拉丁裔群体中的移民政策与心理健康发病率：一项州级分析。
Immigration policies and mental health morbidity among Latinos: A state-level analysis.
作者信息
Hatzenbuehler Mark L, Prins Seth J, Flake Morgan, Philbin Morgan, Frazer M Somjen, Hagen Daniel, Hirsch Jennifer
机构信息
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States.
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States.
出版信息
Soc Sci Med. 2017 Feb;174:169-178. doi: 10.1016/j.socscimed.2016.11.040. Epub 2016 Nov 30.
RATIONALE
Despite abundant state-level policy activity in the U.S. related to immigration, no research has examined the mental health impact of the overall policy climate for Latinos, taking into account both inclusionary and exclusionary legislation.
OBJECTIVE
To examine associations between the state-level policy climate related to immigration and mental health outcomes among Latinos.
METHODS
We created a multi-sectoral policy climate index that included 14 policies in four domains (immigration, race/ethnicity, language, and agricultural worker protections). We then examined the relation of this policy climate index to two mental health outcomes (days of poor mental health and psychological distress) among Latinos from 31 states in the 2012 Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey of non-institutionalized individuals aged 18 years or older.
RESULTS
Individuals in states with a more exclusionary immigration policy climate had higher rates of poor mental health days than participants in states with a less exclusionary policy climate (RR: 1.05, 95% CI: 1.00, 1.10). The association between state policies and the rate of poor mental health days was significantly higher among Latinos versus non-Latinos (RR for interaction term: 1.03, 95% CI: 1.01, 1.06). Furthermore, Latinos in states with a more exclusionary policy climate had 1.14 (95% CI: 1.04, 1.25) times the rate of poor mental health days than Latinos in states with a less exclusionary policy climate. Results were robust to individual- and state-level confounders. Sensitivity analyses indicated that results were specific to immigration policies, and not indicators of state political climate or of residential segregation. No relationship was observed between the immigration policy index and psychological distress.
CONCLUSION
These results suggest that restrictive immigration policies may be detrimental to the mental health of Latinos in the United States.
理论依据
尽管美国州一级有大量与移民相关的政策活动，但尚无研究在考虑包容性和排他性立法的情况下，考察整体政策环境对拉丁裔心理健康的影响。
目的
研究州一级与移民相关的政策环境与拉丁裔心理健康结果之间的关联。
方法
我们创建了一个多部门政策环境指数，其中包括四个领域（移民、种族/族裔、语言和农业工人保护）的14项政策。然后，我们在2012年行为风险因素监测系统（BRFSS）中，考察了该政策环境指数与31个州的拉丁裔的两种心理健康结果（心理健康不佳天数和心理困扰）之间的关系，BRFSS是一项针对18岁及以上非机构化个体的基于人群的健康调查。
结果
与政策排他性较低的州的参与者相比，处于移民政策排他性较强的州的个体心理健康不佳天数的发生率更高（风险比：1.05，95%置信区间：1.00，1.10）。州政策与心理健康不佳天数发生率之间的关联在拉丁裔中显著高于非拉丁裔（交互项的风险比：1.03，95%置信区间：1.01，1.06）。此外，与政策排他性较低的州的拉丁裔相比，处于政策排他性较强的州的拉丁裔心理健康不佳天数的发生率是其1.14倍（95%置信区间：1.04，1.25）。结果对个体和州层面的混杂因素具有稳健性。敏感性分析表明，结果特定于移民政策，而非州政治气候或居住隔离的指标。未观察到移民政策指数与心理困扰之间的关系。
结论
这些结果表明，限制性移民政策可能对美国拉丁裔的心理健康有害。
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