Neighbourhood context and diagnosed mental health conditions among immigrant and non-immigrant youth: a population-based cohort study in British Columbia, Canada.

PURPOSE: Evidence from systematic reviews suggests that adult immigrants living in areas of higher immigrant density (areas with a higher proportion of foreign-born residents) tend to experience fewer mental health problems-likely through less discrimination, greater access to culturally/linguistically appropriate services, and greater social support. Less is known about how such contexts are associated with mental health during childhood-a key period in the onset and development of many mental health challenges. This study examined associations between neighbourhood immigrant density and youth mental health conditions in British Columbia (BC; Canada). METHODS: Census-derived neighbourhood characteristics were linked to medical records for youth present in ten of BC's largest school districts from age 5 through 19 over the study period (1995-2016; n = 138,090). Occurrence of physician assessed diagnoses of mood and/or anxiety disorders, attention deficit hyperactivity disorder (ADHD), and conduct disorder was inferred through International Classification of Diseases (ICD) diagnostic codes in universal public health insurance records. Multi-level logistic regression was used to model associations between neighbourhood characteristics and odds of diagnoses for each condition; models were stratified by generation status (first-generation: foreign-born; second-generation: Canadian-born to a foreign-born parent; non-immigrant). RESULTS: Higher neighbourhood immigrant density was associated with lower odds of disorders among first-generation immigrant youth (e.g., adjusted odds of mood-anxiety disorders for those in neighbourhoods with the highest immigrant density were 0.67 times lower (95% CI: 0.49, 0.92) than those in neighbourhoods with the lowest immigrant density). Such protective associations generally extended to second-generation and non-immigrant youth, but were-for some disorders-stronger for first-generation than second-generation or non-immigrant youth. CONCLUSIONS: Findings suggest there may be protective mechanisms associated with higher neighbourhood immigrant density for mental health conditions in immigrant and non-immigrant youth. It is important that future work examines potential pathways by which contextual factors impact immigrant and non-immigrant youth mental health.

Classroom Immigrant Density Predicts Psychological Well-Being Among Adolescents With an Immigration Background: Findings From the 2017/18 Swedish Health Behaviour in School-Aged Children Study.

Objectives: Group-level characteristics in shared contexts such as schools may affect adolescent psychological health. This study examined if the immigrant density in the classroom was associated with the level of self-reported psychological complaints among students with an immigration background. Methods: Cross-sectional data were derived from 2,619 lower secondary school students (aged 13-15) in the 2017/18 wave of the Swedish Health Behaviour in School-aged Children (HBSC) survey. Using multilevel analysis estimating two-level random intercept linear regression models, classroom immigrant density was considered as a potential predictor of immigrant students' psychological complaints. Results: Students with an immigration background reported significantly fewer psychological complaints, on average, than students without such a background, even when adjusting for other sociodemographic characteristics. A cross-level interaction indicated that both first- and second-generation immigrant students experienced fewer psychological complaints in immigrant-dense classes compared to when the proportion of immigrant students was lower. Conclusion: Students with an immigration background fare better psychologically in classes with a higher proportion of immigrant students. Such compositional effects could be alleviated by strengthening all schools' capacities to provide a more inclusive classroom climate.

Obesity and Regional Immigrant Density.

Canada has an increasingly large immigrant population. Areas of higher immigrant density, may relate to immigrants' health through reduced acculturation to Western foods, greater access to cultural foods, and/or promotion of salubrious values/practices. It is unclear, however, whether an association exists between Canada-wide regional immigrant density and obesity among immigrants. Thus, we examined whether regional immigrant density was related to obesity, among immigrants. Adult immigrant respondents (n = 15,595) to a national population-level health survey were merged with region-level immigrant density data. Multi-level logistic regression was used to model the odds of obesity associated with increased immigrant density. The prevalence of obesity among the analytic sample was 16%. Increasing regional immigrant density was associated with lower odds of obesity among minority immigrants and long-term white immigrants. Immigrant density at the region-level in Canada may be an important contextual factor to consider when examining obesity among immigrants.

Bullying among immigrant and non-immigrant early adolescents: School- and student-level effects.

We examined the association between school immigrant concentration and bullying among immigrant and non-immigrant early adolescents, and identified potential explanatory factors. First generation immigrant students had reduced odds of victimization and perpetration in schools with high (20-60%), compared to low, levels of immigrant concentration. Second generation immigrant students had reduced odds of ethnic/racial victimization in moderately concentrated schools; while non-immigrants had increased odds in the same schools. Non-white students had increased odds of ethnic/racial victimization compared to White students. While students' sense of school belonging and perceived teacher cultural sensitivity were negatively associated with bullying, they did not account for the differential associations noted above. Results demonstrate the importance of immigrant density as a protective school characteristic for immigrant and ethnic minority youth. Additional social processes operating in schools that may explain bullying behaviors among immigrant and non-immigrant youth should be explored to inform programs for promoting inclusion in schools.