Foreign Nativity and Mental Illness

Jan 7, 2008
Foreign Nativity May Not Always Protect Against Mental
Disorders in the US

Though all Latino immigrants tend to display better overall
mental health compared to their US-born counterparts, a
recent study by NIMH-funded researchers has found that the
protective benefits of foreign nativity vary widely across
subgroups of this population. Factors such as neighborhood
stability, perceived discrimination, and the strength of
family bonds all combine to influence the prevalence of
mental disorders across distinctive Latino ethnic groups.
The finding reflects varying immigration and acculturation
processes experienced by Mexicans, Cubans, Puerto Ricans
and other Latino groups. Results of the study were
published in the July 2007 issue of Social Science and
Medicine.

The research team, lead by Dr. Margarita Alegria of Harvard
University, used information from the National Latino and
Asian-American Study (NLAAS) to examine the effect of
foreign nativity on the prevalence of mental disorders
within Latino immigrant populations. The researchers
initially divided the survey population into two groups;
Late-Arrival Immigrants (LAI) who arrived in the US after
age six and those who arrived in the US before age six
(IUSC). The latter group also included Latinos who were
born in the United States, as native born and early-arrival
immigrants share similar language skills and acculturation
experiences. In contrast, late arrival immigrants may have
limited English skills and closer connections to
traditional customs, family structures, and religious
values. Survey participants were further divided based on
ethnic background and country of origin.

These divisions allowed researchers to show that nativity
is only part of the larger picture when considering
susceptibility to various mental disorders. Previous
studies of the “immigrant paradox,” which refers to the
tendency of children of immigrants to have a higher
prevalence of mental disorders than their parents, focused
primarily on nativity while overlooking other sources of
risk. By dividing the Latino population into subgroups
based on country of origin, as well as late (LAI) and early
(IUSC) arrival to the US researchers were able to identify
other factors, such as familial and cultural ties, income
disparities, and perceived social standing, which interact
to influence the prevalence of mental disorders.

For example, Mexican LAI immigrants showed lower risk of
depressive disorders compared to their IUSC counterparts.
However, when family cultural conflict and family burden
were taken into account, LAI Mexicans experienced similar
levels of risk for depression as IUSC. No differences in
risk for anxiety disorders were found for LAI versus IUSC
Latinos. Yet, surprisingly, results showed that immigrant
families with incomes of $15,000 a year or less seemed to
experience lower levels of anxiety disorders than those
families who made above $35,000. The researchers proposed
that the unexpected protective effect of poverty was likely
due to a higher perceived social standing within the low
income families. At the same time, lower-income families
may have lowered expectations for success compared to their
more affluent peers. This may help to limit some of the
stress associated with trying to improve social standing
and achievement.

The study highlights the need for further investigation of
the varying cultural and sociological influences that
affect mental health in immigrant populations. Nativity
alone may not be as protective as once thought. Rather,
family harmony, marital status, and integration in
employment may be key factors for decreased risk for
depression and anxiety disorders. Including comparisons of
immigration arrival across subgroups within an ethnic
population in future studies could be a valuable tool in
determining additional factors that may increase or
decrease the risk for psychiatric disorders in Latino and
other immigrant populations.

Reference:
Alegria, M., et al. Understanding differences in past year
psychiatric disorders for Latinos living in the US. Social
Science & Medicine. 2007 Jul;65(2):214-30.