Immigration,Visible-Minority Status,Gender,and Depression

Abstract

This study examines if the association between length of residence and mental health—as measured by depression—of immigrants post-arrival in the host country is altered by visible-minority status and gender among a sample of immigrants to Toronto, Canada, as compared to the native-born. The analytic sample excluded refugees. Of the 1,911 adults included, 23 percent were foreign-born. Adjusted multivariate results indicate a significant and positive association between depression and length of residence in the host country—but only among visible-minority immigrant men as compared to Canadian-born men. The positive association between depression and length of residence among visible-minority immigrant men is found to be due to a parallel rise in perceived discrimination and the experience of anger with tenure in the host country.

Keywords

immigration mental health anger discrimination visible-minority

The majority of studies that examine the physical and mental health of immigrants report better or the same level of well-being among this group, as compared to the native-born, that deteriorates with tenure in the host country (e.g., Ali 2002; Cook et al. 2009; Montazer and Wheaton 2017). This finding is often reported among nonrefugee immigrants to Western countries and has mainly been corroborated for physical health outcomes (e.g., Jasso et al. 2004; Riosmena, Wong, and Palloni 2013). While research on the mental health of immigrants goes back many decades, research on the mental health of the newer wave of immigrants compared to research on this population’s physical health is still limited. However, studying the mental health of immigrants is important because it is a central indicator of the adaptive response of immigration (Ataca and Berry 2002) and a “social mirror” that efficiently reflects the social conditions in which people live (Pearlin, Avison, and Fazio 2007). Furthermore, immigration is the primary means of population growth in most industrialized countries (Read and Reynalds 2012). In 2018, for example, immigration drove Canada’s population to over 37 million—from 36 million just two years and two months prior—setting a new international migratory record (Statistics Canada 2018). As the number of foreign-born continues to grow, understanding their mental health, and in particular the decline reported with tenure in the host country, will have important consequences for long-term population health and the health care system (Read and Reynolds 2012).

As with findings for physical health, the studies that examine nonrefugee mental health also tend to find that immigrant mental health, on average, deteriorates with tenure in the host country (e.g., Cook et al. 2009; Montazer and Wheaton 2017; Vega and Rumbaut 1991). Of course, the decline in mental health with increase in the length of residence (LOR) is contrary to what common sense would suggest. This decline occurs even though immigrants assimilate socially and economically with tenure in the host country (Salas-Wright, Kagotho, and Vaughn 2014), which should be protective against the development of mental health problems.

The decline in mental health with increase in LOR in the host country, however, may not apply equally to all immigrants. Indeed, this phenomenon is mainly observed among the more recent wave of nonrefugee migrants who are mostly viewed as visible minorities in their new home country (Gee et al. 2006; Goto, Gee, and Takeuchi 2002; Yoo, Gee, and Takeuchi 2009).¹ Yet, visible-minority status is likely not enough for understanding the mental health of the foreign-born. It is also essential to consider other individual-level factors, such as gender, that have significant mental health consequences for migrants (Kwak 2018; Montazer, Wheaton, and Noh 2016). Keeping in mind that people’s experiences vary in relation to their social positions (Pearlin 1999), the present study expands on previous research on the mental health of immigrants to Canada by considering the joint effects of visible-minority status and gender on mental health, as measured by depression, among adult nonrefugee immigrants as compared to the Canadian-born.

More specifically, by using data from the Neighborhood Effects on Health and Well-Being (NEHW) study (O’Campo et al. 2015), this article investigates if (1) the relationship between LOR and depression is altered by visible-minority status and the gender of the respondent and if yes, (2) whether a change in the perception of racial/ethnic discrimination and anger explain the relationship between tenure in the host country and depression. The rationale for these research objectives is elaborated in the following sections.

Background

Visible-Minority Status, Gender, and Mental Health

The scholarship on immigration over the past century presents mirror-image findings of the effects of immigration on mental health. In the early part of the twentieth century, immigrants were viewed as “marginal” people who were at elevated risk for emotional health problems (Montazer and Wheaton 2011; Vega and Rumbaut 1991). This scholarship relied on Warner and Srole’s (1945)“straight line” model of assimilation, where the stress associated with immigration was expected to produce higher emotional problems that diminished with tenure in the host country as immigrants adopted the “cultural patterns” of the host society.

Research on the newer wave of immigrants, those who immigrated post-1965, on the other hand, views the foreign-born as a highly selected group of individuals who were physically, emotionally, financially, and socially able to leave behind the life they knew and venture to a new and foreign land—factors that gave them, at least initially, a mental health advantage over the native-born (Cook et al. 2009; Jasso et al. 2004). The reported mental health advantage among immigrants, however, does not appear to last indefinitely. Indeed, the majority of research on immigrant mental health—in terms of depression, distress, and anxiety, for example — finds that despite improvements in social and economic life conditions, this advantage deteriorates with tenure in the host country (i.e., Cook et al. 2009; Montazer and Wheaton 2017). Yet, immigrants are not a homogeneous group, and as elaborated by segmented assimilation theory (Portes and Zhou 1993), there are diverse trajectories of adaptation and incorporation into the host society that can impact the mental health of the foreign-born. Visible-minority status (Gee et al. 2006; Goto et al. 2002; Yoo et al. 2009) and gender (Kwak 2018; Read and Reynolds 2012) are two such important modifiers of this phenomenon as they are two of the most important bases of life development that impact people’s experiences (Kwak 2018).

Research has attributed the deterioration in immigrant mental health with increase in LOR in part to an increase in varying types of chronic stressors that accompany acculturation (Cook et al. 2009; Montazer 2018; Montazer and Wheaton 2017), such as an increase in family/marital conflict, the perception of underemployment, chronic stressors in general, and dissatisfaction with one’s socioeconomic position, for example (Cook et al. 2009; Montazer 2018; Montazer and Wheaton 2017). This article proposes that visible-minority immigrant men may be especially at risk of losing their mental health advantage with tenure in the host country because of a parallel increase in the experience of a particular chronic stressor: racial/ethnic discrimination. However, it is not expected that discrimination will explain all of the association (Kessler, Mickelson, and Williams 1999) between LOR and mental health among visible-minority men. It is proposed that the increase in LOR will also exert its influence on the mental health of this group of immigrants indirectly through an increase in the experience of anger, controlling for perceived discrimination.

Anger is a strong feeling of displeasure in response to specific provocations (Thomas 1993) and a direct consequence of stress (Mabry and Kiecolt 2005). It is one of the most commonly experienced and readily recognized forms of emotional upset (Schieman 2007), which has cross-cultural universality (Kemper 1978). According to Kemper (1978), people experience strong negative emotions, such as anger, in interactions that they perceive as unjust—such as being treated unfairly or disrespectfully because of one’s race or ethnicity by members of more privileged groups (Mabry and Kiecolt 2005). Emotion norms suggest that anger is expressed more frequently by males than females (Simon and Lively 2010). Yet, empirical evidence on the effect of gender on the frequency of anger is mixed (Schieman 2007). While the scholarship remains inconclusive about the effect of gender on anger, research has found anger to be significantly associated with physical and mental health problems, such as depression (e.g., House 2002; Humber et al. 2013; Simon and Lively 2010); because emotions like anger cannot be maintained for prolonged periods of time, the need to manage this emotion can lead to mental health problems (Wilkins and Pace 2014).

Visible-Minority Status, Gender, Length of Residence, Discrimination, and Anger

According to the stress process model (Pearlin 1999), social and demographic statuses—such as nativity, visible-minority status, and gender, for example—may impact the experience of chronic stressors. Chronic stressors are threats, demands, or structural constraints that are continuous in nature, develop insidiously, and are usually non–self-limiting (Wheaton et al. 2013). Such stressors account for a substantial portion of variation in emotional functioning across groups. One chronic stressor that is a significant source of stress is the perception of ethnic/racial discrimination (Kessler et al. 1999; Lee and Bierman 2018; Mabry and Kiecolt 2005; Magee and Louie 2016). This type of discrimination is a minority group member’s subjective perception of unfair treatment based on racial or ethnic prejudice, which may be apparent at institutional, cultural, or individual levels (Jackson, Brown, and Kirby 1998). Although there is variation between ethnic/racial groups in the perception of discrimination (Brondolo et al. 2015; Carlisle and Stone 2015), substantial data suggest that members of ethnic and racial minority groups are particularly vulnerable to experiencing discrimination because of their race or ethnicity (e.g., Brondolo et al. 2015; Carlisle and Stone 2015; Goto et al. 2002). Even though other cultural cues, such as speaking with an accent, are also important for the experience of discrimination (Goto et al. 2002), visible-minority status may be the most common for the experience of this stressor because visible-minority status is more easily apparent to the potential perpetrator. Additionally, unlike speaking with an accent, visible-minority status is unlikely to change over time.

A growing body of research reports that the perception of ethnic/racial discrimination among immigrants increases with tenure in the host country (Carlisle and Stone 2015; Cook et al. 2009; Gee et al. 2006; Goto et al. 2002; Yoo et al. 2009). Recent arrival immigrants may be less likely to attribute discriminatory behavior to their race or ethnicity because they often come from societies where their ethnic or racial group formed the majority (Mossakowski 2007). Therefore, they may be less aware of the role of race/ethnicity in how one is perceived or treated in their new home country (Gee et al. 2006). This may be especially true for immigrants to Canada, where the ideology of multiculturalism and its emphasis on the right of all individuals to maintain and share their cultural heritage while retaining their right to full participation in Canadian society is highly valued (Fleras and Elliott 1992). Recent immigrants may also believe that others hold the immigrants’ own ethnic group in higher regard than is the case, making them less likely to attribute ill treatment to racial/ethnic discrimination (Brondolo et al. 2015). Even if immigrants perceive discrimination initially, they may have resources such as connection and pride to their country of origin (Yoo et al. 2009), which can temporarily buffer the deleterious effects of discrimination (Gee et al. 2006). Further, they may attribute experiences of discrimination to their inability to speak English or to being foreign-born (Brondolo et al. 2015), for example, which might not be as problematic for emotional outcomes because these types of discrimination may be viewed as “short-term” difficulties.

Over time, however, visible-minority foreign-born individuals become more aware of the collective views held by other host country residents about their group. They become more aware of racial/ethnic discrimination or more likely to attribute types of maltreatment to discrimination and prejudice (Brondolo et al. 2015). Increase in LOR also allows visible-minority immigrants to accumulate a critical mass of discriminatory experiences. The deteriorating effects of discrimination may accumulate over time, “weathering away” protective safeguards and allowing for disadvantage to accumulate (Carlisle and Stone 2015; Gee et al. 2006), which then leads to an increase in anger and other mental health problems (Mabry and Kiecolt 2005; Zhang and Hong 2012).

Gender adds another layer of complexity to the aforementioned relationship. Studies that examine the effect of race/ethnicity on the perception of discrimination report a gender effect (e.g., Assari and Lankarani 2017; Kessler et al. 1999). While high levels of discrimination have been shown to be associated with negative mental and physical health for both men and women (Zhang and Hong 2012), findings show that men are more likely than women to report frequent day-to-day perceived racial/ethnic discrimination (Assari and Lankarani 2017; Kessler et al. 1999). According to the subordinate male target hypothesis (Sidanius and Pratto 1999), people with single subordinate-group identities (i.e., visible-minority) regularly experience more discrimination than people with multiple subordinate group identities (i.e., female and visible-minority) because people with a single devalued identity often bear the brunt of discrimination targeted at their group. Thus, visible-minority men, according to this theory, are more likely to experience discrimination than visible-minority women. Since men have a higher preference for dominance and hierarchy than women, the experience of discrimination is therefore more likely to undermine their feelings of dominance (Assari and Lankarani 2017) and consequently lead to higher anger and other mental health problems among this group with increase in LOR.

The aforementioned arguments lead to the following hypotheses:

Hypothesis 1: The relationship between LOR and mental health problems (as measured by depression) will differ among men and women: Only visible-minority immigrant men will experience an increase in depression with increase in LOR in Canada as compared to native-born respondents (H1).

Hypothesis 2: The positive and significant association between LOR and depression among visible-minority immigrant men is explained by (a) perceived ethnic/racial discrimination (H2a) and (b) anger (H2b).

Sample and Methods

Data

Data from the Neighborhood Effects on Health and Well-Being study (O’Campo et al. 2015) are used to test the aforementioned hypotheses. The NEHW study is an individual-level data set gathered using a cross-sectional, multilevel design across 47 neighborhoods in the metropolitan city of the Greater Toronto Area (GTA). Face-to-face interviews with approximately 50 respondents per neighborhood were conducted between March 2009 and June 2011—yielding a total sample size of 2,412 respondents. The response rate was over 80 percent. To be eligible for the study, individuals had to be a resident of the selected household, between the ages of 25 and 64, and able to communicate in English and had to have lived in the neighborhood for at least six months (for more details on the sampling/study design, see O’Campo et al. 2015). Sampling weights were derived to correct for any selection biases that may have occurred due to these sampling restrictions. For example, the last two eligibility criteria are likely to have led to the underrepresentation of the most recent immigrants. Data were thus weighted by age, sex at birth, total combined household income from all sources, household size, and immigrant status to analytically place more weight on the underrepresented categories and less weight on the overrepresented categories (O’Campo et al. 2015).

The focus of this study is on the effect of immigration on mental health among adult immigrants. Thus, the immigrant sample is restricted to those who came to Canada after the age of 18. This restriction is done to avoid mixing the adaptation trajectories of child/adolescent respondents with those of adults—two groups who are likely to experience qualitatively different sets of issues as migrants (Montazer 2018; Rumbaut 2004). Further, refugees were excluded from the analyses (N = 46) because they are a different group socially and economically than the general immigrant population (Setia et al. 2011). These restrictions resulted in a final sample size of 1,911 respondents.

Although the NEHW study was originally designed as a study of neighborhood effects on health, it contains relevant measures to test the aforementioned hypotheses and 431 foreign-born individuals. These data are also advantageous to the current study since they are based out of Toronto—a metropolitan city comprising close to 50 percent immigrants (O’Campo et al. 2015).

Measures

Mental Health Outcome: Depression

Depression is measured with the 20-item CES-D depression scale (Radloff 1977). This scale is one of the most widely used mental health outcomes in research over the past 30 years (O’Campo et al. 2015). Respondents were asked how often in the past two weeks, for example, “were you bothered by things that usually don’t bother you,”“did you feel like everything you did was an effort,”“I felt depressed,” or “I could not get going.” Respondents were asked whether they felt symptoms such as these none of the time (1), a little of the time (2), some of the time (3), most of the time (4), or all of the time (5). The items were summed to create an index of depression, which ranges between 0 and 59. Higher scores reflect greater depression (α = .92).

Explanatory Variables: Perceived Discrimination and Anger

Six items adapted from the Everyday Discrimination Scale (Williams et al. 1997) were used to construct a perceived discrimination scale. Each respondent was asked to indicate how often (almost every day = 1, at least once a week = 2, a few times a month = 3, a few times a year = 4, less than once a year = 5, never = 6) “In your dad-to-day life, do you experience any of the following because of your race, ethnicity, or culture?”: “You are treated with less respect than other people,”“People think that they’re better than you,”“You are called names or are insulted,” for example. The items were reverse coded and summed to create a perceived discrimination scale (α = .85). Higher values indicated greater perception of discrimination (range, 0–30).

Anger is measured by taking the mean across five items adapted from Schieman, Pearlin, and Meersman (2006). Respondents were asked the number of days in the past week they “felt annoyed or frustrated,”“felt angry,”“yelled at someone or something,”“lost your temper,” and “felt very critical of others.” The index scores each item in number of days (range, 0–7). Higher scores represent greater frequency of anger (α = .82).

Independent Variables

The country of birth of respondents was used to create a dummy variable for foreign-born status (vs. native-born). The respondent was also asked: “To which ethnic or cultural group do you feel you belong to?” Information on ethnic identification and foreign-born status were used to subdivide foreign-born status by visible-minority status. Specifically, the foreign/native-born individuals who identified as Arab or West Asian, African, Caribbean, South Asian, East Asian Pacific Rim, and Latin were assigned to the visible-minority foreign-born (N = 305) or native-born groups (N = 195), and those who indicated white or European ethnicity were assigned to white/European foreign-born (N = 126) or native-born groups (N = 1,285).

Length of residence is measured by subtracting the year of arrival from the year of the interview for those who indicated being born outside of Canada. This variable has an upper value of 44 years for visible-minority immigrants and 46 years for white/European immigrants.

Control Variables

The analyses adjust for a number of covariates since group differences in these characteristics may contribute to health disparities between immigrants and the native-born (e.g., Aseltine, Gore, and Gordon 2000; Cavazos-Rehg, Zayas, and Spitznagel 2007; House 2002; Montazer 2018; Montazer and Wheaton 2017; Montazer and Young 2017; Riosmena et al. 2013; Simon and Lively 2010; Stafford, Newbold, and Lively 2011; Turner, Wheaton, and Lloyd 1995).

Respondent gender is a dummy variable that equals 1 for female and 0 for male. Age is coded as a five-category dummy variable to reflect its possible nonlinear effect (O’Campo et al. 2015). The categories include younger than 30 years of age, between 30 and 39 years of age, between 40 and 49 years of age, between 50 and 59, and those above 60 (as the reference group). Marital status is a dummy variable indexed with four categories: married or common law, divorced or separated, and widowed, versus the never married. Number of children in the household is measured by taking the count of total number of children under the age of 18 living with the respondent. Total number of other negative life events (other than discrimination) is a continuous variable that takes the count of 18 negative life events experienced by the respondent at any time in his or her life (Turner et al. 1995). Some of these items include death of a child or spouse, parental divorce, or physical abuse. This variable ranges between 0 and 11. English language speaking ability is coded 1 for those with limited English language speaking ability versus those who indicated being proficient (0). Total years of education is a continuous variable that measures the total number of years of education of the respondent.

To measure the percentage of residents with the same ethnicity as the respondent, 14 separate ethnic groups—based on Statistics Canada classifications used in the 2006 census (Statistics Canada 2008)—were used to create a percentage measure to account for the number of people in the census tract who match the ethnicity of the respondent (the latter based on self-reports). This measure is considered an individual-level measure since the value varies by individual rather than census tract. Residents not included in these percentages are considered dissimilar from the respondent on that feature.

Immigration entrance category is assessed with the question, “Under which category did you come to Canada?” The answer to this question was used to create three groups: work visa, landed immigrant (a non-Canadian citizen permanent resident), versus all other respondents as the reference category. The total number of years worked for pay before coming to Canada is used to measure premigration employment tenure among the foreign-born only.

A complete model of immigration must also account for possible protective factors (Beiser 2004)—such as socioeconomic status and social support—that may impact the association between LOR and the dependent variable. Protective factors used in the models are perceived social support and three variables that tap at SES: household income, a continuous variable that ranges between $4,800 and $800,000; home ownership (=1 for home owner); and employment status. The average of 16 items from the Medical Outcomes Study (MOS) Social Support Survey (Sherbourne and Stewart 1991) are used to create an index of perceived social support. Respondents were asked how often (none of the time = 1, a little of the time = 2, some of the time = 3, most of the time = 4, or all of the time = 5) they had “someone who shows you love and affection” or “someone to do something enjoyable with,” for example. This variable ranges between 0 and 11, and higher values indicate greater perceptions of social support (α = .96). Employment status is a dummy variable indexed with four categories: employed, homemaker, retired, and other versus the unemployed.

The Analytic Model

The design of the NEHW study clusters respondents by neighborhood. Therefore, error terms across respondents within the same neighborhood are likely correlated. To address clustering concerns and separate the variance in outcomes across neighborhoods (level two) as a proportion of the total variance in each outcome (level one), respectively, all analyses used hierarchical linear modelling (Raudenbush and Bryk 2002).² All variables were grand-mean centered (Raudenbush and Bryk 2002), which makes the intercept interpretable as the value of the response variable (i.e., depression) at the mean value of the predictor variables, and it also helps with avoiding collinearity among predictors (Wu and Wooldridge 2005).³

Twenty-six percent of the sample were missing on at least one of the variables used in the analyses (mainly household income). Thus, multiple imputation methods, with five data sets imputed, were used to impute cases missing values on any of these variables (Little and Rubin 1987). The results produced from each imputed data set were then combined to produce one overall analysis. Results of analysis with the nonimputed data (N = 1,420) generated comparable results to those presented here.

Conditionally relevant variables

LOR only pertains to the foreign-born. Thus, this variable is coded conditionally on foreign-born status to allow for the inclusion of the native-born in the analyses (see Ross and Mirowsky 1992, for a detailed discussion of conditionally relevant variables). The goal is to compare those who are foreign-born with those who are not while simultaneously representing the effect of LOR that only applies to the foreign-born (Ross and Mirowsky 1992). Conditional coding entails that LOR is entered in the model only as an interaction term with a dummy variable for the groups in which the variable is relevant (i.e., foreign-born respondents) and without a main effect.

For example, to test the possibility that LOR in Canada is positive and significantly associated with depression only among visible-minority immigrant men, the model (1) must represent the difference in depression between each foreign-born group (visible-minority or white/European), and the white/European native-born reference group; and (2) must show how the difference changes depending on LOR. Equation 1 shows a simple form of this model. Here, depression (D) is regressed on visible-minority/foreign-born status represented by three dummy variables (VMF = visible-minority foreign-born men, WEF = white/European foreign-born men, VMN = visible-minority native-born men, with white/European native-born men [WEN] as the omitted group) and the interaction term of each of the two foreign-born groups and LOR.

D = b_{0} + b_{1} VMF + b_{2} WEF + b_{3} VMN + b_{4} (LOR - \bar{LOR}) * VMF + b_{5} (LOR - \bar{LOR}) * WEF .

(1)

This method of coding requires that a placeholder value be assigned to LOR for the native-born, which disappears once it is multiplied by 0 (Ross and Mirowsky 1992). Men who are foreign-born, irrespective of visible-minority status, differ from the comparison group (WEN) by an average amount plus a deviation that depends on LOR. In Equation 1, $b_{1}$ represents the conditional difference between foreign-born visible minority men with average LOR and white/European native-born men (reference group), whereas b₄ represents the effect of LOR for foreign-born visible-minority men, as compared to the reference group. Similarly, $b_{2}$ represents the conditional difference between foreign-born white/European men with average LOR and white/European native-born men, whereas b₅ represents the effect of LOR for foreign-born white-European men as compared to the reference group. In these analyses, premigration employment tenure is also a conditionally relevant variable. However, this variable is only conditional on foreign-born status and not subdivided by visible-minority status.

Plan of analysis

Table 1 presents weighted sample characteristics by foreign-born status and visible-minority status for all study variables. Significant differences at the bivariate level between the four groups were tested using chi-square test for categorical variables and ANOVA (Bonferroni post hoc) for continuous variables. To test the first hypothesis, interaction terms between visible-minority status, gender, and LOR were created and tested to see whether results for depression differ for men and women. Results were found to vary by gender, so multivariate results assessing the impact of LOR by visible-minority status on depression are presented separately for men and women in Table 2.⁴ The effect of visible-minority status among the native-born compared to white/European native-born is included in all models. Table 3 presents adjusted multivariate results by gender, which assess the impact of the focal variables on discrimination and anger (controlling for perceived discrimination).⁵ Finally, Table 4 assesses the explanatory role of perceived discrimination and anger in the relationship between LOR and depression by including the effects of (a) perceived discrimination and (b) anger. The explanatory role of perceived discrimination and anger are only assessed if the analyses in Table 2 indicate the relationship between LOR and depression to be significant—namely, for men and/or women. Indirect effects and Sobel tests for mediation—based on information presented in Tables 3 and 4—are calculated to assess the mediation role of perceived discrimination and anger in the relationship between LOR and depression.

Table 1.

Weighted Sample Characteristics of Foreign- and Native-Born Adults in Toronto, Canada (N = 1,911).

	Foreign-Born		Native-Born
	Visible-Minority	White/European	Visible-Minority	White/European
	(N = 305) Mean (SD)	(N = 126) Mean (SD)	(N = 195) Mean (SD)	(N = 1,285) Mean (SD)
Focal variables
Depression	8.88 (11.41)^a	9.14 (11.04)	11.11 (9.13)	10.45 (8.18)
Anger	.84 (1.40)^a,b	1.02 (1.45)^a	1.52 (1.23)	1.52 (1.13)
Perceived discrimination	3.45 (5.20)^a	1.17 (2.62)^a,b	3.62 (3.63)^a	2.12 (3.14)
Length of residence in Canada (foreign-born only)	15.39 (13.80)	19.66 (14.06)	—	—
Female	.52	.58^a	.55	.49
Male (reference)	.48	.42^a	.45	.51
Age
< 30	.04^a,b	.01^a,b	.18^a	.12
30–39	.19^a,b	.18^a,b	.38^a	.26
40–49	.43^a,b	.36^b	.20^a	.31
50–59	.19	.25	.16	.19
>60 (reference group)	.15^b	.20^a,b	.08	.12
Marital status
Married or common-law	.74^a,b	.74^a,b	.53	.56
Divorced or separated	.02	.02	.02	.03
Widowed	.01	.01	.00	.01
Never married (reference group)	.23^a,b	.23^a,b	.45	.40
Number of children in household	1.01 (1.46)^a,b	.80 (1.25)	.67 (.87)	.64 (.75)
Other negative life events	2.30 (2.37) ^a	2.77 (2.54)	2.49 (1.84)	2.73 (1.67)
English speaking ability:
Limited	.09^a,b	.07^a,b	.01	.01
Proficient (reference group)	.91^a,b	.93^a,b	.99	.99
Percentage of residents with same ethnicity as respondent	9.70 (19.22)^a	32.50 (17.29)^a,b	7.93 (12.10)^a	16.19 (9.54)
Immigrant entrance class
Work visa	.08	.15	—	—
Landed immigrant	.71	.64	—	—
All other (reference group)	.21	.21	1.00	1.00
Total years of education	16.71 (5.11)	15.90 (5.17)^b	17.82 (2.70)^a	16.40 (2.83)
Years of premigration employment tenure (foreign-born only)	8.41 (9.22)	7.15 (7.27)	—	—
Employment status
Employed	.64^a	.64	.70	.70
Homemaker	.03	.10^a	.05	.04
Retired	.06^a	.11	.05	.10
Other	.09^a	.03	.07	.05
Unemployed (reference group)	.17^a	.11	.12	.10
Household income (in thousands)	63.04 (67.20)^a,b	91.66 (94.04)	111.09 (86.95)	103.88 (73.61)
Home ownership status
Home owner	.60^a,b	.62^a,b	.78	.70
Not a home owner (reference group)	.40^a,b	.38^a,b	.22	.30
Perceived social support	3.98 (1.06)^a,b	4.07 (.84)^a	4.20 (.62)	4.27 (.58)

Note. Significant mean/proportional differences between foreign-born/visible-minority subgroups are based on ANOVA (Bonferroni post hoc) and chi-square tests (alpha = .05), respectively. Proportions presented for categorical variables, and means (SD) presented for continuous variables.

Significantly different from white/European Canadian-born, p < .05 (two-tailed test).

Significantly different from visible-minority Canadian-born, p < .05 (two-tailed test).

Table 2.

Effects of Visible-Minority Status and Length of Residence (LOR) in Canada on Depression for Men (Models 1 and 2) and Women (Models 3 and 4).

	Men (N = 810)				Women (N = 1,101)
	Visible-Minority Status by LOR(Unadjusted Results)		Visible-Minority Status by LOR (Adjusted Results)		Visible-Minority Status by LOR (Unadjusted Results)		Visible-Minority Status by LOR (Adjusted Results)
	(1)		(2)		(3)		(4)
	Estimated Coefficient		Estimated Coefficient		Estimated Coefficient		Estimated Coefficient
	b	(SE)	b	(SE)	b	(SE)	b	(SE)
Visible-minority status
Foreign-born^a
Visible-minority	−3.21***	(.96)	−5.27***	(1.44)	1.95	(1.05)	.02	(1.62)
White/European	−1.54	(1.72)	−2.11	(2.04)	−.22	(1.63)	−2.57	(1.94)
Native-born^a
Visible-minority	.47	(1.28)	.36	(1.15)	.69	(1.15)	.16	(1.00)
Visible-minority status by LOR (foreign-born only)^b
LOR (visible-minority)	.05**	(.06)	.19**	(.06)	−.18**	(.05)	−.05	(.06)
LOR (white/European)	−.00	(.09)	.01	(.09)	−.06	(.07)	.05	(.07)
Controls
Age (vs. 60 or older)
<30			8.50***	(1.51)			5.35***	(1.51)
30–39			2.52*	(1.27)			5.91***	(1.31)
40–49			3.13*	(1.21)			3.91**	(1.25)
50–59			2.30*	(1.15)			2.80**	(1.09)
Marital status (vs. never married)
Married or common-law			−1.03	(.82)			.75	(.67)
Divorced or separated			−3.54	(2.20)			−2.35	(1.65)
Widowed			5.47	(3.70)			.26	(2.38)
Number of children in household			.16	(.35)			−.15	(.31)
Other negative life events			.84***	(.16)			1.18***	(.14)
Limited English speaking ability (vs. proficient)			2.54	(1.39)			1.31	(1.55)
Percentage of residents with same ethnicity as respondent			.03	(.03)			.02	(.02)
Immigrant entrance class (vs. all other)
Work visa			−1.31	(2.19)			−.25	(1.53)
Landed immigrant			−.54	(1.67)			−1.32	(1.06)
Total years of education			−.14	(.08)			.06	(.08)
Years of premigration employment tenure (foreign-born only)			.18**	(.07)			.07	(.09)
Employment status (vs. unemployed)
Employed			−3.11***	(.88)			−1.44	(.96)
Homemaker			−8.13*	(3.43)			−.94	(1.40)
Retired			−2.71	(1.43)			5.48***	(1.28)
Other			−2.03	(1.57)			.61	(1.36)
Household income (in thousands)			−.005	(.004)			−.01	(.004)
Home owner (vs. not a home owner)			.35	(.71)			−1.37*	(.67)
Perceived social support			−3.65***	(.44)			−4.11***	(.38)
Fixed intercept	9.99***	(.47)	9.15***	(.47)	10.83***	(.49)	9.52***	(.45)
Random intercept (τ00)	5.01	(2.43)*	1.65	(1.48)	5.64**	(2.16)	.65	(1.00)
−2 log likelihood/df	6,129.5/6		5,870.60/28		8,518.24/6		8,146.26/28

White/European Canadian-born is the reference group.

Measured as deviation from the grand-mean for foreign-born persons.

p < .05. **p < .01. ***p < .001 (two-tailed test).

Table 3.

Effects of Visible-Minority Status and Length of Residence (LOR) in Canada on Perceived Discrimination and Anger, Separately for Men and Women (Adjusted Results).

	Men (N = 810)				Women (N = 1,101)
	Perceived Discrimination		Anger		Perceived Discrimination		Anger
	(1)		(2)		(3)		(4)
	Estimated Coefficient		Estimated Coefficient		Estimated Coefficient		Estimated Coefficient
	b	(SE)	b	(SE)	b	(SE)	b	(SE)
Visible-minority status
Foreign-born^a
Visible-minority	.22	(.67)	−1.30***	(.21)	1.47*	(.60)	−.72**	(.24)
White/European	−1.10	(.95)	−.53	(.29)	−.38	(.71)	−.97***	(.27)
Native-born^a
Visible-minority	1.52**	(.54)	−.30	(.16)	1.53	(.37)	−.11	(.14)
Visible-minority status by LOR (foreign-born only)^b
LOR (Visible-minority)	.10**	(.03)	.03***	(.01)	−.002	(.02)	.01	(.01)
LOR (white/European)	.005	(.04)	.01	(.01)	.001	(.03)	.03**	(.01)
Perceived discrimination			.03**	(.01)			.05***	(.01)
Fixed intercept	2.18***	(.23)	1.23***	(.07)	1.47*	(.60)	1.39***	(.07)
Random intercept (τ00)	.90**	(.36)	.07*	(.03)	1.12***	(.30)	.11**	(.04)

Note. Models include all control variables presented in Table 1.

White/European Canadian-born is the reference group.

Measured as deviation from the grand-mean for foreign-born persons.

*p < .05. **p < .01. ***p < .001 (two-tailed test).

Table 4.

Effects of Perceived Discrimination and Anger in the Relationship between Visible-Minority Status and Length of Residence (LOR) in Canada on Depression among Men (Adjusted Results) (N = 810).

	Baseline Model		Plus Perceived Discrimination		(2) Plus Anger
	(1)		(2)		(3)
	Estimated Coefficient		Estimated Coefficient		Estimated Coefficient
	b	(SE)	b	(SE)	b	(SE)
Visible-minority status
Foreign-born^a
Visible-minority	−5.27***	(1.44)	−5.30***	(1.43)	−1.03	(1.32)
White/European	−2.11	(2.04)	−1.80	(2.02)	−.24	(1.83)
Native-born^a
Visible-minority	.36	(1.15)	−.15	(1.15)	.82	(1.03)
Visible-minority status by LOR (foreign-born only)^b
LOR (visible-minority)	.19**	(.06)	.15*	(.06)	.04	(.06)
LOR (White/European)	.01	(.09)	.01	(.09)	−.02	(.08)
Perceived discrimination			.35***	(.08)	.25***	(.07)
Anger					3.16***	(.22)
Fixed intercept	9.15***	(.47)	9.13***	(.47)	9.20***	(.44)
Random intercept (τ00)	1.65	(1.48)	2.49	(1.58)	3.40*	(1.49)
−2 log likelihood/df	5,870.60/28		5,853.6/29		5,678.40/30

Note. Models include all control variables presented in Table 1.

White/European Canadian-born the reference group.

Measured as deviation from the grand-mean for foreign-born persons.

p < .05. **p < .01. ***p < .001 (two-tailed test).

Results

Bivariate results presented in Table 1 indicate that average depression and anger are significantly lower among visible-minority foreign-born persons compared to white/European Canadian-born respondents. There are also differences in average perceived discrimination among some of the groups. For example, visible-minority immigrants report significantly higher average discrimination ( $\bar{X}$ = 3.45) than white/European native-born participants ( $\bar{X}$ = 2.12). This pattern is also observed among Canadian-born visible-minorities who report higher average perceived discrimination ( $\bar{X}$ = 3.62) than white/European Canadian-born and white/European foreign-born ( $\bar{X}$ = 1.17) respondents. There are other noteworthy differences. For instance, average perceived social support and household income are significantly lower among visible-minority immigrants compared to white/European and visible-minority Canadian-born respondents.

Visible-Minority Status, Gender, and Depression

In Table 2, the relationship between LOR by visible-minority status is modeled separately for men (Models 1 and 2) and women (Models 3 and 4), respectively. Results of Model 1 (unadjusted results) of Table 2 indicate that average depression is significantly lower among visible-minority foreign-born men compared to white/European native-born men. Results of post hoc tests (not shown, but available on request) indicate that visible-minority male immigrants also have significantly lower depression than native-born visible-minority males in the sample. This pattern persists in the adjusted model (Model 2). However, results presented in Model 2 also indicate that the difference in depression between visible-minority foreign-born men and white/European native-born men depends on the LOR. Calculations of standardized results of this relationship suggest that as LOR increases by one standard deviation, depression increases by .19 [ $B_{yx} = \frac{(s_{x}) (b_{yx})}{s_{y}}$ = $\frac{9.25}{9.23} (. 19)$ ] standard deviations among visible-minority men.

Figure 1 illustrates the conditional effect of LOR on depression by visible-minority status of the foreign-born compared to the white/European reference group based on Model 2. The solid horizontal line represents the average depression predicted for white/European native-born men. The other two lines in this graph show the predicted depression for the two groups of foreign-born men with increase in LOR. The line for visible-minority immigrant men shows that as LOR increases, their depression increases in relation to white-European native-born respondents. Although not shown in this figure or in Table 2 (Model 2), post hoc tests indicate that as LOR increases, the depression of visible-minority immigrant men also increases in relation to visible-minority native-born men. Thus, while on average, visible-minority foreign-born men have significantly lower depression than native-born men, increase in LOR is associated with an increase in depression among this group of men. Indeed, Figure 1 suggests that the advantage in mental health among this group of immigrants declines with increase in LOR, and at about 25 years in Canada, the depression of this group converges with that of the native-born.

Figure 1.

The relationship between length of residence and depression by visible-minority status among men.

The results for women (Models 3 and 4) paint a different picture. First, results (Model 3 and 4) do not indicate average depression to be significantly different between either of the foreign-born groups compared to white/European native-born women. However, results of Model 3 suggest that with increase in LOR, visible-minority women experience a decline in depression compared to the reference group. This finding is fully explained in Model 4. Thus, the results of Table 2 show that the effect of LOR is positive and significant only among visible-minority men compared to their white/European (and visible-minority) native-born counterparts, providing support for H1.

To test Hypothesis 2, that the positive and significant association between LOR and depression among visible-minority immigrant men is explained by (a) perceived ethnic/racial discrimination (H2a) and (b) anger (H2b), (1) the aforementioned analyses are replicated in Table 3 by gender for perceived discrimination and anger, and (2) these two variables are added to the baseline model (Model 2, Table 2) in Models 2 and 3 of Table 4.

Beginning with Table 3, results for perceived discrimination (Models 1 and 3) indicate that while average discrimination is not different between visible-minority men and white/European men, increase in LOR is positively associated with the experience of discrimination among this group of men compared to white/European native-born men. Among women, on the other hand (Model 3), average perceived discrimination is higher among visible-minority women compared to white/European native-born women, but this relationship is not dependent on LOR.

Results for anger (Models 2 and 4) show that this emotion is significantly lower among visible-minority men and women immigrants, but this relationship depends on LOR only for visible-minority immigrant men. Thus, increase in LOR is positively associated with both perceived discrimination and anger only among visible-minority immigrant men.

Moving to Table 4, results presented in Model 2 indicate that while the addition of perceived discrimination reduces the coefficient for the effect of LOR on depression by 21 percent (.19 – .15 / .19 × 100), the further addition of anger in Model 3 reduces the coefficient for LOR among visible-minority men by 79 percent. Indeed, the coefficient for LOR among this group of men is no longer significant in this model.

The results of Table 4 in conjunction with those reported in Models 1 and 2 of Table 3 indicate that of the total effect of LOR on depression among visible-minority immigrant men, 0.15 (or 79 percent) is indirect through perceived discrimination and anger. However, most of this indirect effect ([.03 × 3.16] / .15 = 63%) is through the effect of anger on depression. The mediation links between LOR and depression among visible-minority immigrant men through an increase in perceived discrimination (Sobel test: t = 2.44, p < .05) and anger (Sobel test: t = 2.94, p < .01) are both significant. Thus, taken together, the results presented here suggest that LOR among visible-minority immigrant men is associated with an increase in depression mainly because of an increase in anger and to a much smaller degree, an increase in perceived discrimination.

Discussion

By using data out of Toronto, which is home to the largest percentage of foreign-born and visible-minorities in Canada (Statistics Canada 2013), the current paper found evidence for the commonly reported finding in the literature of a positive association between LOR and mental health problems as measured by depression, but with one important qualification: Only visible-minority immigrant men experienced an increase in depression with tenure in the host country compared to white/European (and visible-minority) Canadian-born men. The positive association between LOR and depression among this group of men was found to be due to higher anger and to a smaller extent, higher discrimination with tenure in the host country. In adjusted results, visible-minority immigrant women, irrespective of gender, did not experience a decline in mental health with tenure in the host country compared to white/European immigrants.

Previous research has attributed the positive relationship between LOR and emotional problems among immigrants in part to an increase in chronic stressors (Cook et al. 2009; Montazer and Wheaton 2017). One such stressor is the perception of ethnic/racial discrimination (Mabry and Kiecolt 2005). However, the experience of this chronic stressor is not the same for all immigrants. Indeed, as suggested by the stress process model (Pearlin 1999), social and demographic statuses such as visible-minority status and gender may impact the experience of this chronic stressor among immigrants, which in turn may account for a substantial portion of variation in emotional functioning across groups. Following this reasoning and the often reported finding that the perception of ethnic/racial discrimination varies by gender (Assari and Lankarani 2017; Kessler et al. 1999), across immigrants, and with longer tenure in the host country (Carlisle and Stone 2015; Cook et al. 2009; Gee et al. 2006; Goto et al. 2002; Yoo et al. 2009), the current study proposed that the increase in depression among visible-minority immigrant men with longer residence in Canada would be due in part to an increase in the perception of ethnic/racial discrimination (Brondolo et al. 2015; Finch, Kolody, and Vega 2000; Gee et al. 2006; Goto et al. 2002) and anger (House 2002; Simon and Lively 2010).

Discrimination, Anger, and Depression

The effect of discrimination on depression, albeit significant, was small. One reason for the small effect of this chronic stressor on this outcome may be that there are other pathways unexplored that link perceived discrimination to the experience of depression. Increase in the perception of discrimination with tenure in the host country among visible-minority immigrant men may exert its influence on depression by increasing sleep disturbances or rumination about the discriminatory experience, for example. Furthermore, “stress proliferation” (Pearlin 1999), whereby one stressful condition leads to another or enhances the negative effects of existing stressors may also be important in the relationship between discrimination and depression. Increase in the perception of discrimination with tenure in the host country may exert its influence on this outcome by exacerbating acculturative, family, and work stressors, for example.

A second reason may be the measure of perceived discrimination itself. Although the use of a scale, as opposed to a single item measure of discrimination, is a significant methodological advantage (Goto et al. 2002; Williams et al. 1997), it is still not without limitations. Indeed, perceived discrimination has been criticized as being unverifiable (Pascoe and Smart Richman 2009). Thus, it may be helpful for future research to examine a more objective measure of the kinds and frequency of discrimination experienced by respondents. It may also be useful to specify the perpetrator of the discriminatory experience: white/European versus other visible-minority perpetrators. Are visible-minority immigrants angered more by discrimination perpetuated by other visible-minorities than discrimination perpetuated by white/Europeans?

While the indirect effect of LOR on depression through perceived discrimination was small among visible-minority men, an increase in anger with tenure in the host country was found to uniquely mediate 63 percent of the positive relationship between LOR and depression among this group of immigrants. Previous research has also found anger to be significantly associated with mental health problems (House 2002; Simon and Lively 2010). Emotions like anger cannot be maintained for prolonged periods of time. Therefore, the need to manage this emotion can lead to mental health problems (Wilkins and Pace 2014), including depression (Humber et al. 2013). While examining the indirect effect of discrimination on depression through anger was not the focus of these analyses, future research should examine if the increase in anger with tenure in the host country among visible-minority immigrant men is due to perceived discrimination as well as other types of prejudice unavailable in these data—such as language, including accent; religion; and socioeconomic discrimination. Another interesting venue for future research would be to examine if this group of migrants is more likely to experience other chronic stressors, such as underemployment, and dissatisfaction with their socioeconomic position with increase in LOR (Cook et al. 2009; Galarneau and Morissette 2008)—leading to anger and consequently depression (Wilkins and Pace 2014).

Future Research, Strengths and Limitations

Future research should also examine the effect of visible-minority status and gender on mental health in conjunction with membership in other statuses that the individual may hold, including religion, social class, and English language proficiency (Brondolo et al. 2015). Furthermore, individual-level factors, such as degree of identification with one’s ethnic/racial group (Hughes et al. 2015), that may affect the experience of discrimination, anger, and depression should be explored further. It is also important to examine the variation in perceptions of discrimination, anger, and depression across the different racial/ethnic groups that are combined as visible-minorities in this article.⁶ The immigrant sample of the current study was too small to allow for any further distinctions.

It is important to acknowledge several study limitations. First, although the proposed hypotheses suggest causal ordering and the analyses are suggestive of mediation, the cross-sectional nature of the analysis presents challenges, such as the inability to establish true mediation and causal order between the outcome, mediators, and some independent variables (e.g., LOR and perceived social support). These data provide only a snapshot of the relationship between LOR and depression—longitudinal data would be preferable. Second, there may be shared measurement bias between the measures of anger and depression in the current study (Painuly, Sharan, and Mattoo 2005). Furthermore, as with any self-reported data, a latent factor may have caused simultaneous responses for both anger and depression, such as the propensity to report strong emotions. Third, there may be cohort effects confounding the observed patterns; however, the heterogeneous ages of arrival in this sample at each level of LOR may act to indirectly reduce the role of history in the observed patterns. Moreover, all the respondents in this sample immigrated to Canada after the implementation of the points system in 1967, which removed national origin as a criterion of admission and instead introduced a system that assigned points based on the age, education, language skills, and economic characteristics of applicants (Boyd and Vickers 2000). This policy change led to immigration from many different countries and diverse cultural backgrounds than earlier immigrants who mainly migrated from European countries. Fourth, while the analyses controlled for migration entrance category, they do not account for all the pull or push factors in the migration process that may determine the migratory forces unique to any year of arrival—such as the political, economic, and legal conditions (Jasso et al. 2004) in origin countries. Finally, it is important to acknowledge that the effect of LOR on depression was not overly large (b = .19). However, despite this small effect, the findings present an important direction for future research: the examination of the conditional effect of LOR on the mental health of immigrants by individual-level factors such as visible minority status and gender of immigrants.

The benefits of this study outweigh the aforementioned limitations. This is one of the first studies to examine the association between depression and LOR among immigrants, compared to the native-born, disaggregated by visible-minority status and gender. As shown here and as proposed by segmented assimilation theory, immigrants are not a homogeneous group, and research on immigrant adaptation needs to incorporate a more systematic recognition of the influence of individual-level characteristics in the migration process. The data suggest that the notion of a generalized emotional adjustment process among immigrants may be overstated (Montazer and Wheaton 2017). As shown here, only one group, immigrant men who are viewed as visible-minorities in the host country, experience an increase in depression with tenure in the host country because of a parallel increase in the perception of ethnic/racial discrimination and anger.

Footnotes

Acknowledgements

I thank the anonymous reviewers of Society and Mental Health for their helpful comments on this paper.

Funding

The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Grants awarded by Canadian Institute for Health Research grant MOP- 84439 and the Social Science and Health Research Council grant 410-2007-1499 (Blair Wheaton, Patricia O’Campo, P.I.s).

ORCID iD

Shirin Montazer

Notes

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