Does the healthy immigrant effect apply to mental health? Examining the effects of immigrant generation and racial and ethnic background among Australian adults

Abstract

The healthy immigrant effect (HIE) refers to the phenomena in which immigrants show greater health outcomes than the native-born population. However, it is unclear what is the extent to which HIE applies to various outcomes and populations. Much of the work on HIE has revolved around physical health outcomes; mental health, however, has not garnered the same level of attention with regard to HIE. It is also uncertain whether immigrants’ health advantage persists beyond one generation. This study assesses the mental health of the first, second, and third and higher generations (70,517 person-year observations) for individuals from various racial and ethnic backgrounds in Australia using Waves 1−16 of the Household Income and Labour Dynamics in Australia survey. The dependent variable is mental health score and key independent variables include generation and racial and ethnic background. I control for age, educational attainment, labor force status, marital status, remoteness, household income, language, neighborhood disadvantage, citizenship, weight, and gender. Using linear regression with random effects, this study finds that mental health varies by generation; the third and higher generation show the greatest mental health score, followed by the first generation and the second generation, net of controls. Mental health score also varies by racial and ethnic background. Except for English-speaking groups, native-born Australians show a clear advantage over Europeans, North Africans/Middle Easterners, and Asians. Racial and ethnic disparities differ by generation and are strongest among the first generation. My findings extend HIE, which typically emphasize immigrants’ superior health outcomes over the native-born population but do not focus on racial and ethnic disparities among immigrants. My results suggest that immigrant groups vary widely in their mental health outcomes but these lessen over time. Overall, the findings suggest the limited applicability of HIE for a broad range of health outcomes and populations.

Higher prevalence of depressed mood in immigrants’ offspring reflects their social conditions in the host country: The HELIUS study

“…This provides indications that it is beneficial for people from ethnic minority populations to stay attached to the original country's culture and people. Whereas this has been put forward as an explanation for the relative good mental health of immigrants who fit the 'healthy immigrant paradox' [14], our results provide indications to suggest that this beneficial effect also holds for immigrant's offspring.…”

“…Those studies, however, combined data from ethnic minority populations into one category, thereby possibly masking differences between ethnic groups. A study in Australia, as a case in point, has indicated a higher prevalence of mental health problems in the offspring of immigrants of European descent, but not of other ethnic groups [14]. This highlights the importance of distinguishing by ethnic background in future studies.…”

“…Studies on the risk of depression in the offspring of immigrants have shown mixed results [8,[13][14][15][16][17][18], with some studies reporting an elevated risk as compared with the host population, whereas others found risks similar to those in host populations and lower than those in people who have migrated themselves, to be referred to here as immigrants. The number of studies is limited, however, and they cover heterogeneous populations [17].…”

Predictive association between immigration status and chronic pain in the general population: results from the SwePain cohort

“…Taking into consideration our findings, our study did not seem to follow the hypothesis of a ‘healthy immigrant effect’ [ 24 ]. Today, there is extensive ongoing research about the above mentioned phenomenon, yet the findings have been inconclusive [ 25 , 49 – 51 ].…”

Immigrants’ mental health service use compared to that of native Finns: a register study

“…Healthy migrant effect has been documented in many countries, although it does seem to wear off in time [11][12][13]. Considering mental health, evidence of healthy migrant effect is, however, controversial [14].…”