Migration and social determinants of mental health: Results from the Canadian Health Measures Survey

Abstract

OBJECTIVES: Studies worldwide point to increased risk of mental health problems among immigrants. However, the data on Canadian immigrants' mental health are ambiguous. To address this, we examined the relationship of both self-perceived mental health and reported diagnosis of mood disorders with age, gender, migration status, time since migration, and social determinants of health factors. METHODS:We analyzed three cycles of the Canadian Health Measures Survey. Our outcome variables were self-perceived mental health and reported diagnosis of mood disorders. We used weighted logistic regression to model time since migration conditional on age, gender, income, community belonging, education, and employment status for 12 160 participants aged 15-79 years.RESULTS: Recent (within 5 years) migrants reported better self-perceived mental health (odds ratio 3.98, 95% confidence interval [CI]: 2.06-7.70) but this effect disappeared with longer time since immigration. Other predictors were older age, higher income, better sense of community belonging, and being employed. Similarly, diagnosis of mood disorders was less likely to be reported in recent migrants (odds ratio 0.23, 95% CI: 0.10-0.53) with some weak evidence that this was also seen among longer-term migrant residents (>10 years). Diagnosis was also associated with older age, being a woman, lower income, weak sense of community belonging, and being unemployed. DISCUSSION:Our findings indicate that migrants to Canada do not have worse mental health in general, though health and social policies need to attend to the socio-economic determinants, such as low income, unemployment, and a poor sense of community belonging, which contribute to population health outcomes.KEY WORDS: Canada; immigrants; immigration; mental health; social determinants of health La traduction du résumé se trouve à la fin de l'article.

Lifetime and Twelve-Month Prevalence, Persistence, and Unmet Treatment Needs of Mood, Anxiety, and Substance Use Disorders in African American and U.S. versus Foreign-Born Caribbean Women

“…Our findings build on prior literature by presenting estimates of lifetime and twelve-month rates of specific mood, anxiety, and substance use disorders for foreign-born Caribbean women to better aid mental health services planning for this growing population. Consistent with studies of mental health and substance use among African and Caribbean immigrants carried out in other countries [ 54 , 55 , 56 , 57 ], we found Black women who have migrated from the Caribbean had lower rates of psychiatric disorders than Black women born in the U.S., especially for substance use disorders. These results are consistent with the healthy immigrant literature, which finds that foreign-born populations often have better health and mental health outcomes [ 13 , 16 , 54 , 57 , 58 , 59 , 60 , 61 ].…”

“…Consistent with studies of mental health and substance use among African and Caribbean immigrants carried out in other countries [ 54 , 55 , 56 , 57 ], we found Black women who have migrated from the Caribbean had lower rates of psychiatric disorders than Black women born in the U.S., especially for substance use disorders. These results are consistent with the healthy immigrant literature, which finds that foreign-born populations often have better health and mental health outcomes [ 13 , 16 , 54 , 57 , 58 , 59 , 60 , 61 ]. In addition, this study contributes to the literature by demonstrating the chronic course of mental health and substance use disorders, such as dysthymia and panic disorder in African American women, which appear to persist even for women who have accessed mental health services during the lifetime.…”

The negative self-perceived health of migrants with precarious status in Montreal, Canada: A cross-sectional study

“…It was already suggested that recent immigrants to Canada, who are usually highly educated [11], have on average comparable or sometimes better health outcomes than the native population [30]. Some authors describe a healthy immigrant effect in wealthy countries such as Australia, Canada, Europe and USA: recent immigrants have a better physical and mental health status than national born citizens [17,[31][32][33]. However, these health trends seem to deteriorate with years spent in the host country and over time migrant health statuses become closer to the native-born population, as has been observed in Canada and elsewhere [2,3,31].…”

Mental well-being of international migrants to Japan: a systematic review

“…The ‘right to health’ of migrants is enshrined in the Declaration of Alma-Ata (1978) and states receiving countries should take a comprehensive approach to healthcare of such sojourners beyond basic infectious disease control 5. Accordingly, migration is increasingly recognised as a structural socio-economic force that influences health outcomes as a social determinant of health, in general, and mental health, in particular 6 7…”