Emerson Scott D, Petteni Monique Gagné, Puyat Joseph H, Guhn Martin, Georgiades Katholiki, Milbrath Constance, Janus Magdalena, Gadermann Anne M
Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Soc Psychiatry Psychiatr Epidemiol. 2023 May;58(5):693-709. doi: 10.1007/s00127-022-02301-2. Epub 2022 Jun 13.
Evidence from systematic reviews suggests that adult immigrants living in areas of higher immigrant density (areas with a higher proportion of foreign-born residents) tend to experience fewer mental health problems-likely through less discrimination, greater access to culturally/linguistically appropriate services, and greater social support. Less is known about how such contexts are associated with mental health during childhood-a key period in the onset and development of many mental health challenges. This study examined associations between neighbourhood immigrant density and youth mental health conditions in British Columbia (BC; Canada).
Census-derived neighbourhood characteristics were linked to medical records for youth present in ten of BC's largest school districts from age 5 through 19 over the study period (1995-2016; n = 138,090). Occurrence of physician assessed diagnoses of mood and/or anxiety disorders, attention deficit hyperactivity disorder (ADHD), and conduct disorder was inferred through International Classification of Diseases (ICD) diagnostic codes in universal public health insurance records. Multi-level logistic regression was used to model associations between neighbourhood characteristics and odds of diagnoses for each condition; models were stratified by generation status (first-generation: foreign-born; second-generation: Canadian-born to a foreign-born parent; non-immigrant).
Higher neighbourhood immigrant density was associated with lower odds of disorders among first-generation immigrant youth (e.g., adjusted odds of mood-anxiety disorders for those in neighbourhoods with the highest immigrant density were 0.67 times lower (95% CI: 0.49, 0.92) than those in neighbourhoods with the lowest immigrant density). Such protective associations generally extended to second-generation and non-immigrant youth, but were-for some disorders-stronger for first-generation than second-generation or non-immigrant youth.
Findings suggest there may be protective mechanisms associated with higher neighbourhood immigrant density for mental health conditions in immigrant and non-immigrant youth. It is important that future work examines potential pathways by which contextual factors impact immigrant and non-immigrant youth mental health.
系统评价的证据表明，居住在移民密度较高地区（外国出生居民比例较高的地区）的成年移民往往经历较少的心理健康问题，这可能是因为歧视较少、更容易获得文化/语言适配的服务以及更多的社会支持。对于这种环境如何与儿童期心理健康相关联，人们了解较少，而儿童期是许多心理健康挑战开始和发展的关键时期。本研究调查了加拿大不列颠哥伦比亚省（BC）社区移民密度与青少年心理健康状况之间的关联。
在研究期间（1995 - 2016年），从人口普查得出的社区特征与BC省十个最大校区5至19岁青少年的医疗记录相关联（n = 138,090）。通过通用公共医疗保险记录中的国际疾病分类（ICD）诊断代码推断医生评估的情绪和/或焦虑症、注意力缺陷多动障碍（ADHD）和品行障碍的诊断情况。采用多层次逻辑回归模型来分析社区特征与每种疾病诊断几率之间的关联；模型按代际状态分层（第一代：外国出生；第二代：父母为外国出生但在加拿大出生；非移民）。
社区移民密度较高与第一代移民青少年患疾病的几率较低相关（例如，移民密度最高社区的青少年患情绪 - 焦虑症的调整几率比移民密度最低社区的青少年低0.67倍（95% CI：0.49，0.92））。这种保护关联通常也适用于第二代和非移民青少年，但对于某些疾病，第一代青少年的关联比第二代或非移民青少年更强。
研究结果表明，较高的社区移民密度可能对移民和非移民青少年的心理健康状况存在保护机制。未来的工作研究背景因素影响移民和非移民青少年心理健康的潜在途径非常重要。
