Keys Hunter M, Kaiser Bonnie N, Foster Jennifer W, Burgos Minaya Rosa Y, Kohrt Brandon A
a Nell Hodgson Woodruff School of Nursing and Rollins School of Public Health , Emory University , Atlanta , GA , USA.
Ethn Health. 2015;20(3):219-40. doi: 10.1080/13557858.2014.907389. Epub 2014 Apr 14.
Many Haitian migrants live and work as undocumented laborers in the Dominican Republic. This study examines the legacy of anti-Haitian discrimination in the Dominican Republic and association of discrimination with mental health among Haitian migrants.
This study used mixed methods to generate hypotheses for associations between discrimination and mental health of Haitian migrants in the Dominican Republic. In-depth interviews were conducted with 21 Haitian and 18 Dominican community members and clinicians. One hundred and twenty-seven Haitian migrants participated in a pilot cross-sectional community survey. Instruments included culturally adapted Kreyòl versions of the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) and a locally developed function impairment scale.
Haitian migrants described humiliation (imilyasyon) as a reason for mental distress and barrier to health care. Dominicans reported that discrimination (discriminación) was not a current social problem and attributed negative social interactions to sociocultural, behavioral, and biological differences between Dominicans and Haitians. These qualitative findings were supported in the quantitative analyses. Perceived discrimination was significantly associated with depression severity and functional impairment. Perceived mistreatment by Dominicans was associated with a 6.6-point increase in BDI score (90% confidence interval [CI]: 3.29, 9.9). Knowing someone who was interrogated or deported was associated with a 3.4-point increase in BAI score (90% CI: 0.22, 6.64).
Both qualitative and quantitative methods suggest that perceived discrimination and the experience of humiliation contribute to Haitian migrant mental ill-health and limit access to health care. Future research should evaluate these associations and identify intervention pathways for both improved treatment access and reduction of discrimination-related health risk factors.
许多海地移民在多米尼加共和国作为无证劳工生活和工作。本研究考察了多米尼加共和国反海地歧视的遗留影响以及歧视与海地移民心理健康之间的关联。
本研究采用混合方法来生成多米尼加共和国海地移民歧视与心理健康之间关联的假设。对21名海地和18名多米尼加社区成员及临床医生进行了深入访谈。127名海地移民参与了一项试点横断面社区调查。所使用的工具包括经文化调适的克里奥尔语版贝克抑郁量表（BDI）和贝克焦虑量表（BAI）以及一个当地开发的功能损害量表。
海地移民将羞辱（imilyasyon）描述为心理困扰的一个原因以及获得医疗保健的障碍。多米尼加人报告称歧视（discriminación）并非当前的社会问题，并将负面的社会互动归因于多米尼加人和海地人之间的社会文化、行为和生物学差异。这些定性研究结果在定量分析中得到了支持。感知到的歧视与抑郁严重程度和功能损害显著相关。多米尼加人感知到的虐待与BDI得分增加6.6分相关（90%置信区间[CI]：3.
