known about their access to health care in Japan. Based on Andersen's model, we examined the factors associated with access to healthcare among Nepalese migrants in Japan.

Methods

We conducted a cross-sectional study among 642 Nepalese migrants residing in 10 prefectures of Japan. We used multivariable logistic regression model to explore the key predisposing, enabling, and need factors associated with access to healthcare among the migrants.

Results

The migrants who had stayed in Japan longer were more likely to perceive better access to a doctor/health worker (AOR = 1.11, 95% CI 1.03–1.19).The migrants were more likely to perceive better access to a doctor/health worker (AOR = 1.79, 95% CI 1.17–2.73) when they did not need Japanese language interpreter during visit to health facilities. They were also less likely not to see a doctor/health worker when needed (AOR = 0.34, 95% CI 0.21–0.56). The migrants were less likely to perceive better access to a doctor/health worker when they had not paid the health insurance premium regularly (AOR = 0.21, 95% CI 0.13–0.33).Their low perception of better access to a doctor/health worker was also associated with self-rated health status as poor or fair (AOR = 0.60, 95% CI 0.41–0.89).

Conclusion

Nepalese migrants have poor access to health care in Japan. The key factors associated with their access to health care are the length of stay (predisposing factor), Japanese language skill and health insurance (enabling factors) and self-rated health status (need factor).

Variation in Major Depressive Disorder Onset by Place of Origin Among U.S. Latinos

Using a nationally representative sample of 2514 U.S. Latinos, this study examined the extent to which major depressive disorder (MDD) onset differs by place of origin and the factors associated with it. The Kaplan-Meier method estimated the survival and hazard functions for MDD onset by place of origin, and Cox proportional hazards models identified its associative factors. Approximately 13% of the sample had experienced MDD in their lifetimes. Cuban respondents showed the highest survival function, while Puerto Ricans showed the lowest. With the entire sample, the smoothed hazard function showed that the risk of MDD onset peaked in the late 20s and early 80s. Puerto Rican respondents showed the highest risk of MDD during their 20s and 30s, whereas Cuban respondents showed a relatively stable pattern over time. The results from the Cox proportional hazards model indicated that age, sex, and marital status were significantly related to MDD onset (p < .05). In addition, the effect of U.S.-born status on MDD onset was greater among Mexican respondents than among Puerto Ricans. Findings from the present study demonstrate that different Latino subgroups experience different and unique patterns of MDD onset over time. Future research should account for the role of immigration status in examining MDD onset.

Social Determinants of Depression Among Hispanic Women

BACKGROUND

Depression is the number one cause of disability in the world. Hispanic women are at a higher risk for depression than Caucasian and African American women. This is in part due to multiple social determinants of health that affect the individual, family, aggregates, and community.

OBJECTIVE

To investigate the social determinants of depression among Hispanic women in South Florida.

DESIGN

This is a secondary cross-sectional data analysis. A total of 280 Hispanic women from South Florida between 18 and 50 years of age were analyzed.

RESULTS

Depression is prevalent among Hispanic women in South Florida (37.5%). Education, health status, and living with partner were significant predictors of depression in the sample.

CONCLUSION

Development of a culturally tailored risk assessment tool that highlights the social determinants of depression in Hispanic women is essential, as it could be used as a standard practice in primary care and other appropriate settings.

Mental health and migration: depression, alcohol abuse, and access to health care among migrants in Central Asia

One-fifth of Kazakhstan's population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N = 450). We used survey logistic regression adjusted for clustering of workers within stalls. Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia.

Long-Term Depressive Symptoms and Acculturative Stress Issues Among Immigrants From the Former Soviet Union

BACKGROUND

Previous studies regarding depressive symptoms and acculturative stress among immigrants have been limited to the initial period after immigration.

OBJECTIVE

The relationships between depressive symptoms, acculturation, and acculturative stress among immigrants from the former Soviet Union were examined in this descriptive study.

DESIGN

Eighty immigrants from the former Soviet Union who had immigrated within the past 20 years were recruited in various community locations.

RESULTS

Participants (N = 80), including recent and longer residing immigrants, reported elevated depressive symptoms and acculturative stress. Acculturative stress predicted depressive symptoms, controlling for dominant culture (American) immersion. However, length of time in the United States was not associated with depressive symptoms, ethnic culture immersion, or acculturative stress.

CONCLUSIONS

Our results suggest that elevated depressive symptoms are related to acculturative stress but are not confined to the initial adjustment period. Steps to decrease acculturative stress might help decrease depressive symptoms in immigrants regardless of the number of years lived in the United States.

Prevalence, correlates of major depression: A mental health survey among undergraduates at a mainland Chinese university

INTRODUCTION

This cross-sectional survey among Chinese university students aimed to estimate the prevalence and risk factors of major depressive disorder (MDD) among undergraduates, in order to provide basic information for the prevention and treatment of depression among the college-aged population.

METHODS

A total of 2,046 undergraduates were interviewed face to face using the World Health Organization Composite International Diagnostic Interview Version 3.0 (WHO-CIDI, version 3.0). Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used to diagnose MDD. Logistic regression was used to evaluate the associations between MDD and selected correlates.

RESULTS

The survey response rate was 90.1% (N = 1,843). The prevalence rates of MDD were 3.9% (lifetime), 2.4% (12 months) and 0.4% (30 days). No significant gender or age differences were found in prevalence rates. No sociodemographic characteristics were related to the lifetime prevalence of MDD. In contrast, family structure and environment factors specifically being from a single-parent family (odds ratio [OR] = 2.513, confidence interval [CI] = 1.404-2.500), parents having mental problems (OR = 1.809, CI = 1.104-2.964), and physical punishment (OR = 1.789, CI = 1.077-3.001) were associated with higher lifetime prevalence of MDD.

DISCUSSION

These findings showed a relatively lower prevalence of DSM-IV/CIDI MDD in this sample of Chinese undergraduates than that reported for students in other countries. However, the prevalence rate for university students was higher than that reported for general Chinese population. Family structure and socio-environmental factors in the student's family of origin significantly correlated with the lifetime prevalence of MDD.

Comparison of major depressive disorder onset among foreign-born Asian Americans: Chinese, Filipino, and Vietnamese ethnic groups

Using a nationally representative sample of 1280 Asian Americans, we examined the extent to which major depressive disorder (MDD) onset differs by ethnicity and its associated factors for each of the three ethnic groups: Vietnamese, Filipino, and Chinese. We employed the Kaplan-Meier method to estimate the survival and hazard functions for MDD onset by ethnicity, and cox proportional hazards models to identify socio-demographic and immigration-related factors associated with MDD onset. Approximately 7% of the entire sample had experienced MDD onset in their lifetime. Filipino immigrants showed the highest survival function, followed by Vietnamese immigrants over time. Those who were never-married or divorced were more likely to experience MDD onset when compared to their married or cohabiting counterparts. Those who immigrated at a younger age were more likely to experience MDD onset than were those who immigrated at an older age. However, there were ethnic variations in terms of the risk factors that were associated with MDD onset across these three ethnic groups. Findings from this study signal the importance of understanding the differing experiences of MDD onset by ethnicity.

Comparison of symptoms in African-American, Asian-American, Mexican-American and Non-Hispanic White patients with major depressive disorder

The study compared depressive and associated psychopathological symptoms in 17 African-American, 19 Asian-American, 22 Mexican-American and 41 Non-Hispanic White patients with unipolar major depressive disorder. Overall, severity of depression was comparable among the groups both on clinician-rated and subject-rated measures. However, ethnic-minority groups were more likely to experience diurnal variation of mood, with worsening in the evening. Furthermore, Asian-Americans and Mexican-Americans reported greater severity of anxiety and somatic symptoms. The findings suggest that clinicians should be aware of potential differences in symptom presentation when assessing and treating depressed patients from different ethnic groups.