Association Between Health-Related Quality of Life and Being an Immigrant Among Adolescents, and the Role of Socioeconomic and Health-Related Difficulties

Abstract

To develop satisfactorily, adolescents require good health-related quality of life (QOL, including physical health, psychological health, social relationships and living environment). However, for poorly understood reasons, it is often lacking, especially among immigrants with lower family and socioeconomic resources. This study assessed health-related QOL of European and non-European immigrant adolescents and the contributions of socioeconomic difficulties, unhealthy behaviors, and violence. It included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3; 1,451 French adolescents, 54 European immigrants and 54 non-European immigrants), who completed a self-administered questionnaire including sex, age, socioeconomic characteristics (family structure, parents’ education, occupation, and income), unhealthy behaviors (uses of tobacco/alcohol/cannabis/hard drugs, obesity, and involvement in violence), having sustained violence, sexual abuse, and the four QOL domains measured with the World Health Organization’s WHOQOL-BREF (poor: score < 25th percentile). Data were analyzed using logistic regression models. Poor physical health, psychological health, social relationships, and living environment affected more European immigrants (26% to 35%) and non-European immigrants (43% to 54%) than French adolescents (21% to 26%). European immigrants had a higher risk of poor physical health and living environment (gender-age-adjusted odds ratio 2.00 and 1.88, respectively) while non-European immigrants had a higher risk for all poor physical health, psychological health, social relationships, and living environment (3.41, 2.07, 3.25, and 3.79, respectively). Between 20% and 58% of these risks were explained by socioeconomic difficulties, parts of which overlapped with unhealthy behaviors and violence. The associations between the two sets of covariates greatly differed among French adolescents and immigrants. Poor QOL was more common among European and non-European immigrants due to socioeconomic difficulties and associated unhealthy behaviors and violence. The different risk patterns observed between French adolescents and immigrants may help prevention.

Quality of life and recreational cannabis use

“…Recreational cannabis use was weakly associated with lower Mental QoL in the six studies, that utilized QoL measures that yield a distinct Mental/Psychological QoL domain score . Five (of the six) studies reported that cannabis use was associated with lower Mental QoL scores and one was inconclusive .…”

“…The cross‐sectional studies ranged from 56 to 43,093 with a mean of 8,544 and a median of 2,864 ( n = 7). However, again, the cannabis users often only made up a small proportion of the total number of subjects in each study …”

“…Four additional studies controlled for the frequency of cannabis use, however, none reported the modality of use (ie, smoked vs vaporized) or the strain/characteristics of cannabis that subjects utilized . The remaining four studies, almost one‐half of this group, controlled for none of the three variables …”

“…Nine studies utilized QoL measures to investigate the impact of recreational cannabis on QoL in subjects from general populations . The study designs were primarily cross‐sectional/cohort, with the exceptions being a prospective longitudinal observational, and a monozygotic co‐twin control (Table ) …”

Association between Suicide Ideation and Attempts and Being an Immigrant among Adolescents, and the Role of Socioeconomic Factors and School, Behavior, and Health-Related Difficulties

“…They have more frequently poor parents’ education, non-intact families, poor socioeconomic resources, economic uncertainty, and access to health care [16,21,22,23,24,25]. They also have more school, behavior, and health-related difficulties [16,26,27]. These sets of factors may predict suicide behaviors [2,28].…”