a Bureau of Epidemiology Services, Division of Epidemiology , New York City Department of Health and Mental Hygiene , New York , NY , USA.
b Center for Population Health Sciences , Stanford Medicine , Stanford , CA , USA.
Ethn Health. 2017 Dec;22(6):575-584. doi: 10.1080/13557858.2016.1244743. Epub 2016 Oct 24.
Neighborhood-level factors such as ethnic densities and social cohesion have been negatively associated with psychological distress among Latino Americans. Yet, existing evidence is based on either specific neighborhood factors or particular Latino subgroups. The objective of the study was to assess difference in psychological distress between each of four Latino subgroups (Puerto Ricans, Dominicans, Mexicans, other Latinos) and non-Latino white adults in New York City, and quantify total neighborhood-level influence on these differences.
We used the combined Community Health Survey data from 2009, 2010, and 2012 surveys. We estimated the odds ratios (ORs) for self-reported non-specific psychological distress (Kessler-6 questions scale ≥ 13) by race/ethnicity using logistic regression models. We further adjusted these estimates for both observed and unobserved neighborhood-level confounding using the conditional pseudolikelihood method for complex survey data.
Puerto Ricans were more likely to be psychologically distressed (OR = 1.58, 95% CI = 1.18, 2.12) compared with non-Latino whites, whereas the opposite was seen in other Latino subgroups. Accounting for full neighborhood-level confounding increased the disparity for Puerto Ricans (OR = 1.79, 95% CI = 1.26-2.54). For the other subgroups, lower odds of psychological distress were no longer observed or attenuated after accounting for neighborhood-level confounding. Overall neighborhood-level factors were associated with lower psychological distress at greater extent among all Latinos subgroups versus non-Latino whites in New York City.
Despite substantial variations of psychological distress across Latino subgroups, the study shows evidence that neighborhood-level factors might play a protective role in all Latino subgroups.
邻里层面的因素,如族裔密度和社会凝聚力,与拉丁裔美国人的心理困扰呈负相关。然而,现有证据要么基于特定的邻里因素,要么基于特定的拉丁裔亚群。本研究的目的是评估在纽约市,四个拉丁裔亚群(波多黎各人、多米尼加人、墨西哥人、其他拉丁裔人)与非拉丁裔白种成年人之间,心理困扰的差异,并量化邻里层面因素对这些差异的总影响。
我们使用了 2009、2010 和 2012 年调查的社区健康调查综合数据。我们使用逻辑回归模型,根据种族/族裔,估算自我报告的非特定心理困扰(Kessler-6 问题量表≥13)的比值比(OR)。我们进一步使用复杂调查数据的条件伪似然法,对观察到的和未观察到的邻里层面混杂因素进行调整。
与非拉丁裔白人相比,波多黎各人更有可能出现心理困扰(OR=1.58,95%CI=1.18,2.12),而其他拉丁裔亚群则相反。考虑到完全的邻里层面混杂因素后,波多黎各人的差异更大(OR=1.79,95%CI=1.26-2.54)。对于其他亚群,在考虑邻里层面混杂因素后,不再观察到或减弱了心理困扰的低几率。总体而言,在纽约市,所有拉丁裔亚群的邻里层面因素与非拉丁裔白人相比,与较低的心理困扰程度关联更为密切。
尽管拉丁裔亚群之间存在显著的心理困扰差异,但研究表明,邻里层面的因素可能对所有拉丁裔亚群都起到保护作用。