Background: Immigrants to Canada are less likely to report depression compared with the non-immigrant population. This healthy migrant effect has not so far been explained by demographic and socioeconomic determinants of health.
Aim: The present study examined whether the psychological health advantage of immigrants varied across Canadian health regions and investigated the hypothesis of immigrant density as a determinant of immigrant mental health advantage.
Methods: Data from the 2000—2001 Canadian Community Health Survey were used to build multi-level models estimating variation in depression within and between health regions by immigrant/visible minority status.
Results: Immigrant and visible minority residents were less likely to experience depression compared with the general population. Depression varied across health regions and the extent of variation was greater for visible minorities. The likelihood of depression decreased with increasing percentage of immigrants in the region among visible minority participants but not among whites.
Conclusions: The protection against depression afforded by immigrant and visible minority status in Canada appears to depend on contextual factors, notably the percentage of immigrants in the region. Future work should seek to better characterize the experiences of visible minorities in different settings.
Abada, T., Hou, F. & Ram, B. ( 2007) Racially mixed neighborhoods, perceived neighborhood social cohesion, and adolescent health in Canada. Social Science and Medicine, 65, 2004-2017.
2.
Ali, J. ( 2002) Mental health of Canada’s immigrants. Health Reports, 13(Suppl), 101-111.
3.
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) . Washington, DC: American Psychiatric Press.
4.
Aneshensel, C., Wight, R.G., Miller-Martinez, D., Botticello, A.L., Karlamangla, A.S. & Seeman, T.E. ( 2007) Urban neighborhoods and depressive symptoms among older adults. Journal of Gerontology, 62B, S52-S59.
5.
BEcares, L., Nazroo, J. & Stafford, M.(2009) The buffering effects of ethnic density on experienced racism and health . Health and Place, 15, 670-678.
6.
Bergeron, P., Auger, N. & Hamel, D.(2009) Poids, santé générale et santé mentale: La situation de divers sous-groupes d’immigrants au Canada . Canadian Journal of Public Health, 100, 215-220.
7.
Cairney, J. ( 1998) Gender differences in the prevalence of depression amongCanadian adolescents. Canadian Journal of Public Health , 89, 181-182.
8.
Dean, J.A. & Wilson, K.(2009) ‘Education? It is irrelevant to my job now. It makes me very depressed…’: Exploring the health impacts of under/unemployment among highly skilled recent immigrants in Canada. Ethnicity and Health, 14, 185-204.
9.
Dunn, J.R. & Dyck, I. ( 2000) Social determinants of health in Canada’s immigrant population: Results from the National Population Health Survey. Social Science and Medicine, 51, 1573-1593.
10.
Galea, S., Ahern, J., Nandi, A., Tracy, M., Beard, J. & Vlahov, D. ( 2007) Urban neighborhood poverty and the incidence of depression in a population-based cohort study. Annals of Epidemiology , 17, 171-179.
11.
Guo, G. & Zhao, H. ( 2000) Multilevel modeling for binary data. Annual Review of Sociology, 26, 441-462.
12.
Halpern, D. & Nazroo, J. ( 2000) The ethnic density effect: Results from a national community survey of England and Wales. International Journal of Social Psychiatry, 46, 34-46.
13.
Harris, R., Tobias, M., Jeffreys, M., Waldegrave, K., Karlsen, S. & Nazroo, J. ( 2006) Effects of self-reported racial discrimination and deprivation on Māori health and inequalities in New Zealand: Cross-sectional study . Lancet, 367, 2005-2009.
14.
Holley, H.L. ( 1998) Geography and mental health: A review. Social Psychiatry and Psychiatric Epidemiology, 33, 535-542.
15.
Hyman, I. ( 2004) Setting the stage: Reviewing current knowledge on the health of Canadian immigrants. What is the evidence and where are the gaps?Canadian Journal of Public Health, 95, 1-4.
16.
Jia, H., Moriarty, D.G. & Kanarek, N.(2009) County-level social environment determinants of health-related quality of life among US adults: A multilevel analysis. Journal of Community Health, 34, 430-439.
17.
Karlsen, S., Nazroo, J.Y., McKenzie, K., Bhui, K. & Weich, S. ( 2005) Racism, psychosis and common mental disorder among ethnic minority groups in England. Psychological Medicine , 35, 1795-1803.
18.
Kessler, R.C., Andrew, G., Mroczek, D.U., Ustun, T.B. & Wittchen, H.U. ( 1998) The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF). International Journal of Methods in Psychiatric Research, 7, 171-185.
19.
Laroche, M. ( 2001) Health status and health service utilization of Canada’s immigrant and non-immigrant populations. Canadian Public Policy , 26, 51-73.
20.
Matheson, F.I., Moineddin, R., Dunn, J.R., Creatore, M.I., Gozdyra, P. & Glazier, R.H. ( 2003) Urban neighborhoods, chronic stress, gender and depression . American Journal of Epidemiology, 157, 730-737.
21.
Moriarty, D.G., Zack, M.M., Holt, J.B., Chapman, D.P. & Safran, M.A.(2009) Geographic patterns of frequent mental distress: US adults, 1993-2001 and 2003-2006. American Journal of Preventive Medicine , 36, 497-505.
22.
Newbold, B. ( 2009) The short-term health of Canada’s new immigrant arrivals: Evidence from LSIC. Ethnicity and Health, 14, 315-336.
23.
Newbold, K.B. & Danforth, J. ( 2003) Health status and Canada’s immigrant population . Social Science and Medicine, 57, 1981-1995.
24.
Noh, S. & Avison, W.R. ( 1996) Asian immigrants and the stress process: A study of Koreans in Canada. Journal of Health and Social Behavior , 37, 192-206.
25.
Noh, S., Beiser, M., Kaspar, V., Hou, F. & Rummens, J. ( 1999) Perceived racial discrimination, depression and coping: A study of Southeast Asian refugees in Canada. Journal of Health and Social Behavior, 40, 193-207.
26.
Ostir, G.V., Eschbach, K., Markides, K.S. & Goodwin, J.S. ( 2003) Neighbourhood composition and depressive symptoms among older Mexican Americans. Journal of Epidemiology and Community Health, 57, 987-992.
27.
Philo, C. ( 2005) The geography of mental health: An established field? Current Opinion in Psychiatry, 18, 585-591.
28.
Pickett, K.E. & Wilkinson, R.G. ( 2008) People like us: Ethnic group density effects on health . Ethnicity and Health, 13, 321-334.
29.
Propper, C., Jones, K., Bolster, A., Burgess, S., Johnston, R. & Sarker, R. ( 2005) Local neighbourhood and mental health: Evidence from the UK. Social Science and Medicine, 61, 2065-2083.
30.
Reijneveld, S.A. & Schene, A.H. ( 1998) Higher prevalence of mental disorders in socioeconomically deprived urban areas in the Netherlands: Community or personal disadvantage ? Journal of Epidemiology and Community Health, 52, 2-7.
31.
Shaw, R.J., Atkin, K.A., Becares, L., Albor, C., Stafford, M., Kiernan, K., Nazroo, J.Y., Wilkinson, R.G. & Pickett, K.E. (in preparation) A systematic review of the impact of ethnic density on adult mental health.
32.
Stafford, M. & Marmot, M. ( 2003) Neighbourhood deprivation and health: Does it affect us all equally? International Journal of Epidemiology, 32, 357-366.
33.
Statistics canada (2002) Canadian Community Health Survey Cycle 1.1 (2000-2001). Ottawa: Statistics Canada. Accessed 28 February 2010 , from http://www.statcan.gc.ca/imdb-bmdi/document/3226_D7_T9_V1-eng.pdf .
34.
Statistics Canada (2007) Immigrants’ Perspectives on their First Four Years in Canada: Highlights from Three Waves of the Longitudinal Survey of Immigrants to Canada. Accessed 28 February 2010, from http://www.statcan.gc.ca/pub/11-008-x/2007000/pdf/9627-eng.pdf .
35.
Statistics Canada (2009a) CANSIM Table 109-0200. Ottawa: Statistics Canada. Accessed 28 February 2010, from http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.exe?Lang=E&RootDir=CII/&ResultTemplate=CII/CII___&Array_Pick=1&ArrayId=1090200.
36.
Statistics Canada (2009b) Ethnic Diversity and Immigration. Ottawa: Statistics Canada. Accessed 28 February 2010, from http://www.41.statcan.ca/2008/30000/ceb30000_000_e.htm.
37.
Tiwari, S.K. & Wang, J. ( 2008) Ethnic differences in mental health service use among white, Chinese, South Asian and South East Asian populations living in Canada . Social Psychiatry and Psychiatric Epidemiology , 43, 866-871.
38.
Veenstra, G. ( 2005) Location, location, location: Contextual and compositional health effects of social capital in British Columbia, Canada. Social Science Medicine, 60, 2059-2071.
39.
Weich, S., Holt, G., Twigg, L., Jones, K. & Lewis, G. ( 2003) Geographic variation in the prevalence of common mental disorders in Britain: A multilevel investigation. American Journal of Epidemiology, 157, 730-737.
40.
Wickrama, K.A.S., Noh, S. & Bryant, C.M. ( 2005) Racial differences in adolescent distress: Differential effects of the family and community for blacks and whites. Journal of Community Psychology, 33, 261-282.
