Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY.
Department of Population Health, NYU Grossman School of Medicine, New York, NY.
Ethn Dis. 2020 Sep 24;30(4):553-562. doi: 10.18865/ed.30.4.553. eCollection 2020 Fall.
Although the fastest growing minority group, Asian Americans receive little attention in mental health research. Moreover, aggregated data mask further diversity within Asian Americans. This study aimed to examine depression risk by detailed Asian American subgroup, and further assess determinants within and between three Asian ethnic subgroups.
Needs assessment surveys were collected in 16 Asian American subgroups (six Southeast Asian, six South Asian, and four East Asian) in New York City from 2013-2016 using community-based sampling strategies. A final sample of N=1,532 completed the PHQ-2. Bivariate comparisons and multivariable logistic models explored differences in depression risk by subgroup.
Southeast Asians had the greatest depression risk (19%), followed by South Asians (11%) and East Asians (9%). Among Southeast Asians, depression risk was associated with lacking health insurance (OR=.2, 95% CI: 0-.6), not having a provider who speaks the same language (OR=3.2, 95% CI: 1.3-8.0), and lower neighborhood social cohesion (OR= .94, 95% CI: .71-.99). Among South Asians, depression risk was associated with greater English proficiency (OR=3.9, 95% CI: 1.6-9.2); and among East Asians, depression risk was associated with ≤ high school education (OR=4.2, 95% CI: 1.2-14.3). Additionally, among Southeast Asians and South Asians, the highest depression risk was associated with high levels of discrimination (Southeast Asian: OR=9.9, 95% CI: 1.8-56.2; South Asian: OR=7.3, 95% CI: 3.3-16.2).
Depression risk and determinants differed by Asian American ethnic subgroup. Identifying factors associated with depression risk among these groups is key to targeting limited public health resources for these underserved communities.
亚裔美国人是增长最快的少数族裔群体之一,但在心理健康研究中却很少受到关注。此外,汇总数据掩盖了亚裔美国人内部的进一步多样性。本研究旨在通过详细的亚裔美国人亚组检查抑郁风险,并进一步评估三个亚裔族群内和族群间的决定因素。
2013 年至 2016 年,采用基于社区的抽样策略,在纽约市的 16 个亚裔美国人亚组(6 个东南亚裔、6 个南亚裔和 4 个东亚裔)中收集需求评估调查。共有 1532 名参与者完成了 PHQ-2。采用双变量比较和多变量逻辑模型,根据亚组探讨抑郁风险的差异。
东南亚裔的抑郁风险最高(19%),其次是南亚裔(11%)和东亚裔(9%)。在东南亚裔中,抑郁风险与缺乏医疗保险(OR=0.2,95%CI:0-0.6)、没有讲同种语言的医生(OR=3.2,95%CI:1.3-8.0)和较低的邻里社会凝聚力(OR=0.94,95%CI:0.71-0.99)相关。在南亚裔中,抑郁风险与较高的英语水平(OR=3.9,95%CI:1.6-9.2)相关;而在东亚裔中,抑郁风险与高中以下教育程度(OR=4.2,95%CI:1.2-14.3)相关。此外,在东南亚裔和南亚裔中,最高的抑郁风险与高度歧视相关(东南亚裔:OR=9.9,95%CI:1.8-56.2;南亚裔:OR=7.3,95%CI:3.3-16.2)。
亚裔美国人的抑郁风险和决定因素因族裔群体而异。确定这些群体中与抑郁风险相关的因素是为这些服务不足的社区提供有限的公共卫生资源的关键。