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Abstract
BackgroundIn the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions.MethodData was collected from questionnaires as a part of the Oslo Health Study 2000–2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress.ResultsPakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48–1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29–1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19–0.29) to 0.07 (0.01–0.12) and 0.12 (0.07–0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminatedConclusionPoor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously.
Highlights
In the Norwegian context, higher mental distress has been reported for the nonWestern immigrants compared to the ethnic Norwegians and Western immigrants
In Norwegians, psychological distress improved with the increase in education level but no such association was observed for ethnic Pakistanis
This study has revealed the importance of psychosocial factors in addition to SE factors on the psychological distress among Pakistani immigrants in Oslo
Summary
In the Norwegian context, higher mental distress has been reported for the nonWestern immigrants compared to the ethnic Norwegians and Western immigrants This high level of distress is often related to different socio-economic conditions in this group. The psychosocial factors that might be influenced by migration, and thereby pose a negative effect on mental health, are social support, social participation and feeling of powerlessness. Social support provides a direct and indirect buffering effect, which moderates the impact of stress on health [8] Social participation is another psychosocial factor that has been extensively studied in relation to health and survival [9]. Powerlessness, a less studied phenomenon in relation to mental health, has two dimensions: the psychosocial dimension deals with self-esteem, self-trust and self-efficacy, whereas the social action oriented dimension involves control over one's own life situations [11]. Our previous knowledge based on empirical studies related to empowerment has shown that it is positively associated with perceived quality of life [12], self-esteem and social support [13] and negatively associated with the severity of psychiatric symptoms [14]
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