Comparing Mental Health of US Children of Immigrants and Non-Immigrants in 4 Racial/Ethnic Groups

The lived experience of acculturative stress in second-generation Haitian American emerging adults

Second-generation Haitian American emerging adults function within three cultures; the American culture, Black American culture, and the Haitian culture. Balancing and living within multiple cultures while trying to grow in autonomy and adulthood can affect the mental health of emerging adults. Gaining independence while finding identity coupled with cultural expectations can contribute to increasing stress levels. The aim of this phenomenological inquiry is to explore the lived experience of second generation Haitian American emerging adults while focusing on mental health. This descriptive phenomenological inquiry explored the mental health effects of acculturative stress in emerging adults who identified as second-generation Haitian Americans. The population sample consisted of 30 participants ages 19-29 years, with a mean of (Mage = 25.97, SD = 2.95). Data was collected through semi-structured one-on-one interviews, which were guided by fifteen open ended questions. Thematic analysis approach was applied to the qualitative data. Saturation was reached after 23 participant interviews and 7 additional interviews after saturation to confirm result findings. Resulting themes revealed that Haitian parents and culture were strict, a dual identity, and lack of awareness/support for mental health in the culture were stressors. Themes of admiration for the Haitian culture and resiliency serve as possibilities as to why participants pursued higher education. The triple minority status of the heritage culture has contributed to increased stress levels resulting in the expression of anxiety, depression and self-critical thoughts such as feelings of imposter syndrome.

Trajectories of maternal parenting stress and adolescent behavioral symptoms in unmarried families: The role of family immigration status

BACKGROUND

Maternal parenting stress during childhood may have important influences on offspring internalizing and externalizing behaviors during adolescence in unmarried households, but it is unclear whether effects differ across different trajectory patterns of maternal parenting stress and for native-born vs. immigrant families.

METHODS

Using data from the Future of Families and Child Wellbeing Study, we identified trajectory patterns of maternal parenting stress from ages 1-9 years using semi-parametric group-based trajectory modeling. We used negative binomial regression models to estimate associations between maternal parenting stress trajectories and adolescent behavioral symptoms at age fifteen.

RESULTS

Five maternal parenting stress trajectory groups were identified among the 1982 unmarried families included in this study, representing consistently low (9.2 %), consistently mild (54.2 %), moderate and decreasing (14.4 %), moderate and increasing (16.0 %) and consistently high (6.2 %) levels of maternal parenting stress. For adolescent internalizing symptoms, all maternal parenting stress trajectory groups exhibited higher symptoms compared to the consistently low group: IRR for consistently mild: 1.21 (95 % CI: 0.98-1.56); IRR for moderate/decreasing: 1.34 (95 % CI: 1.04-1.74); IRR for moderate/increasing: 1.62 (95 % CI: 1.28-2.13); and IRR for consistently high: 1.74 (95 % CI = 1.29-2.41). Similar results were observed for adolescent externalizing symptoms. Stronger effects of maternal parenting stress trajectories on adolescent externalizing symptoms were observed among native-born vs. immigrant families.

LIMITATIONS

Differential attrition and same-source bias may lead to under- or over-estimation of the associations of interest.

CONCLUSIONS

Interventions targeting unmarried families with elevated maternal parenting stress during childhood may reduce behavioral symptoms in adolescence.

Acculturating Systems of Care to Ensure Healthy Futures for Latine Migrant Youth

Migration across the Americas is an ever-changing process with current trends including increased migration into the United States of Latine youth. Experiences before, during, and after migration can increase the risk of psychiatric illness, including discriminatory and exclusionary experiences when accessing care. Acculturation typically focuses on the process that the immigrant group experiences when coming into contact with a host culture. Members of the host culture and systems of care can take intentional steps to acculturate themselves in an integrative manner in an effort to reduce host-immigrant friction and better coordinate care across systems.

Effect of online intervention based on life skills for mental health, self-efficacy and coping skills among Arab adolescents in the Klang Valley, Malaysia: A cluster randomised controlled trial protocol

BACKGROUND

Migrant children and adolescents face a significantly increased risk of mental health issues. Focusing on this population's mental health issues is fundamental and requires more attention to detect and reduce these burdens in adulthood. Nevertheless, life skills intervention can improve mental health. Its effects on Arab migrant adolescents have not been tested. Here, an evaluation protocol of the effect of an online life skills-based intervention for improving depression, anxiety, stress, self-efficacy, and coping skills among Arab adolescents in Malaysia will be examined.

MATERIAL AND METHODS

This cluster randomised controlled trial (RCT) will involve 207 Arab students (14-18 years old) from 12 Arabic schools in the Klang Valley. The schools will be assigned randomly to an intervention (online life skills programme) or control group at a 1:1 ratio. The researcher will deliver eight one-hour sessions to the intervention group weekly. The control group will receive the intervention at the evaluation end. Both groups will complete assessments at baseline, and immediately and three months after the intervention. The primary outcome is anxiety, depression, and stress [Depression Anxiety and Stress Scale-21 (DASS-21)]. The secondary outcomes are self-efficacy (General Self-Efficacy Scale) and coping skills (Brief COPE Inventory). Data analysis will involve the Generalised Estimation Equation with a 95% confidence interval. P < .05 will indicate significant inter- and intra-group differences.

DISCUSSION

This will be the first cluster RCT of an online life skills education programme involving Arab adolescent migrants in Malaysia. The results could support programme effectiveness for improving the participants' mental health problems (depression, anxiety, stress), increasing their self-efficacy, and enhancing their coping skills. The evidence could transform approaches for ameliorating migrant children and adolescents' mental well-being.

TRIAL REGISTRATION

The study is registered with the Clinical Trial Registry (Identifier: NCT05370443).

Acculturation and Mental Health: A Scoping Review

Background: Acculturative stress theory and the healthy immigrant paradox provide conflicting frameworks from which to study the mental health of immigrant groups. This scoping review aims to provide clarity on the mental health effects of acculturation. Review Question: How are anxiety, depression, and stress expressed in the adolescent and adult children of immigrants? Method: Considering various generational classifications, 1333 articles were screened and 25 articles were selected. This review highlights the presentation of cultural stress and its mental health effects in the children of immigrants ranging from 13 to 28 years of age. Conclusions: Social support is necessary as these children and young adults work to reconcile different worldviews. There is a need for a multifaceted approach to health care that incorporates the development of culturally appropriate responses to stressors. Collaboration among health practitioners growing in cultural competency can assist this population not only in the development of coping strategies, but also in self-actualization. The conflicting results found in this review suggest a need for more work in the area of acculturation stress, to grow the understanding of health practitioners within various cultural groups in order to transform mental health clinical practice.

At the intersection of race and immigration: a comprehensive review of depression and related symptoms within the US Black population

Although the literature on the differences between Black people and White people in terms of differences in major depressive disorder and related self-reported symptoms is robust, less robust is the literature on how these outcomes are patterned within the US Black population and why differences exist. Given increased ethnic diversity of Black Americans due to increases in immigration, continued aggregation may mask differences between Black ethnic-immigrant groups and Black Americans with more distant ancestral ties to Africa (African Americans). The purpose of this narrative review was to comprehensively synthesize the literature on depression and related symptoms within the US Black population across immigration- and ethnicity-related domains and provide a summary of mechanisms proposed to explain variation. Findings revealed substantial variation in the presence of these outcomes within the US Black population by nativity, region of birth, age at immigration, and Caribbean ethnic origin. Racial context and racial socialization were identified as important, promising mechanisms for better understanding variations by region of birth and among those born or socialized in the United States, respectively. Findings warrant data collection efforts and measurement innovation to better account for within-racial differences in outcomes under study. A greater appreciation of the growing ethnic-immigrant diversity within the US Black population may improve understanding of how racism differentially functions as a cause of depression and related symptoms within this group.

Health Care for Children in Immigrant Families: Key Considerations and Addressing Barriers

One in four US children is a child in an immigrant family. Children in immigrant families (CIF) have distinct health and health care needs that vary by documentation status, countries of origin, and health care and community experience caring for immigrant populations. Health insurance access and language services are fundamental to providing health care to CIF. Promoting health equity for CIF requires a comprehensive approach to both the health and social determinants of health needs of CIF. Child health providers can promote health equity for this population through tailored primary care services and partnerships with immigrant-serving community organizations.

Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis

Objective

To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children.

Methods

Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models.

Results

Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11-1.44)], poor physical health [OR 1.34 (95% CI 1.11-1.61)], mental disorder [OR 1.24 (95% CI 1.00-1.52)], and death [OR 1.11 (95% CI 1.01-1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87-0.97)]. The difference of substance use risk was not found between the two groups.

Conclusion

Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42021214115.

Mental Health in Immigrant Children and Adolescents in Northern Chile Mental Health in Immigrant Children and Adolescents

Approximately 1.251.225 foreign-born migrants reside in Chile, including 183.315 children. This study compares mental health indicators in immigrant and non-immigrant children to understand the mental health effects of migration. A cross-sectional study of 634 students from Chilean schools was conducted. Fifty percent of the students were immigrants. The System for the Evaluation of Children and Adolescents was used to evaluate mental health. No significant differences were observed in mental health indicators between immigrant and non-immigrant children. At both elementary and secondary levels, immigrant students had higher rates of contextual problems (family problems and problems with peers) and lower scores in integration and social consequence. Immigrant students in elementary schools scored lower in self-esteem. The higher rates of contextual problems in immigrant children should be addressed through structural changes in migration policies, such as providing support for employment of parents, welfare assistance, and access to health systems.

Do assets explain the relation between race/ethnicity and probable depression in U.S. adults?

Depression is a leading cause of disability in the U.S. across all race/ethnicity groups. While non-Hispanic Black and Hispanic persons have worse physical health on most indicators than non-Hispanic White persons, the literature on the association between race/ethnicity and rates of depression is mixed. Given unequal distribution of assets across racial/ethnic groups, it is possible that social and economic differences may explain differential rates of depression across race/ethnicity groups. Using National Health and Nutrition Examination Survey (NHANES) data from 2007–2016, we constructed a nationally representative sample of 26,382 adults over 18 years old (11,072 non-Hispanic White, 5,610 non-Hispanic Black, 6,981 Hispanic, and 2,719 Other race). We measured symptoms of depression using the Patient Health Questionnaire-9 (PHQ-9), with a score of 10 or more indicating probable depression. We identified three kinds of assets: financial assets (income), physical assets (home ownership), and social assets (marital status and education). We estimated the weighted prevalence of probable depression across race/ethnicity groups, odds ratios controlling for assets, and predicted probabilities of probable depression across race/ethnicity and asset groups. Three results contribute to our understanding of the differences in probable depression rates between race/ethnicity groups: 1) Non-Hispanic Black and Hispanic persons had a higher weighted prevalence of probable depression in the U.S. than non-Hispanic White persons. In models unadjusted for assets, non-Hispanic Black and Hispanic persons had 1.3 greater odds of probable depression than non-Hispanic White persons (p<0.01). 2) We found an inverse relation between assets and probable depression across all race-ethnicity groups. Also, non-Hispanic Black and Hispanic persons had fewer assets than non-Hispanic Whites. 3) When we controlled for assets, non-Hispanic Black and Hispanic persons had 0.8 times lower odds of probable depression than non-Hispanic White persons (p<0.05). Thus, when holding assets constant, minorities had better mental health than non-Hispanic White persons in the U.S. These three findings help to reconcile findings in the literature on race/ethnicity and depression. Given vastly unequal distribution of wealth in the U.S., it is not surprising that racial minorities, who hold fewer assets, would have an overall larger prevalence of mental illness, as seen in unadjusted estimates. Once assets are taken into account, Black and Hispanic persons appear to have better mental health than non-Hispanic White persons. Assets may explain much of the relation between race/ethnicity group and depression in the U.S. Future research should consider the role of assets in protecting against mental illness.

Examining Psychological Distress Across Intersections of Immigrant Generational Status, Race, Poverty, and Gender

While many studies have documented the health outcomes of immigrants, little is known about the direct and intersectional influences of generational status on mental health. We conducted a population-based cross-sectional study using data from the California Health Interview Survey from 2015 to 2016 (N = 41,754) to compare the prevalence of psychological distress among first-generation immigrants and non-immigrants relative to second-generation immigrants, overall and across intersections of race, poverty status, and gender. Second-generation and non-immigrant respondents had a significantly higher prevalence (10.1% and 9.4%, respectively) of psychological distress compared to first-generation immigrants (5.9%). Prevalence ratios comparing first-generation to second-generation immigrants were suggestive of an association where first-generation immigrants had lower prevalence of psychological distress compared to second-generation, though not statistically significant (0.81, 95% Confidence interval 0.63, 1.04). Prevalence ratios of non-immigrants relative to second-generation immigrants were not statistically significant (1.12, 95% Confidence interval 0.84, 1.50).

Associations among Early Exposure to Neighborhood Disorder, Fathers' Early Involvement, and Children's Internalizing and Externalizing Problems

PURPOSE

This study aimed to examine (1) the effects of early exposure to neighborhood disorder and fathers' early involvement on children's long-term internalizing and externalizing problems, and (2) whether fathers' early involvement buffered effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

METHOD

We used five waves of Fragile Family and Child Wellbeing study data and conducted multi-level longitudinal mixed-effects models to examine relationships among early exposure to neighborhood disorder, fathers' early involvement, and children's internalizing and externalizing problems.

RESULTS

Results indicated that early exposure to neighborhood disorder was associated with increased children's internalizing and externalizing problems, while fathers' early involvement was associated with decreased children's internalizing and externalizing problems. However, fathers' early involvement did not buffer the negative effects of early exposure to neighborhood disorder on children's internalizing and externalizing problems.

DISCUSSION

The findings suggest the importance of neighborhood order and fathers' early involvement in decreasing children's internalizing and externalizing problems. Developing neighborhood-level interventions and improving fathers' involvement in early childhood are potential strategies to prevent children's behavioral problems in the long term.

Mental health status compared among rural-to-urban migrant, urban and rural school-age children in Guangdong Province, China

BACKGROUND

Previous research has documented mental health status among rural-to-urban migrant children (labeled as "migrant children" henceforth) and urban children. However, the findings remain unclear. In addition, far less attention has been paid to rural children's psychological outcomes. The purpose of this study was to compare mental health status among migrant, urban and rural school-age children in Guangdong Province, China.

METHODS

This was a cross-sectional study involving 372 migrant, 254 urban and 268 rural children selected respectively from 3 private schools, 4 public schools and 2 village schools in Guangdong Province, China. Participants provided their socio-demographic information and completed the Strengths and Difficulties Questionnaire (SDQ) to assess mental health. One-way analyses of variance (ANOVAs) and Bonferroni post hoc test were used to evaluate SDQ scores differences. A multiple linear regression analysis was conducted to measure mental health differences among children after controlling for socio-demographics. Chi-square analyses were used to assess differences in the prevalence of mental health problems among children.

RESULTS

Bonferroni post hoc test showed that migrant and rural children reported significantly higher scores than urban peers in emotional symptoms, hyperactivity/inattention and total difficulties score (p < 0.01). In addition, migrant children reported a higher peer problems score compared to urban children (p < 0.001). In multiple linear regression analysis, rural and migrant children reported significantly a higher total difficulties score than urban children (p = 0.046 and 0.024, respectively). Additionally, female gender, having insurance, seldom communicating with parents, and higher monthly household income were negatively associated with a higher total difficulties score. Conversely, children's father with secondary education was positively associated with a higher total difficulties score. The prevalence of mental health problems among rural, migrant and urban children were 26.5, 18.8 and 15.0% (χ2 = 11.41, p = 0.003), respectively.

CONCLUSIONS

Rural and migrant children reported poorer mental health than urban children. Female gender, having insurance, seldom communicating with parents, and higher monthly household income were associated with better mental health of children. However, children's father with secondary education was associated with poorer mental health of children. Given the different effects of socio-demographics, further support might be provided accordingly to improve the mental health of school-age children.

Factors Influencing Low Prevalence of Neurodevelopmental Disabilities Among US Hispanic/Latino Children

OBJECTIVES

Hispanic/Latino (H/L) children have lower prevalence of neurodevelopmental disabilities (NDD) than other groups. The explanations for this are complex, but may be related to nativity, language barriers, and lack of access to and utilization of healthcare. Previous research focused on how these factors affect children with NDD, but little research has jointly examined whether these factors predict NDD. This study examines whether social and environmental factors explain low prevalence of NDD in this population.

METHODS

This study uses nationally representative Integrated Public Use Microdata Series National Health Interview Survey data (N = 200,622) and multivariate logistic regression analysis to compare NDD prevalence in white and H/L children (average age of 10.2), and examines whether nativity, healthcare access, healthcare utilization, and language barriers explain this disability disparity.

RESULTS

Findings reveal that the H/L NDD disparity is not explained by differences in access to or utilization of healthcare, or as a result of language differences that may create barriers to NDD diagnosis. While H/L children whose sampled adult was born in the USA have lower rates of NDD than whites, H/Ls whose sampled adult were not born in the USA have even lower probability of NDD than H/Ls who were born in the USA.

CONCLUSIONS

These findings may be a result of cultural differences in knowledge or understanding of what constitutes a disability or the result of differential treatment within the healthcare system among H/Ls. The findings underscore the importance of accessible and culturally appropriate health and clinical care interventions among H/L communities.

Comparative Study of Life Quality Between Migrant Children and Local Students in Small and Medium-Sized Cities in China

Every child deserves a fair chance in life. However, migrant children are at higher risk of developing mental health problems. The problem of migrant children who have left their hukou registration place for 6 months or longer with their parents from rural areas to cities in China has become a unique social issue in the social transformation of China. However, even up to this day, little is known about life satisfaction of migrant children in small and medium-sized cities. To investigate the current situation of migrant children's life satisfaction, several scales including Chinese Adolescent Students' Life Satisfaction Questionnaire, Social Economic Status Scale, Social Support Rating Scale and big five inventory were used to obtain data on 142 migrant children and 165 local primary school students. Results showed that migrant children's life satisfaction was significantly lower when compared to local non-migrant students. The study also highlighted that subjective and objective support, utilization of support, conscientiousness and parent's educational level were predictive factors of life satisfaction. Migrant children' life satisfaction was not optimistic and social support was significantly influencing factors of migrant children's life satisfaction, so they need a support system of government, school, community, family to help them through difficulties.

Comparing the mental health of rural-to-urban migrant children and their counterparts in china: Protocol for a systematic review and meta-analysis

BACKGROUND

In recent years, the issue of migrant children with peasant parents working in cities has attracted widespread attention in recent years because of the sheer number and the benefits bundled in China's household. The focus has gradually extended from early education opportunities to all aspects of physical and mental development, especially the social adaptation and mental health of migrant children. The negative impact of environment changes on migrant children' mental health is very worrying for parents and the society. Some studies have found that immigrant children's mental health is significantly lower than their peers, but there are also studies that hold the opposite view. Thus, the mental health status of migrant children is still a controversial issue, which may have a certain relationship with the potential differences in the specific problems of mental health, regions, comparison objects, and researchers. The objective of this protocol is to investigate whether mental health and subdimensions differ between rural-to-urban migrant children and their counterparts living in China and examine study characteristics that might result in differences among studies.

METHODS

We will search PubMed, Embase, OVID, ERIC, Web of Science, and Chinese databases including CNKI, Chongqing VIP, and Wan Fang data from start to April 2018. Cross-sectional studies with a comparison of migrant children and their counterparts will be included. The primary outcome will be the mean and standard deviation of mental health and its sub-dimensions. Standardized mean difference is used as the main effect value. Subgroup analyses will be carried out by the location of studies and school type of. Sensitivity analyses will be conducted to assess the robustness of the findings. Analyses will be performed with RevMan and Stata software.

RESULTS

This systematic review and meta-analysis will compare the mental health status of rural-to-urban migrant children and their counterparts living in China.

CONCLUSION

The results of this systematic and meta-analysis will be helpful to get a more reliable understanding of the mental health of rural-to-urban migrant children and the reasons for the controversy on this issue.

More secure attachment to the father and the mother is associated with fewer depressive symptoms in adolescents

AIM

To investigate whether more secure attachment to the father and the mother is associated with less depressive symptoms among adolescents, and to explore possible sex differences.

METHOD

A population-based sample of adolescents completed a school-based survey assessing demographic data, attachment to father and mother, as well as depressive symptoms. Participation rate was 80% of the eligible population, and 3,988 adolescents (1,937 boys and 2,051 girls) had complete data for the analyses.

RESULTS

Paired samples t tests showed that participants rated their attachment to mothers as slightly more secure than their attachment to fathers (t = 15.94, P < 0.001; boys: t = 5.23, P < 0.001; girls: t = 16.16, P < 0.001). In linear regression analyses there was an association between the outcome, number of depressive symptoms, and more secure attachment to the mother for boys (B = -0.532; 95% confidence interval [CI] -0.656, -0.407, P < 0.001) and for girls (B = -0.623; 95% CI -0.730, -0.516, P < 0.001). Analogous results were found for more secure attachment to the father for boys (B = -0.499; 95% CI -0.608, -0.391, P < 0.001) and for girls (B = -0.494; 95% CI -0.586, -0.401, P < 0.001).

CONCLUSIONS

Understanding the relationship between attachment to both father and mother and depressive symptoms in adolescent boys and girls is essential for further development of strategies for prevention and treatment of depression.