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Neighbourhood context and diagnosed mental health conditions among immigrant and non-immigrant youth: a population-based cohort study in British Columbia, Canada

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Abstract

Purpose

Evidence from systematic reviews suggests that adult immigrants living in areas of higher immigrant density (areas with a higher proportion of foreign-born residents) tend to experience fewer mental health problems—likely through less discrimination, greater access to culturally/linguistically appropriate services, and greater social support. Less is known about how such contexts are associated with mental health during childhood—a key period in the onset and development of many mental health challenges. This study examined associations between neighbourhood immigrant density and youth mental health conditions in British Columbia (BC; Canada).

Methods

Census-derived neighbourhood characteristics were linked to medical records for youth present in ten of BC’s largest school districts from age 5 through 19 over the study period (1995–2016; n = 138,090). Occurrence of physician assessed diagnoses of mood and/or anxiety disorders, attention deficit hyperactivity disorder (ADHD), and conduct disorder was inferred through International Classification of Diseases (ICD) diagnostic codes in universal public health insurance records. Multi-level logistic regression was used to model associations between neighbourhood characteristics and odds of diagnoses for each condition; models were stratified by generation status (first-generation: foreign-born; second-generation: Canadian-born to a foreign-born parent; non-immigrant).

Results

Higher neighbourhood immigrant density was associated with lower odds of disorders among first-generation immigrant youth (e.g., adjusted odds of mood-anxiety disorders for those in neighbourhoods with the highest immigrant density were 0.67 times lower (95% CI: 0.49, 0.92) than those in neighbourhoods with the lowest immigrant density). Such protective associations generally extended to second-generation and non-immigrant youth, but were—for some disorders—stronger for first-generation than second-generation or non-immigrant youth.

Conclusions

Findings suggest there may be protective mechanisms associated with higher neighbourhood immigrant density for mental health conditions in immigrant and non-immigrant youth. It is important that future work examines potential pathways by which contextual factors impact immigrant and non-immigrant youth mental health.

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Funding

Funding was provided by Canadian Institutes of Health Research.

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Authors and Affiliations

  1. Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Scott D. Emerson, Monique Gagné Petteni, Martin Guhn, Constance Milbrath, Magdalena Janus & Anne M. Gadermann

  2. School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Joseph H. Puyat

  3. Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada

    Joseph H. Puyat & Anne M. Gadermann

  4. Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada

    Katholiki Georgiades & Magdalena Janus

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  1. Scott D. Emerson
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  2. Monique Gagné Petteni
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Correspondence to Scott D. Emerson.

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Appendix

Appendix

See Fig. 3 and Tables 4, 5, 6.

Fig. 3
figure 3

Proportions of mental health conditions, by generation status and neighbourhood immigrant density quartile

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Table 4 Odds of mental health conditions among first-generation immigrant youth associated with 10% increases in neighbourhood immigrant density
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Table 5 Odds of mental health conditions among first-generation immigrant youth associated with neighbourhood immigrant density (moderate-high immigrant density [Q4-Q2 quartiles] vs low immigrant density [Q1/lowest quartile])
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Table 6 Interaction terms for associations of neighbourhood immigrant density quartiles with mental health conditions by youth generation status
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Emerson, S.D., Petteni, M.G., Puyat, J.H. et al. Neighbourhood context and diagnosed mental health conditions among immigrant and non-immigrant youth: a population-based cohort study in British Columbia, Canada. Soc Psychiatry Psychiatr Epidemiol 58, 693–709 (2023). https://doi.org/10.1007/s00127-022-02301-2

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