The use of diagnosis-specific rates of mental hospitalization to estimate underutilization by immigrants

Morgan, Peter; Andrushko, Elizabeth

doi:10.1016/0037-7856(77)90043-9

Cited by 12 publications

(11 citation statements)

References 23 publications

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“…It is quite possible that the rates for the native population continued to increase, as it would be comprised of more and more descendants of immigrants; it might even surpass the rates of foreign‐born subjects, as the offspring of immigrants were exposed either longer than new immigrants or at a more vulnerable period. This could explain the paradoxical results of lower rates for all admissions for schizophrenia in recent immigrants reported by Morgan and Andrushko in Toronto (103).…”

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confidence: 93%

Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration

Dealberto

2010

Acta Psychiatr Scand

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Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration Dealberto M-J. Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration.Objectives: Compare the risk for schizophrenia in immigrants to countries of recent and longstanding immigration. Compare prevalence and incidence rates in black subjects under different conditions. Method: An electronic literature search was complemented by review articles and cross-references. Studies reporting standard diagnosis and incidence or prevalence rates were included. Results: Immigrants had an increased risk for schizophrenia in countries of longstanding immigration, but with lower risk ratios than in those of recent immigration. The risk was higher in black immigrants and the black population living in the United States. But incidence and prevalence rates in Africa and the Caribbean were similar to those of international studies. Conclusion: Comparing the most recent generation of immigrants with descendants of previous ones may account for the lower risk ratios observed in countries of longstanding vs. recent immigration. Two neurobiological hypotheses are proposed to explain the epidemiological findings in black populations and in immigrants.

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confidence: 93%

Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration

Dealberto

2010

Acta Psychiatr Scand

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“…However, less emphasis has been placed on possible underrepresentation by not considering psychiatric patients admitted under physicians and other non-psychiatrists. Cochrane (1977,1980) and Morgan & Andrushko (1977) are noted exceptions to the general rule of using only first admissions. The only other comparable study was that of Morgan & Andrushko (1977) who included all admissions for 1971 to all 21 hospitals serving the Toronto catchment area.…”

Section: Discussionmentioning

confidence: 99%

“…Murphy (1974) has forwarded the former hypothesis, arguing that different rates for migrants persisted into the second and third generations. Andrushko (1977) argued that migrants in Toronto underutilized existing medical services and that milder psychiatric cases were not hospitalized. Andrushko (1977) argued that migrants in Toronto underutilized existing medical services and that milder psychiatric cases were not hospitalized.…”

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confidence: 99%

Relationship between country of birth and psychiatric admissions in Western Australia

Burvill

Reymond

Stampfer

et al. 1982

Acta Psychiatr Scand

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The rates of admissions in 1976-78 to all hospitals in Western Australia, both psychiatric and non-psychiatric, of patients with a primary psychiatric diagnosis were analysed specifically for country of birth and whether they lived in Perth or in country areas. Eastern European migrants had the highest hospitalization rates, and Southern European migrants the lowest. Rates for schizophrenia were high in the Eastern Europeans, and for alcoholism low in Southern European and Asian females and high in Northern European males. The United Kingdom migrants were most like the Australian born in regards to admission rates, diagnostic composition, and in the distribution of hospitalization patterns between psychiatrists and non-psychiatrists. Women, especially Southern European, in the country areas are at special risk to be admitted for neurosis/personality disorder.

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“…It assessed 2867 admissions for psychiatric diagnoses to 21 hospitals serving the Toronto catchment area. Morgan and Andrushko 12 reported that rates of admissions for schizophrenia were higher for native-born Canadians than foreign-born populations (rate ratio of schizophrenia admissions by foreign-born people divided by schizophrenia admissions by native-born people: males 0.87; females 0.71). The second Canadian study 13 assessed psychiatric admissions in British Columbia between 1902 and 1913.…”

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confidence: 99%

“…These studies [6][7][8][9][10][11] were mainly done in European settings, including the United Kingdom and Sweden. Two Canadian studies 12,13 have been done. The first was a Toronto study 12 conducted in 1971.…”

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confidence: 99%

First- Generation Immigrants and Hospital Admission Rates for Psychosis and Affective Disorders: An Ecological Study in Ontario

et al. 2011

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Objective: The immigrant population in Canada, and particularly in Ontario, is increasing. Our ecological study first assessed if there was an association between areas with proportions of first-generation immigrations and admissions rates for psychotic and affective disorders. Second, this study examined if area-level risks would persist after controlling for area socioeconomic factors in census-derived geographical areas-Forward Sortation Areas (FSAs)-in Ontario.Methods: Ontario's inpatient admission records from 1996 to 2005 and census data from 2001 were analyzed to derive FSA rates of first admissions for psychotic disorders and affective disorders per 100 000 person-years. Negative binomial regression models were adjusted, first, for FSA age and sex and, second, also for FSA population density and average income.Results: Using age-and sex-adjusted models, admission rates for psychotic disorders were higher in areas with greater proportions of immigrants. These areas were associated with lower admission rates for affective disorders. When FSA average income and population density were added to the models, the influence of immigrants was attenuated to nonsignificant levels in models predicting psychotic disorders admission rates. However, greater proportions of immigrants remained significantly protective when predicting rates of affective disorders. Discussion: Our study provides insight about the influence of area-level variables on risk of admission for psychotic and affective disorders in high immigrant areas. There is a dearth of current Canadian research on immigrant admission for psychotic disorders at the individual or area level. Future area-and individual-level studies may better identify groups at risk and possible explanations.Can J Psychiatry. 2011;56(7):418-426. Clinical Implications• Health care administrators may want to consider factors related to the immigrant experience, such as economic deprivation and high population density, when planning culturally sensitive services for affective and psychotic disorders.• There is a need to further investigate immigrant risk for psychotic and affective disorders in Canada, both in clinical and in research settings. Limitations• It is unknown if the observed area-level effects persist at the individual level.• Our study could not disentangle the impact of social and immigration factors on admission risk at the individual level.• Our study does not address pathways to care.

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The use of diagnosis-specific rates of mental hospitalization to estimate underutilization by immigrants

Cited by 12 publications

References 23 publications

Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration

Ethnic origin and increased risk for schizophrenia in immigrants to countries of recent and longstanding immigration

Relationship between country of birth and psychiatric admissions in Western Australia

First- Generation Immigrants and Hospital Admission Rates for Psychosis and Affective Disorders: An Ecological Study in Ontario

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