Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.
National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia.
Aust N Z J Psychiatry. 2021 Sep;55(9):883-891. doi: 10.1177/0004867420981414. Epub 2020 Dec 17.
Immigrants' mental health is a growing public health concern. Neighbourhood characteristics in the host society may contribute to the poor mental health observed among immigrants. In this study, we aimed to investigate the association between neighbourhood-level social fragmentation and socioeconomic characteristics with psychological distress among immigrants and non-immigrants living in Australia.
We conducted cross-sectional secondary data analysis of 228,039 participants from the Sax Institute's 45 and Up Study, with psychological distress measured with the Kessler 10 (K10) and area-level social fragmentation and economic advantage/disadvantage measured at the statistical area level 1 (areas containing approximately 400 people). Multilevel logistic models were used to examine the extent to which differences across the least and most fragmented and economic advantage/disadvantage neighbourhoods contributed to the prevalence of high psychological distress (K10 score ⩾ 22).
Immigrants accounted for about 23% of the sample. Slightly more immigrants (34.8%) compared to non-immigrants (32.9%) lived in fragmented areas. Although immigrants were over represented in areas with socioeconomic advantage (40% vs 33.9%), the prevalence of high psychological distress in neighbourhoods with higher social fragmentation and socioeconomic disadvantage was higher in immigrants than non-immigrants. Immigrants had 17% (95% confidence interval = [12%, 22%]) higher odds of having high psychological distress compared to non-immigrants. There was no evidence of an interaction between social fragmentation or socioeconomic disadvantage and immigrant status. Living in fragmented or socioeconomically disadvantaged areas was associated with higher psychological distress among immigrants and non-immigrants. English as a second language and low annual income were significant predictors of psychological distress in immigrants over and above area-level characteristics.
Immigrants are vulnerable to mental health issues, but the characteristics of the area they live in are also important. Helping immigrants settle into well-integrated and economically advantaged areas may decrease the possibility of mental health issues.
移民的心理健康是一个日益严重的公共卫生问题。移民所在的东道社会的邻里特征可能导致移民中观察到的心理健康状况不佳。在这项研究中，我们旨在调查邻里层面的社会分割程度和社会经济特征与生活在澳大利亚的移民和非移民的心理困扰之间的关联。
我们对萨克研究所的 45 岁及以上研究中的 228039 名参与者进行了横断面二次数据分析，使用 Kessler 10（K10）量表衡量心理困扰，使用统计区域一级（包含约 400 人的区域）衡量区域层面的社会分割程度和经济优势/劣势。多水平逻辑模型用于检查在最少和最多分割以及经济优势/劣势的邻里之间的差异在多大程度上导致了高心理困扰（K10 得分≥22）的流行程度。
移民约占样本的 23%。与非移民（32.9%）相比，略多的移民（34.8%）居住在分割区域。尽管移民在社会经济优势地区的代表性过高（40%比 33.9%），但在社会分割程度较高和社会经济劣势的邻里中，移民的高心理困扰发生率高于非移民。与非移民相比，移民发生高心理困扰的几率高 17%（95%置信区间[12%，22%]）。社会分割或社会经济劣势与移民身份之间没有交互作用。生活在分割或社会经济劣势地区与移民和非移民的更高心理困扰相关。英语作为第二语言和年收入低是移民心理困扰的重要预测因素，超过了区域特征。
移民容易受到心理健康问题的影响，但他们居住的地区的特征也很重要。帮助移民融入经济优势和融入度高的地区可能会减少心理健康问题的可能性。
