Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Public Health, California State University, Fullerton, CA, USA.
J Affect Disord. 2024 Sep 15;361:157-164. doi: 10.1016/j.jad.2024.06.002. Epub 2024 Jun 7.
Self-reported health (SRH) is an important indicator of mental health outcomes. More information, however, is needed on whether this association varies by birthplace (defined as US-born or non-US-born) and citizenship status (i.e., non-US-born citizen, non-US citizen, and US-born citizen).
We examined the associations between SRH and depression among non-US-born US citizens, non-US citizens, and US-born citizens aged 18 years and older using weighted cross-sectional data from the 2010-2018 National Health Interview Survey (n = 139,884). Logistic regression models were used to assess the association between depression and SRH by citizenship status, adjusting for covariates.
US-born citizens reported the highest prevalence of depression (40.3 %), and non-US-born citizens reported the highest prevalence of poor/fair SRH (14.5 %). Individuals with fair/poor SRH had a significantly increased likelihood of depression relative to those with good/very good/excellent for non-US-born US citizens (Adjusted Odds Ratio [AOR] = 2.42, 95 % Confidence Interval [95 % CI] = 2.04-2.88), non-US citizens (AOR = 2.80, 95 % CI = 2.31-3.40), and US-born citizens (AOR = 2.31, CI = 2.18-2.45).
The study is cross-sectional, reducing the strength of determining causal relationships. Also, there is a possible response bias due to the self-reported nature of the data.
Our study indicates that fair/poor SRH is significantly associated with an increased likelihood of depression regardless of an individual citizenship status. Additionally, immigrants with fair/poor SRH had higher increased odds of depression. Therefore, mental healthcare interventions tailored for immigrants can reduce mental health problems and disparities among immigrants.
自我报告的健康状况(SRH)是心理健康结果的一个重要指标。然而,我们需要更多的信息来了解这种关联是否因出生地(定义为美国出生或非美国出生)和公民身份状况(即非美国出生公民、非美国公民和美国出生公民)而异。
我们使用 2010-2018 年全国健康访谈调查(n=139884)的加权横断面数据,研究了 SRH 与 18 岁及以上非美国出生的美国公民、非美国公民和美国出生公民的抑郁之间的关联。使用逻辑回归模型,根据公民身份状况调整协变量,评估抑郁与 SRH 之间的关联。
美国出生的公民报告的抑郁发生率最高(40.3%),而非美国出生的公民报告的健康状况不佳/差的比例最高(14.5%)。与健康状况良好/非常好/优秀的人相比,自我报告健康状况不佳/差的人患抑郁的可能性显著增加,而非美国出生的美国公民(调整后的优势比[OR]为 2.42,95%置信区间[95%CI]为 2.04-2.88)、非美国公民(OR 为 2.80,95%CI 为 2.31-3.40)和美国出生的公民(OR 为 2.31,CI 为 2.18-2.45)。
该研究是横断面的,降低了确定因果关系的强度。此外,由于数据的自我报告性质,可能存在响应偏倚。
我们的研究表明,无论个体的公民身份状况如何,健康状况不佳/差与抑郁的可能性增加显著相关。此外,自我报告健康状况不佳/差的移民患抑郁的几率增加更高。因此,针对移民的定制化心理健康保健干预措施可以减少移民的心理健康问题和差异。