The Relation Between Age at Immigration and Mental Health

Abstract

Immigrants in the United States are a growing population, but little is known about how their mental health may vary by their age at immigration. In Chapter 1, we used logistic regression to estimate the odds of incident depression and anxiety in a large, nationally-representative sample of US adults. We found those who immigrated between ages 0-5 years old (early-childhood) were more likely than those born in the US to develop depression and anxiety, while those who immigrated during adolescence or later were less likely to develop depression and anxiety. In Chapter 2, we used Poisson regression to estimate the effect of childhood adversities on the risk for depression and anxiety in a large sample of immigrants. We also estimated and decomposed the joint effects of childhood adversities and age at immigration into components due to the effect of childhood adversities alone, the effect due to age at immigration alone, and the effect due to their interaction. We found that childhood adversities significantly interacted with age at immigration such that those with the greatest risk were those who immigrated during early-childhood and had exposure to childhood adversities. When the joint effects of childhood adversities and age at immigration were decomposed, the effect of age at immigration alone was consistently greater than that of childhood adversities alone across all adversities. While synergistic effects were present for both depression and anxiety, antagonistic effects between childhood adversities and age at immigration were only present for depression. In Chapter 3, we estimated the prevalence of mental treatment by age at immigration in a large, nationally-representative sample of US adults who were prevalent with depression or anxiety and compared the usage of different treatment modalities between immigrants and non-immigrants. We found that those who immigrated during early-childhood had similar, and at times higher, treatment use that those born in the US. Those who immigrated after early-childhood had consistently lower treatment use than those born in the US. We also found that fewer immigrants across all ages at immigration were prescribed medication for their symptoms and more immigrants visited the emergency room for their symptoms.