Choi Sunha, Kim Giyeon, Lee Sungkyu
College of Social Work, The University of Tennessee, Knoxville, TN, USA.
Alabama Research Institute on Aging and Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
Psychiatr Q. 2016 Dec;87(4):675-688. doi: 10.1007/s11126-016-9418-2.
Using the 2004-2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals' mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults' immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities.
本研究使用了2004 - 2007年医疗支出小组调查数据，这些数据与地区卫生资源档案中的县级数据相关联，旨在检验“健康移民效应”是否适用于外国出生的老年人的心理健康。此外，为了检验族裔密度对外国出生的老年人心理健康的保护作用，本研究考察了一个县中外籍出生人口的百分比如何影响老年人的移民身份（美国出生情况和在美国的居住时长）与其心理健康状况之间的关系。样本包括来自美国50个州和华盛顿特区920个县（二级单位）的29,011名个体（一级单位）。使用简短型健康调查问卷12的心理成分汇总量表、凯斯勒量表（K - 6）和患者健康问卷（PHQ - 2），对美国出生的个体（n = 24,225）、早期移民（在美国居住≥15年；n = 3866）和近期移民（在美国居住<15年；n = 920）进行了比较。结果表明，与美国出生的个体相比，近期移民在所有这三项测量指标上的心理健康状况都更差，与早期移民相比，在K - 6和PHQ - 2测量指标上的心理健康状况也更差。县级较高的外国出生人口密度与个体较差的心理健康状况相关。然而，在完全条件多层模型中发现的显著交互作用表明，外国出生人口高密度仅在近期移民中是心理健康状况变差的风险因素，而在美国出生的人群中并非如此。总之，研究结果揭示了近期移民老年人的脆弱性，尤其是那些生活在外国出生人口密度高的县的老年人。
