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The influence of immigrant status and concentration on psychiatric disorder in Canada: a multi-level analysis

Published online by Cambridge University Press:  25 February 2011

N. M. Menezes ,
K. Georgiades  and
M. H. Boyle
N. M. Menezes*
Affiliation:
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
K. Georgiades
Affiliation:
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
M. H. Boyle
Affiliation:
Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
*
*Address for correspondence: Dr N. M. Menezes, 25 Charlton Ave E., #703, Hamilton, ON L8N 1Y2, Canada. (Email: [email protected])
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Abstract

Background

Many studies have reported an increased incidence of psychiatric disorder (particularly psychotic disorders) among first generation adult immigrants, along with an increasing risk for ethnic minorities living in low-minority concentration neighborhoods. These studies have depended mostly on European case-based databases. In contrast, North American studies have suggested a lower risk for psychiatric disorder in immigrants, although the effect of neighborhood immigrant concentration has not been studied extensively.

Method

Using multi-level modeling to disaggregate individual from area-level influences, this study examines the influence of first generation immigrant status at the individual level, immigrant concentration at the neighborhood-level and their combined effect on 12-month prevalence of mood, anxiety and substance-dependence disorders and lifetime prevalence of psychotic disorder, among Canadians.

Results

Individual-level data came from the Canadian Community Health Survey (CCHS) 1.2, a cross-sectional study of psychiatric disorder among Canadians over the age of 15 years; the sample for analysis was n=35 708. The CCHS data were linked with neighborhood-level data from the Canadian Census 2001 for multi-level logistic regression. Immigrant status was associated with a lower prevalence of psychiatric disorder, with an added protective effect for immigrants living in neighborhoods with higher immigrant concentrations. Immigrant concentration was not associated with elevated prevalence of psychiatric disorder among non-immigrants.

Conclusions

The finding of lower 12-month prevalence of psychiatric disorder in Canadian immigrants, with further lessening as the neighborhood immigrant concentration increases, reflects a model of person–environment fit, highlighting the importance of studying individual risk factors within environmental contexts.

Keywords

Epidemiologyimmigrantsmental healthmultilevel analysisprevalence
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 10 , October 2011 , pp. 2221 - 2231
Copyright
Copyright © Cambridge University Press 2011

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