Abstract
Evidence has demonstrated that immigrants have a mental health advantage over the indigenous population of developed countries. However, much of the evidence-base demonstrating this mental health advantage is susceptible to confounding and inadequate adjustment across immigrant and non-immigrant groups preventing a rigorous assessment of a ’healthy migrant effect’. To compare the risk of common mental disorders in the immigrant population compared to the non-immigrant population in ethnic minority groups in England. A propensity-score matched analysis was carried out to adequately balance immigrant and non-immigrant groups for known confounders using the EMPIRIC national survey of Black-Caribbean, Indian, Pakistani and Bangladeshi groups. The mental health of participants was assessed using the validated Revised Clinical Interview Schedule tool. Immigrant participants were significantly less likely to have a common mental disorder than non-immigrant participants; OR = 0.47, (95% CI 0.40, 0.56). The results from this study demonstrate that a mental health advantage exists in ethnic minority immigrants compared to non-immigrants when balancing the two groups for confounding factors. This may be due to immigrants possessing certain personality traits, such as "psychological hardiness", that the migration process may select for.
Highlights
A growing body of evidence has demonstrated the epidemiological paradox that immigrants have better overall health than the indigenous population of developed countries, named ‘the healthy migrant effect’, which describes both a physical and mental health advantage [1,2,3,4]
Another study looking at mood, anxiety and personality disorders amongst first and second generation immigrants in the United States demonstrated the ‘healthy migrant effect’ when comparing immigrants with the indigenous population, but there was a higher prevalence of mental health conditions in second generation migrants [6]
Using the cross-sectional Ethnic Minority Psychiatric Rates in the Community (EMPIRIC) survey the aim of this study is to compare the risk of common mental disorders, as a global measure, in immigrants compared to non-immigrants in ethnic minorities in the UK
Summary
A growing body of evidence has demonstrated the epidemiological paradox that immigrants have better overall health than the indigenous population of developed countries, named ‘the healthy migrant effect’, which describes both a physical and mental health advantage [1,2,3,4]. A number of potential reasons may exist for a potential mental health advantage in immigrants compared to nonimmigrant minorities; one important explanation theorises that certain selection factors may favour immigrants, such as the drive to take chances and negotiate difficult circumstances. These personality attributes may provide a more robust coping mechanism when dealing with some of the adversity associated with the minority status [7, 8]. Another theory describes how acculturative stressors affect nonimmigrant minorities differently; this includes asymmetric acculturation from being born in different countries and attempting to integrate in their resident country and facing restrictive processes due to discrimination and a weak position within society [7,8,9,10]
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