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Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors.

ABSTRACT: Pre-migration and post-migration factors may influence the health of immigrants. Using a cross-national framework that considers the effects of the sending and receiving social contexts, we examined the extent to which pre-migration and post-migration factors, including individual and neighborhood level factors, influence depressive symptoms at a 2-year follow-up time point. Data come from the Boston Puerto Rican Health Study, a population-based prospective cohort of Puerto Ricans between the ages of 45 and 75 y. The association of neighborhood ethnic density with depressive symptomatology at follow-up was significantly modified by sex and level of language acculturation. Men, but not women, experienced protective effects of ethnic density. The interaction of neighborhood ethnic density with language acculturation had a non-linear effect on depressive symptomatology, with lowest depressive symptomatology in the second highest quartile of language acculturation, relative to the lowest and top two quartiles among residents of high ethnic density neighborhoods. Results from this study highlight the complexity, and interplay, of a number of factors that influence the health of immigrants, and emphasize the significance of moving beyond cultural variables to better understand why the health of some immigrant groups deteriorates at faster rates overtime.

SUBMITTER: Arevalo SP

PROVIDER: S-EPMC4498998 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors.

Arévalo Sandra P SP Tucker Katherine L KL Falcón Luis M LM

Social science & medicine (1982) 20150529

Pre-migration and post-migration factors may influence the health of immigrants. Using a cross-national framework that considers the effects of the sending and receiving social contexts, we examined the extent to which pre-migration and post-migration factors, including individual and neighborhood level factors, influence depressive symptoms at a 2-year follow-up time point. Data come from the Boston Puerto Rican Health Study, a population-based prospective cohort of Puerto Ricans between the ag ...[more]

PMID: 26057720

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Project description:ObjectiveTo examine mediation and moderation of racial/ethnic all-cause mortality disparities among Veteran Health Administration (VHA)-users by neighborhood deprivation and residential segregation.Data sourcesElectronic medical records for 10/2008-9/2009 VHA-users linked to National Death Index, 2000 Area Deprivation Index, and 2006-2009 US Census.Study designRacial/ethnic groups included American Indian/Alaskan Native (AI/AN), Asian, non-Hispanic black, Hispanic, Native Hawaiian/Other Pacific Islander, and non-Hispanic white (reference). We measured neighborhood deprivation by Area Deprivation Index, calculated segregation for non-Hispanic black, Hispanic, and AI/AN using the Isolation Index, evaluated mediation using inverse odds-weighted Cox regression models and moderation using Cox regression models testing for neighborhood*race/ethnicity interactions.Principal findingsMortality disparities existed for AI/ANs (HR = 1.07, 95%CI:1.01-1.10) but no other groups after covariate adjustment. Neighborhood deprivation and Hispanic segregation neither mediated nor moderated AI/AN disparities. Non-Hispanic black segregation both mediated and moderated AI/AN disparities. The AI/AN vs. non-Hispanic white disparity was attenuated for AI/ANs living in neighborhoods with greater non-Hispanic black segregation (P = .047). Black segregation's mediating effect was limited to VHA-users living in counties with low black segregation. AI/AN segregation also mediated AI/AN mortality disparities in counties that included or were near AI/AN reservations.ConclusionsNeighborhood characteristics, particularly black and AI/AN residential segregation, may contribute to AI/AN mortality disparities among VHA-users, particularly in communities that were rural, had greater black segregation, or were located on or near AI/AN reservations. This suggests the importance of neighborhood social determinants of health on racial/ethnic mortality disparities. Living near reservations may allow AI/AN VHA-users to maintain cultural and tribal ties, while also providing them with access to economic and other resources. Future research should explore the experiences of AI/ANs living in black communities and underlying mechanisms to identify targets for intervention.

Project description:The study aimed to investigate if psychosocial factors moderate the association between objective walkability and different domains of children's physical activity (PA). A second aim of the study was to investigate the direct associations between psychosocial factors and children's PA. Based on previous literature, it was hypothesized that walkability would be more strongly related to PA among children with negative psychosocial profiles.Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children (BEPAS-child). In total, data from 494 children and one of their parents were included in the study. Children wore an accelerometer for 7 consecutive days and together with one of their parents, they completed the Flemish Physical Activity Questionnaire. Parents filled out a questionnaire concerning their child's psychosocial factors toward PA (i.e. parental attitude toward their child's PA, parental social norm toward their child's PA, parental support, friend support, children's self-efficacy, and perceived benefits and barriers toward sports and PA). Neighborhood walkability was calculated using geographical information systems (GIS). Multilevel cross-classified analyses were conducted.Of the 42 investigated interactions between neighborhood walkability and psychosocial factors in relation to PA among children, only 7 significant interactions were found of which 3 were only significant among children from low-income neighborhoods. Parental support and self-efficacy were positive correlates of children's PA in high- and low-income neighborhoods independent of the level of walkability, but effect sizes were small.The hypothesis that walkability would be more strongly related to PA among children with negative psychosocial profiles could not be confirmed and in general, psychosocial factors and objective walkability did not interact in relation to children's PA. Focusing on parental support and self-efficacy towards PA can possibly cause small effects on children's PA in both high- and low-walkable neighborhoods, as well as in high- and low-income neighborhoods.

Dataset Information

Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors.

Publications

Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors.

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