Inequalities in depressive symptoms between natives and immigrants in Europe: the mediating role of social exclusion

Abstract

The aim of this study was to analyze inequalities in depressive symptoms between natives and immigrant groups according to their length of residence in Europe, and to test the mediating role of social exclusion in explaining these differences. The study is based on cross-sectional data from the 7th round of the 2014 European Social Survey (sample of 1,792 immigrants and 22,557 native-born Europeans). Dependent variables: self-reported depressive symptoms. Independent variables: immigrant background and social exclusion factors that were classified into four groups. Socially excluded individuals were those less advantaged in each factor. All analyses were stratified by the length of residence. The independent and overall associations between Social Exclusion and health outcomes were examined using binary logistic regression models (OR; IC95%). Immigrants had a higher prevalence of self-reported depressive symptoms than natives; those residing in Europe for 1-10 years and > 20 years had the highest prevalence. Multidimensional social exclusion factors analyzed together completely explained these differences for immigrants residing in Europe for 1-10 years and partially for immigrants residing for > 20 years. The economic factors also explained these differences completely for 1-10 years and partially for immigrants residing for > 20 years. Policies should offer migrants the possibility to settle in good social and economic condition, promote efforts to eliminate social exclusion and prevent the associated health inequalities.

Reliability and Validity of the Turkish Version of the Mini Depression Status Test (MDST-TR)

“…In contrast to the German sample, where the MDST cut-off score for depression was < 11 (Christen et al, 2019), our ROC analyses revealed a cut-off score of < 10 for the clinical group (AUC .77) and < 11 for the healthy group, with an AUC value of .78, which indicates a good separation between subjects with and without depression, with GDS results as an external criterion. As mentioned previously, Turkish migrants are affected more by psychiatric diseases (Aichberger et al, 2010; Igde et al, 2019), and migrants, in general, are affected more by depression (Arias-Uriona & Guillén, 2020). Turkish healthy subjects are classified as possibly depressed when scoring 11, and Turkish patients are classified as possibly depressed when scoring 10 points in the MDST.…”

“…Our study also found evidence that education is an important factor in cognitive test performance (Anapa et al, 2021). It is well known that migrants face barriers in accessing health services, mainly because of language deficits and social disadvantages (Arias-Uriona & Guillén, 2020; Klein & von dem Knesebeck, 2018; Steinbach, 2018). Furthermore, health literacy plays an important role in the utilization of health services.…”