Self-perceived workplace discrimination and mental health among immigrant workers in Italy: a cross-sectional study.

BACKGROUND: The process of immigration is associated with poor mental and physical health. While the workplace represents an important context of social integration, previous studies evaluating the effect of discrimination experienced in the workplace found worse mental health status among immigrants. The aim of this study was to investigate whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, evaluating the contribution of other personal experiences, such as loneliness and life satisfaction. METHODS: A cross-sectional study was conducted on a sample of 12,408 immigrants (aged 15-64) living and working in Italy. Data were derived from the first national survey on immigrants carried out by the Italian National Institute of Statistics (Istat). Mental health status was measured through the Mental Component Summary (MCS) of the SF-12 questionnaire. A linear multivariate linear regression was carried out to evaluate the association between mental health status, self-perceived workplace discrimination, and sociodemographic factors; path analysis was used to quantify the mediation effect of self-perceived loneliness, level of life satisfaction, and the Physical Component Summary (PCS). RESULTS: Mental health status was inversely associated (p < 0.001) with self-perceived workplace discrimination (ß:-1.737), self-perceived loneliness (ß:-2.653), and physical health status (ß:-0.089); it was directly associated with level of life satisfaction (ß:1.122). As confirmed by the path analysis, the effect of self-perceived workplace discrimination on MCS was mediated by the other factors considered: self-perceived loneliness (11.9%), level of life satisfaction (20.7%), and physical health status (3.9%). CONCLUSIONS: Our study suggests that self-perceived workplace discrimination is associated with worse mental health status in immigrant workers through personal experiences in the workplace and explains the effect of the exposure to workplace discrimination on immigrants' psychological well-being. Our findings suggest that an overall public health response is needed to facilitate the social integration of immigrants and their access to health services, particularly those services that address mental health issues.

[Perceived discrimination at work for being an immigrant: a study on self-perceived mental health status among immigrants in Italy]. / Capitolo 5: Discriminazione percepita sul luogo di lavoro in quanto straniero: uno studio sulla salute mentale percepita dagli immigrati in Italia.

BACKGROUND: exposure to discrimination is widely understood as a social determinant of psychophysical health and a contributing factor to health inequities among social groups. Few studies exist, particularly in Italy, about the effects of discrimination among immigrants at workplace. OBJECTIVES: to analyse the association between perceived discrimination at work for being an immigrant and mental health status among immigrants in Italy. SETTING AND PARTICIPANTS: a sub-sample of 12,408 immigrants residing in Italy was analysed. MAIN OUTCOME MEASURES: data came from the survey "Social conditions and integration of foreign citizens in Italy", carried out in 2011-2012 by the Italian National Institute of Statistics (Istat). Self-perceived mental health status was measured through mental component summary (MCS) of SF-12 questionnaire, assuming as worse health status MCS score distribution ≤1st quartile. In order to evaluate the probability of poor health status, a multivariate log-binomial model was performed assuming: discrimination at work for being an immigrant as determinant variable; age, gender, educational level, employment status, area of origin, residence in Italy, length of stay in Italy, self-perceived loneliness and satisfaction about life as potential confounding variables. RESULTS: among immigrants, 15.8% referred discrimination at his/her workplace in Italy for being an immigrant. Higher probability of poor mental health status was observed for immigrants who referred discrimination at workplace (Prevalence Rate Ratio - PRR: 1.16) who arrived in Italy since at least 5 years (PRR: 1.14), for not employed subjects (PRR: 1.31), and for people from the Americas (PRR: 1.14). Lower probability of poor mental health status was found in immigrants from Western- Central Asia (PRR: 0.83) and Eastern-Pacific Asia (PRR: 0.79). Compared to immigrants residing in North-Eastern Italy, higher probability of worse mental health status was observed in people who resided in Northern-Western (PRR: 1.30), Central (PRR: 1.26), and Southern (PRR: 1.15) Italian regions. CONCLUSIONS: our findings confirm that discrimination at workplace for being an immigrant is a risk factor for self-perceived mental health among immigrants in Italy, suggesting that an overall public health response is essential in addition to work-based interventions. Improving working conditions, promoting organisational strategies to support coping behaviours, and challenging discrimination can improve mental health status of immigrants.