Purpose European studies about ethnic inequalities in depressive symptoms are scarce, show inconclusive results and are complicated by the discussion of what constitute (im)migrant and ethnic minority groups. Moreover, comparisons across countries are hampered by a lack of comparable measures of depressive symptoms. This study aims to assess the prevalence and determinants of depressive symptoms among immigrants, ethnic minorities and natives in 23 European countries. Methods Multilevel analyses are performed using data from the third wave of the European Social Survey (ESS-3). This dataset comprises information about 36 970 respondents, aged 21 years or older, of whom 13,3 % immigrants and 6,2 % ethnic minorities. Depressive symptoms were assessed with an eightitem version of the Center for Epidemiologic Studies-Depression scale. Main determinants are immigrant status, socio-economic conditions and the experience of ethnic discrimination in the host country. ResultsThe results show that immigrants and ethnic minorities do experience more depressive symtoms than natives in an essential part of the countries. Moreover, socio-economic conditions and the experience of ethnic discrimination are important risk factors. Immigrant status seems irrelevant, once the other risk factors are accounted for. Finally, immigrant and ethnic minority groups do not consist of the same individuals and therefore have different prevalence rates of depressive symptoms. ConclusionsThe prevalence rates of depressive symptoms are higher for immigrant and ethnic minority groups in a substantial part of the European countries. A clear definition is indispensable for developing policies that address the right targeted population.

This paper provides an empirical study of the between-individual and between-country differences in the popular legitimacy of European healthcare systems. In order to explain two dimensions of popular legitimacy (satisfaction and support for state responsibility), we assess the impact of self-interest motives (income and personal health), ideology (egalitarianism) and institutional arrangements (level of service provision, and private and government health expenditure). For this purpose, data from the European Social Survey Round 4 (ESS-4, 2008(ESS-4, -2009 are analysed by means of multilevel models. Universal high support for state responsibility is found, while satisfaction varies considerably, with particularly low levels found in Eastern European and former Soviet Union countries. It appears that individuals are not guided by self-interest motives and ideology alone. In addition to these factors interacting, the results suggest that state-provided healthcare might be in everyone's interest. Introducing a patient perspective could advance our understanding of healthcare legitimacy.

Higher-educated people experience enhanced mental health. We ponder whether the mental health benefits of educational attainment are limitless. At the individual level, we look at the impact of job-education mismatch. At the societal level, we hypothesize that diminishing economic returns on education limit its mental health benefits. Using a subsample of individuals aged 20 to 65 years (N = 28,288) from 21 countries in the European Social Survey (ESS 2006), we estimate the impact on depressive symptoms of characteristics at both the employee level (years of education and job-education mismatch) and the labor market/country level (the gap between the nontertiary and tertiary educated in terms of unemployment risks and earnings). The results show that educational attainment produces mental health benefits in most European countries. However, in some of the countries, these benefits are limited or even completely eliminated by education-labor market misfit.

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