Lifetime prevalence of mental disorders among Asian Americans: Nativity, gender, and sociodemographic correlates (original) (raw)
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Psychiatric disorders among foreign-born and US-born Asian-Americans in a US national survey
Social Psychiatry and Psychiatric Epidemiology, 2006
Background Among Hispanics, Non-Hispanic Whites and Non-Hispanic Blacks studies have found lower risk for psychiatric disorders among the foreign-born than among the US-born. We examine the association of nativity and risk for psychiatric disorder in a national sample of the Asian-American (AA) population. Methods Data on 1,236 AAs from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) are analyzed using logistic regression and discrete time survival models to specify differences between the foreign-born and US-born in the lifetime occurrence of mood, anxiety and substance use disorders. Results Foreign-born AAs had significantly lower risk for all classes of disorder compared with US-born AAs (OR = 0.16–0.59). Risk for all classes of disorder was lowest for those foreign-born AAs who arrived in the US as adults. Among foreign-born AAs risk of first onset was lowest relative to the US-born in years prior to their arrival in the US and tended to rise to levels equal to that of the US-born with longer duration of residence in the US. Conclusions Among AAs, risk for psychiatric disorders is lower among the foreign-born than among the US-born. The pattern of change in risk over time suggests that both the developmental timing and the duration of experience in the US contribute to increases in risk.
2006
Objectives. We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. Methods. Data were derived from the National Latino and Asian American Study, the first national epidemiological survey of Asian Americans in the United States. Results. The relationships between immigration-related factors and mental disorders were different for men and women. Among women, nativity was strongly associated with lifetime disorders, with immigrant women having lower rates of most disorders compared with US-born women. Conversely, English proficiency was associated with mental disorders for Asian men. Asian men who spoke English proficiently generally had lower rates of lifetime and 12-month disorders compared with nonproficient speakers. Conclusions. For Asian Americans, immigration-related factors were associated with mental disorders, but in different ways for men and women. Future studies will need to examine gender as an important factor in specifying the association between immigration and mental health.
Immigration and Mental Disorders among Asian Americans
California Center For Population Research, 2007
Objectives. We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders. Methods. Data were derived from the National Latino and Asian American Study, the first national epidemiological survey of Asian Americans in the United States. Results. The relationships between immigration-related factors and mental disorders were different for men and women. Among women, nativity was strongly associated with lifetime disorders, with immigrant women having lower rates of most disorders compared with US-born women. Conversely, English proficiency was associated with mental disorders for Asian men. Asian men who spoke English proficiently generally had lower rates of lifetime and 12-month disorders compared with nonproficient speakers. Conclusions. For Asian Americans, immigration-related factors were associated with mental disorders, but in different ways for men and women. Future studies will need to examine gender as an important factor in specifying the association between immigration and mental health.
Immigration-Related Factors and Mental Disorders Among Asian Americans
American Journal of Public Health, 2007
Objectives. We examined lifetime and 12-month rates of any depressive, anxiety, and substance abuse disorders in a national sample of Asian Americans. We focused on factors related to nativity and immigration as possible correlates of mental disorders.
This study analyzed the National Epidemio- logical Survey on Alcohol and Related Conditions data, 2001–2002, to compare the prevalence and odds of DSM- IV mood, anxiety, and substance use disorders and mental health service use across Asian American subethnic groups (648 East Asians, 485 Southeast Asians, 298 South Asians). Asian American subethnic groups varied in life- time prevalence of psychiatric disorders (p = 0.004), mainly due to differences in the presence of any substance use disorder (p = 0.06), and specifically, drug use disor- ders (p = 0.02). While Southeast Asians had the highest prevalence of substance use disorders (16.7 %), fewer Southeast Asians with substance use disorders used mental health services (11.1 %) compared to South Asians with substance use disorders (24.2 %). East Asians compared to South Asians had significantly lower odds of mental health service use for substance use disorders (confidence inter- val = 0.08–0.84). Asian American subethnic groups vary in the prevalence of mental disorders and in mental health service use, especially for substance use disorders
A robust socioeconomic gradient in health is well-documented, with higher socioeconomic status (SES) associated with better health across the SES spectrum. However, recent studies of U.S. racial/ethnic minorities and immigrants show complex SES-health patterns (e.g., flat gradients), with individuals of low SES having similar or better health than their richer, U.S.-born and more acculturated counterparts, a so-called "epidemiological paradox" or "immigrant health paradox". To examine whether this exists among Asian Americans, we investigate how nativity and occupational class (white-collar, blue-collar, service, unemployed) are associated with subjective health (self-rated physical health, self-rated mental health) and 12-month DSM-IV mental disorders (any mental disorder, anxiety, depression). We analyzed data from 1530 Asian respondents to the 2002e2003 National Latino and Asian American Study in the labor force using hierarchical multivariate logistic regression models controlling for confounders, subjective social status (SSS), material and psychosocial factors theorized to explain health inequalities. Compared to U.S.-born Asians, immigrants had worse socioeconomic profiles, and controlling for age and gender, increased odds for reporting fair/poor mental health and decreased odds for any DSM-IV mental disorder and anxiety. No strong occupational class-health gradients were found. The foreign-born healthprotective effect persisted after controlling for SSS but became nonsignificant after controlling for material and psychosocial factors. Speaking fair/poor English was strongly associated with all outcomes. Material and psychosocial factors were associated with some outcomes e perceived financial need with subjective health, uninsurance with self-rated mental health and depression, social support, discrimination and acculturative stress with all or most DSM-IV outcomes. Our findings caution against using terms like "immigrant health paradox" which oversimplify complex patterns and mask negative outcomes among underserved sub-groups (e.g., speaking fair/poor English, experiencing acculturative stress). We discuss implications for better measurement of SES and health given the absence of a gradient and seemingly contradictory finding of nativity-related differences in self-rated health and DSM-IV mental disorders.
Psychiatry Research, 2013
Using a nationally representative sample of 1280 Asian Americans, we examined the extent to which major depressive disorder (MDD) onset differs by ethnicity and its associated factors for each of the three ethnic groups: Vietnamese, Filipino, and Chinese. We employed the Kaplan-Meier method to estimate the survival and hazard functions for MDD onset by ethnicity, and cox proportional hazards models to identify socio-demographic and immigration-related factors associated with MDD onset. Approximately 7% of the entire sample had experienced MDD onset in their lifetime. Filipino immigrants showed the highest survival function, followed by Vietnamese immigrants over time. Those who were never-married or divorced were more likely to experience MDD onset when compared to their married or cohabiting counterparts. Those who immigrated at a younger age were more likely to experience MDD onset than were those who immigrated at an older age. However, there were ethnic variations in terms of the risk factors that were associated with MDD onset across these three ethnic groups. Findings from this study signal the importance of understanding the differing experiences of MDD onset by ethnicity.