Abstract
BackgroundSocial capital may theoretically explain health inequalities between social groups, but empirical evidence is lacking. Some studies indicate that social capital may be particularly important for immigrant health. Nearly 16% of Sweden’s population are foreign-born immigrants and research has shown them to be susceptible to psychological distress, though significant variation has been found between groups. In this study, we investigate the following hypotheses: 1) if non-refugees have better mental health than Swedish-born, and refugees experience worse mental health than Swedish-born; 2) if mental health status converges with that of Swedish-born with longer duration of residence; and 3) if social capital mediates the effect of immigrant status on psychological distress for different immigrant groups as compared to Swedish-born.MethodsThis cross-sectional study uses baseline data from the Stockholm Public Health Cohort and includes 50,498 randomly-selected individuals from Stockholm County in 2002, 2006, and 2010. Mental health was measured as psychological distress, using the 12-item General Health Questionnaire. Social capital was measured using indicators of bonding, bridging, and linking social capital. Both cognitive and structural aspects were measured for the latter two indicators. Mediation was tested using logistic regression and the Sobel test.ResultsThe results show that refugees generally had greater odds of psychological distress than non-refugees compared to their respective Swedish-born counterparts. Among immigrant men, both refugees and non-refugees had significantly greater odds of psychological distress than Swedish-born men. Only refugee women in Sweden 10 years or more had significantly greater odds of psychological distress compared to Swedish-born women. The mediation analysis demonstrated that indicators of social capital mediated the association for all immigrant men (except non-refugees in Sweden 3-9 years) and for refugee women in Sweden 10 years or more. While bonding social capital showed the greatest mediatory role among the three social capital types, adding them together had the strongest explanatory effect.ConclusionsSocial capital explains differences in mental health for some immigrant groups, highlighting its role as a potentially important post-migration factor. Increased investment from policy-makers regarding how social capital can be promoted among new arrivals may be important for preventing psychological distress.
Highlights
Social capital may theoretically explain health inequalities between social groups, but empirical evidence is lacking
The aim of this study is to explore whether social capital can explain mental health inequalities between foreign-born immigrant groups and Swedish-born
The occurrence of psychological distress peaked at 10-19 years in Sweden for immigrant women, whereas it progressively decreased for immigrant men
Summary
Social capital may theoretically explain health inequalities between social groups, but empirical evidence is lacking. 16% of Sweden’s population are foreign-born immigrants and research has shown them to be susceptible to psychological distress, though significant variation has been found between groups. 16% of Sweden’s population is foreign-born immigrants [2] and research has shown some groups to be susceptible to psychological distress [3]. Some variance in mental health status between immigrant groups is attributed to differences in pre-migration factors, such as exposure to trauma due to war or premigration economic status [4,5,6]. Numerous studies have demonstrated that immigrants are disproportionately affected by mental ill-health on account of factors relating to the individual’s social position in the new society, such as socioeconomic status, gender, ethnicity, and culture [4, 7,8,9]
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