Social Psychiatry and Psychiatric Epidemiology
Volume 52, Issue 4, 2017, Pages 391-398

Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes (Article)

Malmusi D.* , Palència L. , Ikram U.Z. , Kunst A.E. , Borrell C.
  • a Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, Barcelona, 08023, Spain, Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, Madrid, 28029, Spain
  • b Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, Barcelona, 08023, Spain, Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, Madrid, 28029, Spain
  • c Academic Medical Center, University of Amsterdam, PO Box 22660, Amsterdam, 1100 DD, Netherlands
  • d Academic Medical Center, University of Amsterdam, PO Box 22660, Amsterdam, 1100 DD, Netherlands
  • e Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, Barcelona, 08023, Spain, Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, Madrid, 28029, Spain, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader, 88, Barcelona, 08003, Spain

Abstract

Purpose: We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe. Methods: This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as “advanced economy” by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables. Results: In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65–1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57–1.13) and inclusive countries (0.60 and 0.36–0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries. Conclusions: Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants’ health is shaped by integration policies in their host country. © 2017, Springer-Verlag Berlin Heidelberg.

Author Keywords

Social determinants Integration policy Europe Depression immigrant status

Index Keywords

male Emigrants and Immigrants female depression Aged Humans cross-sectional study ethnology public policy Europe Cross-Sectional Studies psychology Young Adult human adult migrant middle aged Adolescent
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85012241873&doi=10.1007%2fs00127-017-1348-2&partnerID=40&md5=7439934b1a73b5b556fa122674c46bb8
DOI: 10.1007/s00127-017-1348-2
ISSN: 09337954
Cited by: 8
Original Language: English