Li Yueling, Hofstetter C Richard, Irving Veronica, Chhay Doug, Hovell Melbourne F
Center for Behavioral Epidemiology and Community Health, 9245 Sky Park Ct, Ste 230, San Diego, CA, 92123-4388, USA.
J Immigr Minor Health. 2014 Dec;16(6):1035-44. doi: 10.1007/s10903-013-9953-y.
This study documents the indirect effects of social and environmental variables as mediated by immigrant stress and physical health. Using data from a large dual frame sample of first generation mandarin speaking Chinese immigrants in metropolitan Los Angeles counties with the largest groups of Chinese immigrants, this study uses a path analytic approach to trace how predictors are related to depressive symptoms and to measure direct and indirect influences of variables. Although bivariate analyses suggested that many predictors were associated with depressive symptoms, multivariate path analysis revealed a more complex structure of mediated associations. In the multivariate path analysis only reports of physical health and immigrant stress were directly related to depressive symptoms (P < 0.05), while acculturation, time in the US, income, US citizenship, and distance of persons on whom one could rely were related to stress (but not to physical health status) and only to depressive symptoms as mediated by stress. Age and educational attainment were related to health status (and to stress as mediated by physical health) and to depressive symptoms as mediated by both health and stress. These variables were also unrelated directly to health status and to depressive symptoms. Associations were evaluated using statistical significance, P < 0.05. This study demonstrates the significance of stress and health as mediators of variables in the larger context of the physical environment and suggests that the mechanisms linking ecological characteristics of immigrants to depressive symptoms may be stress and physical health among immigrants.
本研究记录了社会和环境变量通过移民压力和身体健康所产生的间接影响。本研究使用来自洛杉矶大都市地区第一代说普通话的华裔移民的大型双框架样本数据，这些地区是华裔移民群体最大的地区。本研究采用路径分析方法来追踪预测因素与抑郁症状之间的关系，并测量变量的直接和间接影响。尽管双变量分析表明许多预测因素与抑郁症状有关，但多变量路径分析揭示了一个更为复杂的中介关联结构。在多变量路径分析中，只有身体健康报告和移民压力与抑郁症状直接相关（P<0.05），而文化适应、在美国的时间、收入、美国公民身份以及可依赖的人的距离与压力相关（但与身体健康状况无关），并且仅通过压力中介与抑郁症状相关。年龄和教育程度与健康状况相关（并通过身体健康中介与压力相关），并通过健康和压力中介与抑郁症状相关。这些变量也与健康状况和抑郁症状无直接关系。使用统计显著性（P<0.05）评估关联。本研究证明了压力和健康作为变量在更大的物理环境背景下的中介作用的重要性，并表明将移民的生态特征与抑郁症状联系起来的机制可能是移民中的压力和身体健康。
