Pahwa P, Karunanayake C P, McCrosky J, Thorpe L
Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Chronic Dis Inj Can. 2012 Jun;32(3):164-76.
Immigration continues to transform the ethnic composition of the Canadian population. We investigated whether longitudinal trends in mental distress vary between seven cultural and ethnic groups and whether mental distress within the same ethnic group varies by demographic (immigrant status, sex, age, marital status, place and length of residence), socio-economic (education, income), social support and lifestyle factors.
The study population consisted of 14 713 respondents 15 years and older from the first six cycles of the National Population Health Survey (NPHS); 20% reported themselves to be immigrant at Cycle 1, in 1994/1995. The logistic regression model was fitted by modifying a multivariate quasi-likelihood approach, and robust variance estimates were obtained by using balanced repeated replication techniques.
Based on the multivariable model and self-reported data, we observed that female respondents were more likely to report moderate/high mental distress than male respondents; younger respondents more than older respondents; single respondents more than those in a relationship; urban-dwellers more than rural-dwellers; less educated respondents more than more educated respondents; current and former smokers more than non-smokers; and those living in a smoking household more than those living in non-smoking households. The relationship between ethnicity and mental distress was modified by immigrant status, sex, social involvement score and education. Confirming other research, we found an inverted U-shaped relationship between length of stay and mental distress: those who had lived in Canada for less than 2 years were less likely to report moderate/high mental distress, while those who had lived in Canada for 2 to 20 years were significantly more likely to report moderate/high mental distress than those who had lived in Canada for more than 20 years.
There is a need to develop ethnicity-specific mental health programs targeting those with low education attainment and low social involvement. Policies and programs should also target women, the younger age group (15-24 years) and low-income adequacy groups.
移民持续改变着加拿大人口的种族构成。我们调查了七个文化和种族群体中心理困扰的纵向趋势是否存在差异，以及同一族裔群体中心理困扰是否因人口统计学因素（移民身份、性别、年龄、婚姻状况、居住地点和时长）、社会经济因素（教育程度、收入）、社会支持和生活方式因素而有所不同。
研究人群包括来自全国人口健康调查（NPHS）前六个周期的14713名15岁及以上的受访者；在1994/1995年的第一个周期中，20%的受访者称自己为移民。通过修改多元拟似然方法拟合逻辑回归模型，并使用平衡重复复制技术获得稳健的方差估计值。
基于多变量模型和自我报告数据，我们观察到女性受访者比男性受访者更有可能报告中度/高度心理困扰；年轻受访者比年长受访者更易如此；单身受访者比处于恋爱关系中的受访者更易如此；城市居民比农村居民更易如此；受教育程度较低的受访者比受教育程度较高的受访者更易如此；当前吸烟者和曾经吸烟者比不吸烟者更易如此；居住在吸烟家庭的人比居住在非吸烟家庭的人更易如此。种族与心理困扰之间的关系因移民身份、性别、社会参与得分和教育程度而有所改变。与其他研究结果一致，我们发现居住时长与心理困扰之间呈倒U形关系：在加拿大居住不到2年的人报告中度/高度心理困扰的可能性较小，而在加拿大居住2至20年的人报告中度/高度心理困扰的可能性显著高于在加拿大居住超过20年的人。
有必要针对受教育程度低和社会参与度低的人群制定特定种族的心理健康项目。政策和项目还应针对女性、年轻年龄组（15 - 24岁）和低收入充足群体。
