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Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study

OBJECTIVE: While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requi...

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Autores principales: Durbin, Anna, Moineddin, Rahim, Lin, Elizabeth, Steele, Leah S, Glazier, Richard H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360831/
https://www.ncbi.nlm.nih.gov/pubmed/25770230
http://dx.doi.org/10.1136/bmjopen-2014-006690
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author Durbin, Anna
Moineddin, Rahim
Lin, Elizabeth
Steele, Leah S
Glazier, Richard H
author_facet Durbin, Anna
Moineddin, Rahim
Lin, Elizabeth
Steele, Leah S
Glazier, Richard H
author_sort Durbin, Anna
collection PubMed
description OBJECTIVE: While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requires considering the effects of interacting factors. This study assessed the inter-relationship between recent immigration status, living in deprived areas and service use for non-psychotic mental health disorders. STUDY DESIGN: Matched population-based cross-sectional study. SETTING: Ontario, Canada, where healthcare use data for 1999–2012 were linked to immigration data and area-based material deprivation scores. PARTICIPANTS: Immigrants in urban Ontario, and their age-matched and sex-matched long-term residents (a group of Canadian-born or long-term immigrants, n=501 417 pairs). PRIMARY AND SECONDARY OUTCOME MEASURES: For immigrants and matched long-term residents, contact with primary care, psychiatric care and hospital care (emergency department visits or inpatient admissions) for non-psychotic mental health disorders was followed for 5 years and examined using conditional logistic regression models. Intersectionality was investigated by including a material deprivation quintile by immigrant status (immigrant vs long-term resident) interaction. RESULTS: Recent immigrants in urban Ontario were more likely than long-term residents to live in most deprived quintiles (immigrants—males: 22.8%, females: 22.3%; long-term residents—both sexes: 13.1%, p<0.001). Living in more deprived circumstances was associated with greater use of mental health services, but increases were smaller for immigrants than for long-term residents. Immigrants used less mental health services than long-term residents. CONCLUSIONS: This study adds to existing research by suggesting that immigrant status and deprivation have a combined effect on recent immigrants’ care use for non-psychotic mental health disorders. In settings where immigrants are over-represented in deprived areas, policymakers focused on increasing immigrants’ access of mental health services should broadly address the influence of structural and cultural factors beyond the disadvantage.
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spelling pubmed-43608312015-03-25 Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study Durbin, Anna Moineddin, Rahim Lin, Elizabeth Steele, Leah S Glazier, Richard H BMJ Open Mental Health OBJECTIVE: While newcomers are often disproportionately concentrated in disadvantaged areas, little attention is given to the effects of immigrants’ postimmigration context on their mental health and care use. Intersectionality theory suggests that understanding the full impact of disadvantage requires considering the effects of interacting factors. This study assessed the inter-relationship between recent immigration status, living in deprived areas and service use for non-psychotic mental health disorders. STUDY DESIGN: Matched population-based cross-sectional study. SETTING: Ontario, Canada, where healthcare use data for 1999–2012 were linked to immigration data and area-based material deprivation scores. PARTICIPANTS: Immigrants in urban Ontario, and their age-matched and sex-matched long-term residents (a group of Canadian-born or long-term immigrants, n=501 417 pairs). PRIMARY AND SECONDARY OUTCOME MEASURES: For immigrants and matched long-term residents, contact with primary care, psychiatric care and hospital care (emergency department visits or inpatient admissions) for non-psychotic mental health disorders was followed for 5 years and examined using conditional logistic regression models. Intersectionality was investigated by including a material deprivation quintile by immigrant status (immigrant vs long-term resident) interaction. RESULTS: Recent immigrants in urban Ontario were more likely than long-term residents to live in most deprived quintiles (immigrants—males: 22.8%, females: 22.3%; long-term residents—both sexes: 13.1%, p<0.001). Living in more deprived circumstances was associated with greater use of mental health services, but increases were smaller for immigrants than for long-term residents. Immigrants used less mental health services than long-term residents. CONCLUSIONS: This study adds to existing research by suggesting that immigrant status and deprivation have a combined effect on recent immigrants’ care use for non-psychotic mental health disorders. In settings where immigrants are over-represented in deprived areas, policymakers focused on increasing immigrants’ access of mental health services should broadly address the influence of structural and cultural factors beyond the disadvantage. BMJ Publishing Group 2015-03-13 /pmc/articles/PMC4360831/ /pubmed/25770230 http://dx.doi.org/10.1136/bmjopen-2014-006690 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Mental Health
Durbin, Anna
Moineddin, Rahim
Lin, Elizabeth
Steele, Leah S
Glazier, Richard H
Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title_full Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title_fullStr Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title_full_unstemmed Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title_short Examining the relationship between neighbourhood deprivation and mental health service use of immigrants in Ontario, Canada: a cross-sectional study
title_sort examining the relationship between neighbourhood deprivation and mental health service use of immigrants in ontario, canada: a cross-sectional study
topic Mental Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360831/
https://www.ncbi.nlm.nih.gov/pubmed/25770230
http://dx.doi.org/10.1136/bmjopen-2014-006690
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