The link between ethnicity, social disadvantage and mental health problems in a school-based multiethnic sample of children in the Netherlands

Abstract

To investigate to what extent differences in prevalence and types of mental health problems between ethnic minority and majority youth can be explained by social disadvantage. Mental health problems were assessed in a sample of 1,278 schoolchildren (55% Dutch, 32% Moroccan and 13% Turkish; mean age: 12.9 ± 1.8) using the Strengths and Difficulties Questionnaire self-report and teacher report. Measures of family socioeconomic status, neighbourhood deprivation, perceived discrimination, family structure, repeating a school year, housing stability and neighbourhood urbanization were used as indicators of social disadvantage, based on which a cumulative index was created. Ethnic minority youth had more externalizing and fewer internalizing problems than majority youth. Perceived discrimination and living in an unstable social environment were associated with mental health problems, independent of ethnicity. A dose-response relationship was found between social disadvantage and mental health problems. The adjusted odds ratio for mental health problems was 4.16 (95% CI 2.49-6.94) for more than four compared with zero indicators of social disadvantage. Social disadvantage was more common in ethnic minority than in majority youth, explaining part of the differences in prevalence of mental health problems. Ethnic minority youth in the Netherlands have a different profile of mental health problems than majority youth. In all ethnic groups, the risk of mental health problems increases with the degree of social disadvantage. The higher prevalence of externalizing problems among ethnic minority youth is explained partly by their disadvantaged social position. The findings suggest that social factors associated with ethnicity are likely to explain mental health problems in ethnic groups.

Factors associated with psychiatric symptoms and psychiatric disorders in ethnic minority youth

“…Social factors associated with ethnicity seem to be most important in explaining differences between ethnic minority and majority youth. A disadvantaged ethnic minority position, characterized by a low socio-economic status (SES), a low social status and experiencing discrimination, has repeatedly been associated with mental health problems in ethnic minorities [5,7,8]. Although social disadvantage may partly explain why mental health problems are more prevalent in socially disadvantaged ethnic minority groups, it does not explain which members of these groups will develop such problems.…”

“…Although social disadvantage may partly explain why mental health problems are more prevalent in socially disadvantaged ethnic minority groups, it does not explain which members of these groups will develop such problems. Studies carried out within a socially disadvantaged ethnic minority group are needed to explore factors that make some children resilient and others vulnerable to developing mental health problems [7]. As social and cultural characteristics of ethnic groups differ, and the degree of social disadvantage in ethnic groups varies, such factors should be explored in specific ethnic groups separately.…”

“…Specific to ethnic minorities, factors associated with migration, the minority position or cultural background at ethnic minority group level should be taken into account as well [5,10]. The degree of social disadvantage explained differences in the prevalence of mental health problems between ethnic minority and majority youth [7]. As the degree of social disadvantage within a group can still be substantial, it may also explain differences in mental health within the group.…”

“…Moroccan-Dutch children have an increased risk to develop mental health problems and psychotic disorders in (young) adulthood [7,13,14]. Moroccans living in the Netherlands have a low SES, a low social status and are exposed to a high degree of discrimination [13,15,16].…”

Large sample size in child and adolescent psychiatric research: the way of salvation?

“…Four studies used questionnaires in large samples of children and adolescents [1,2,5,7]. One population-based study rendered possible via linkage of records of three health data sets compared disordered (ADHD; n = 11,902) and non-disordered children (healthy controls; n = 27,304) under 18 years [11].…”