A Scoping Review of Associations Between Ethno-Cultural Context and Mental Health in Canada
Publication: Canadian Journal of Community Mental Health
20 September 2021
Abstract
It is unclear how ethno-cultural concentration of residential areas relates to the mental health of immigrant, refugee, ethno-cultural, and racialized (IRER) groups. Communities of higher ethno-cultural density are theorized to support IRER groups’ mental health via community supports, access to culturally/linguistically appropriate healthcare, and lower discrimination/stigma. This article reviewed quantitative studies that examined relationships between communities’ ethno-cultural density and mental health among IRER groups in Canada. Eleven of the sixteen reviewed studies (almost 70%) observed protective associations between ethno-cultural density and mental health; patterns were more mixed for studies with child populations, suggesting associations may differ based on developmental phases. Findings suggested there was more support in protective associations of higher areal ethno-cultural density with regard to community mental health of IRER groups in Canada.
Résumé
On ne sait pas comment la concentration ethnoculturelle des zones résidentielles est liée à la santé mentale des groupes d’immigrants, de réfugiés, ethnoculturels et racialisés (IRER). Les communautés de densité ethnoculturelle plus élevée sont théorisées pour soutenir la santé mentale des groupes IRER par le biais de soutiens communautaires, l’accès à des soins de santé culturellement / linguistiquement appropriés et une réduction de la discrimination / stigmatisation. Cet article a passé en revue des études quantitatives qui ont examiné les relations entre la densité ethnoculturelle des communautés et la santé mentale des groupes IRER au Canada. Onze des seize études examinées (près de 70%) ont observé des associations protectrices entre la densité ethnoculturelle et la santé mentale; les modèles étaient plus mélangés pour les études avec des populations d’enfants, ce qui suggère que les associations peuvent différer en fonction des phases de développement. Les résultats suggèrent des associations protectrices de densité ethnoculturelle plus élevée en ce qui concerne la santé mentale communautaire des groupes IRER au Canada.
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References
Abada T., Hou F., and Ram B. 2007 Racially mixed neighborhoods, perceived neighborhood social cohesion, and adolescent health in Canada Social Science & Medicine 65 10 2004 -2017
Astell-Burt T., Maynard M. J., Lenguerrand E., and Harding S. 2012 Racism, ethnic density and psychological well-being through adolescence: Evidence from the determinants of adolescent social well-being and health longitudinal study Ethnicity & Health 17 1–2 71 -87
Asvat Y. and Malcarne V. L. 2008 Acculturation and depressive symptoms in Muslim university students: Personal-family acculturation match International Journal of Psychology: Journal International De Psychologie 43 2 114 -124 https://doi.org/10.1080/00207590601126668
Bassani & George. (2012). Social capital and immigrant children’s behaviour in Canada. In Adolescent Behavior. Nova Science Publishers.
Bécares L., Dewey M. E., and Das-Munshi J. 2018 Ethnic density effects for adult mental health: Systematic review and meta-analysis of international studies Psychological Medicine 48 12 2054 -2072 https://doi.org/10.1017/S0033291717003580
Bécares L., Nazroo J., and Stafford M. 2009 The buffering effects of ethnic density on experienced racism and health Health & Place 15 3 700 -708 https://doi.org/10.1016/j.healthplace.2008.10.008
Beiser M., Hamilton H., Rummens J. A., Oxman-Martinez J., Ogilvie L., Humphrey C., and Armstrong R. 2010 Predictors of emotional problems and physical aggression among children of Hong Kong Chinese, Mainland Chinese and Filipino immigrants to Canada Social Psychiatry and Psychiatric Epidemiology 45 10 1011 -1021
Bennett N. C., Salway S., and Piekut A. 2020 What pathways have been theorised and tested between ethnic density and mental ill-health?: A theory-based systematic review Journal of Epidemiology and Community Health 74 Suppl 1 A17 -A17 https://jech.bmj.com/content/74/Suppl_1/A17.1
Berry J. W. and Hou F. 2016 Immigrant acculturation and wellbeing in Canada Canadian Psychology/Psychologie Canadienne 57 4 254
Berry, J. W., Phinney, J. S., Sam, D. L., & Vedder, P. (2006). Immigrant youth in cultural transition: Acculturation, identity, and adaptation across national contexts. Lawrence Erlbaum Associates Publishers.
Bronfenbrenner, U., & Morris, P. A. (2007). The Bioecological Model of Human Development. In Handbook of Child Psychology. American Cancer Society. https://doi.org/10.1002/9780470147658.chpsy0114
Chau S. and Lai D. W. 2011 The size of an ethno-cultural community as a social determinant of health for Chinese seniors Journal of Immigrant and Minority Health 13 6 1090 -1098
Chiu M., Amartey A., Wang X., and Kurdyak P. 2018 Ethnic differences in mental health status and service utilization: A population-based study in Ontario, Canada The Canadian Journal of Psychiatry 63 7 481 -491
City of Ottawa. (2016). Racialized People, Equity and Inclusion Lens Snapshot. https://documents.ottawa.ca/sites/documents/files/racializd_ss_en.pdf
Clarke D., Colantonio A., Rhodes A., and Escobar M. 2008 Ethnicity and mental health: Conceptualization, definition and operationalization of ethnicity from a Canadian context Chronic Diseases in Canada 28 4 20
Das-Munshi J., Becares L., Dewey M. E., Stansfeld S. A., and Prince M. J. 2010 Understanding the effect of ethnic density on mental health: Multi-level investigation of survey data from England BMJ 341 c5367 https://doi.org/10.1136/bmj.c5367
Das-Munshi J., Schofield P., Bhavsar V., Chang C.-K., Dewey M. E., Morgan C., Stewart R., Thornicroft G., and Prince M. J. 2019 Ethnic density and other neighbourhood associations for mortality in severe mental illness: A retrospective cohort study with multi-level analysis from an urbanised and ethnically diverse location in the UK The Lancet Psychiatry 6 6 506 -517 https://doi.org/10.1016/S2215-0366(19)30126-9
de Rocquigny, J. Y. (2014). Manitoba’s francophone children: What determines EDI scores?
Deri C. 2005 Social networks and health service utilization Journal of Health Economics 24 6 1076 -1107
Dinesen P. T., Schaeffer M., and Sønderskov K. M. 2020 Ethnic Diversity and Social Trust: A Narrative and Meta-Analytical Review Annual Review of Political Science 23 1 441 -465 https://doi.org/10.1146/annurev-polisci-052918-020708
Doucerain M. M. 2019 Moving forward in acculturation research by integrating insights from cultural psychology International Journal of Intercultural Relations 73 11 -24 https://doi.org/10.1016/j.ijintrel.2019.07.010
Dwan K., Gamble C., Williamson P. R., and Kirkham J. J. 2013 Systematic Review of the Empirical Evidence of Study Publication Bias and Outcome Reporting Bias—An Updated Review PLOS ONE 8 7 e66844 https://doi.org/10.1371/journal.pone.0066844
Elliott P. and Wartenberg D. 2004 Spatial epidemiology: Current approaches and future challenges Environmental Health Perspectives 112 9 998 -1006
Emerson S. D., Minh A., and Guhn M. 2018 Ethnic density of regions and psychiatric disorders among ethnic minority individuals International Journal of Social Psychiatry 64 2 130 -144 https://doi.org/10.1177/0020764017747909
Faris, R. E. L., & Dunham, H. W. (1939). Mental disorders in urban areas: An ecological study of schizophrenia and other psychoses. http://psycnet.apa.org/psycinfo/1939-01453-000
French S. E., Seidman E., Foundation W. T. G., Allen L., and Aber J. L. 2006 The development of ethnic identity during adolescence Developmental Psychology 1 -10
Georgiades K., Boyle M. H., and Duku E. 2007 Contextual influences on children’s mental health and school performance: The moderating effects of family immigrant status Child Development 78 5 1572 -1591
Georgiades K., Boyle M. H., and Fife K. A. 2013 Emotional and behavioral problems among adolescent students: The role of immigrant, racial/ethnic congruence and belongingness in schools Journal of Youth and Adolescence 42 9 1473 -1492
Government of Canada, S. C. (2019, June 3). Population and demography statistics. https://www.statcan.gc.ca/eng/subjects-start/population_and_demography
Guhn M., Zumbo B. D., Janus M., and Hertzman C. 2011 Validation theory and research for a population-level measure of children’s development, wellbeing, and school readiness Social Indicators Research 103 2 183 -191
Hertzman C. and Boyce T. 2010 How experience gets under the skin to create gradients in developmental health Annual Review of Public Health 31 1 329 -347 https://doi.org/10.1146/annurev.publhealth.012809.103538
Hou F. 2006 Spatial Assimilation of Racial Minorities in Canada’s Immigrant Gateway Cities Urban Studies 43 7 1191 -1213 https://doi.org/10.1080/00420980600711993
Hughes D. L., Del Toro J., and Way N. 2017 Interrelations among dimensions of ethnic-racial identity during adolescence Developmental Psychology 53 11 2139 -2153 https://doi.org/10.1037/dev0000401
Immigration Refugees and Citizenship Canada. (2020). Syrian Outcomes Report. https://www.canada.ca/en/immigration-refugees-citizenship/corporate/reports-statistics/evaluations/syrian-outcomes-report-2019.html
Janus M. and Offord D. R. 2007 Development and psychometric properties of the Early Development Instrument (EDI): A measure of children’s school readiness Canadian Journal of Behavioural Science/Revue Canadienne Des Sciences Du Comportement 39 1 1
Jass, G., & Massey, D. S. (2004). Immigrant health: Selectivity and acculturation. IFS Working Papers.
Jurcik T., Ahmed R., Yakobov E., Solopieieva-Jurcikova I., and Ryder A. G. 2013 Understanding the role of the ethnic density effect: Issues of acculturation, discrimination and social support Journal of Community Psychology 41 6 662 -678
Jurcik T., Sunohara M., Yakobov E., Solopieiva-Jurcikova I., Ahmed R., and Ryder A. G. 2019 Acculturation and adjustment of migrants reporting trauma: The contextual effects of perceived ethnic density Journal of Community Psychology 47 6 1313 -1328 https://doi.org/10.1002/jcop.22183
Jurcik T., Yakobov E., Solopieieva-Jurcikova L., Ahmed R., Sunohara M., and Ryder A. G. 2015 Unraveling Ethnic Density Effects, Acculturation, and Adjustment: The Case of Russian-Speaking Immigrants from the Former Soviet Union Journal of Community Psychology 43 5 628 -648 https://doi.org/10.1002/jcop.21708
Kanagaratnam P., Pain C., McKenzie K., Ratnalingam N., and Toner B. 2017 Recommendations for Canadian Mental Health Practitioners Working With War-Exposed Immigrants and Refugees Canadian Journal of Community Mental Health https://doi.org/10.7870/cjcmh-2017-010
Kessler R. C., Berglund P., Demler O., Jin R., Merikangas K. R., and Walters E. E. 2005 Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication Archives of General Psychiatry 62 6 593 https://doi.org/10.1001/archpsyc.62.6.593
Khan M. M., Kobayashi K., Vang Z. M., and Lee S. M. 2017 Are visible minorities “invisible” in Canadian health data and research? A scoping review International Journal of Migration, Health and Social Care
Kobayashi K. M., Prus S., and Lin Z. 2008 Ethnic differences in self-rated and functional health: Does immigrant status matter? Ethnicity & Health 13 2 129 -147 https://doi.org/10.1080/13557850701830299
Kramer M. R. and Hogue C. R. 2009 Is Segregation Bad for Your Health? Epidemiologic Reviews 31 1 178 -194 https://doi.org/10.1093/epirev/mxp001
Lara-Cinisomo S., Xue Y., and Brooks-Gunn J. 2013 Latino youth’s internalising behaviours: Links to immigrant status and neighbourhood characteristics Ethnicity & Health 18 3 315 -335
Larson R. W., Moneta G., Richards M. H., and Wilson S. 2002 Continuity, stability, and change in daily emotional experience across adolescence Child Development 73 4 1151 -1165
Leduc N. and Proulx M. 2004 Patterns of health services utilization by recent immigrants Journal of Immigrant Health 6 1 15 -27
Malzberg, B. (1964). Mental disease in Canada, 1950-1952: A study of comparative incidence of mental disease among those of British and French origin. Research Foundation for Mental Hygiene.
Menezes N. M., Georgiades K., and Boyle M. H. 2011 The influence of immigrant status and concentration on psychiatric disorder in Canada: A multi-level analysis Psychological Medicine 41 10 2221 -2231
Mental Health Commission of Canada. (2016). The case for diversity: Building the case to improve mental health services for immigrant, refugee, ethno-cultural and racialized populations : report to the Mental Health Commission of Canada. http://madgic.library.carleton.ca/deposit/govt/ca_fed/mhcc_casefordiversity_2016_eng.pdf
Merikangas K. R., He J., Burstein M., Swanson S. A., Avenevoli S., Cui L., Benjet C., Georgiades K., and Swendsen J. 2010 Lifetime prevalence of mental disorders in US adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A) Journal of the American Academy of Child & Adolescent Psychiatry 49 10 980 -989
Merten E. C., Cwik J. C., Margraf J., and Schneider S. 2017 Overdiagnosis of mental disorders in children and adolescents (in developed countries) Child and Adolescent Psychiatry and Mental Health 11 1 5
Milbrath C. and Guhn M. 2019 Neighbourhood culture and immigrant children’s developmental outcomes at kindergarten Early Childhood Research Quarterly 48 198 -214 https://doi.org/10.1016/j.ecresq.2019.03.006
Minh A., Muhajarine N., Janus M., Brownell M., and Guhn M. 2017 A review of neighborhood effects and early child development: How, where, and for whom, do neighborhoods matter? Health & Place 46 155 -174
O’Donnell S., Vanderloo S., McRae L., Onysko J., Patten S. B., and Pelletier L. 2016 Comparison of the estimated prevalence of mood and/or anxiety disorders in Canada between self-report and administrative data Epidemiology and Psychiatric Sciences 25 04 360 -369
Omariba D. W. R., Ng E., and Vissandjée B. 2014 Differences between immigrants at various durations of residence and host population in all-cause mortality, Canada 1991-2006 Population Studies 68 3 339 -357 https://doi.org/10.1080/00324728.2014.915050
Pahwa P., Karunanayake C. P., McCrosky J., and Thorpe L. 2012 Longitudinal trends in mental health among ethnic groups in Canada Chronic Diseases and Injuries in Canada 32 3 164 -176
Pan S. W. and Carpiano R. M. 2013 Immigrant density, sense of community belonging, and suicidal ideation among racial minority and white immigrants in Canada Journal Of Immigrant And Minority Health / Center For Minority Public Health 15 1 34 -42 https://doi.org/10.1007/s10903-012-9657-8
Pearson, C., Janz, T., & Ali, J. (2013). Mental and substance use disorders in Canada. Statistics Canada Ottawa, Ontario. http://www.statcan.gc.ca/pub/82-624-x/2013001/article/11855-eng.pdf
Pendakur, K., & Pendakur, R. (2015). The Colour of Money Redux: Immigrant/Ethnic Earnings Disparity in Canada 1991– 2006. In Discussion Papers (No. dp15-13; Discussion Papers). Department of Economics, Simon Fraser University. https://ideas.repec.org/p/sfu/sfudps/dp15-13.html
Pickett K. E. and Wilkinson R. G. 2008 People like us: Ethnic group density effects on health Ethnicity & Health 13 4 321 -334
Picot, G., & Lu, Y. (2017). Chronic Low Income Among Immigrants in Canada and its Communities. 11, 43.
Puchala C., Vu L. T. H., and Muhajarine N. 2010 Neighbourhood Ethnic Diversity Buffers School Readiness Impact in ESL Children Canadian Journal of Public Health / Revue Canadienne de Sante’e Publique 101 S13 -S18
Qadeer & Kumar. (2007). Toronto’s Ethnic Enclaves: Sites of Segregation or Communities of Choice? Ontario Metropolis Centre Presentation.
Reitmanova S. and Gustafson D. L. 2009 Mental Health Needs of Visible Minority Immigrants in a Small Urban Center: Recommendations for Policy Makers and Service Providers Journal of Immigrant and Minority Health 11 1 46 -56 https://doi.org/10.1007/s10903-008-9122-x
Shaw R. J., Atkin K., Bécares L., Albor C. B., Stafford M., Kiernan K. E., Nazroo J. Y., Wilkinson R. G., and Pickett K. E. 2012 Impact of ethnic density on adult mental disorders: Narrative review The British Journal of Psychiatry 201 1 11 -19 https://doi.org/10.1192/bjp.bp.110.083675
Stafford M., Newbold B. K., and Ross N. A. 2011 Psychological distress among immigrants and visible minorities in Canada: A contextual analysis The International Journal Of Social Psychiatry 57 4 428 -441 https://doi.org/10.1177/0020764010365407
Statistics Canada. (2017). Immigration and Ethnocultural Diversity in Canada. https://www150.statcan.gc.ca/n1/daily-quotidien/171025/dq171025b-eng.htm
Thombs B. D., Kwakkenbos L., Levis A. W., and Benedetti A. 2018 Addressing overestimation of the prevalence of depression based on self-report screening questionnaires CMAJ 190 2 E44 -E49 https://doi.org/10.1503/cmaj.170691
United National High Commissioner for Refugees. (2020). UNHCR - Global Trends 2019: Forced Displacement in 2019. https://www.unhcr.org/globaltrends2019/
Vang Z., Sigouin J., Flenon A., and Gagnon A. 2015 The Healthy Immigrant Effect in Canada: A Systematic Review Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau Stratégique de Connaissances Changements de Population et Parcours de Vie Document de Travail 3 1 http://ir.lib.uwo.ca/pclc/vol3/iss1/4
Veenstra G. 2009 Racialized identity and health in Canada: Results from a nationally representative survey Social Science & Medicine 69 4 538 -542 https://doi.org/10.1016/j.socscimed.2009.06.009
Walks R. A. and Bourne L. S. 2006 Ghettos in Canada’s cities? Racial segregation, ethnic enclaves and poverty concentration in Canadian urban areas The Canadian Geographer / Le Géographe Canadien 50 3 273 -297 https://doi.org/10.1111/j.1541-0064.2006.00142.x
Walks R. A. and Maaranen R. 2008 Gentrification, Social Mix, and Social Polarization: Testing the Linkages in Large Canadian Cities Urban Geography 29 4 293 -326 https://doi.org/10.2747/0272-3638.29.4.293
Wang L. and Hu W. 2013 Immigrant health, place effect and regional disparities in Canada Social Science & Medicine 98 8 -17 https://doi.org/10.1016/j.socscimed.2013.08.040
Wechsler H. and Pugh T. F. 1967 Fit of individual and community characteristics and rates of psychiatric hospitalization American Journal of Sociology 73 3 331 -338
Williams D. R. and Collins C. 2001 Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health Public Health Reports 116 5 404 -416 https://doi.org/10.1093/phr/116.5.404
Wilson E., Chen A. H. M., Grumbach K., Wang F., and Fernandez A. 2005 Effects of limited English proficiency and physician language on health care comprehension Journal Of General Internal Medicine 20 9 800 -806
Wilson, M. (2017). Strengthening the Case for Investing in Canada’s Mental Health System: Economic Considerations. Mental Health Commission of Canada.
Wu Z., Hou F., Schimmele C., and Carmichael A. 2018 Co-ethnic concentration and trust in Canada’s urban neighbourhoods Urban Studies 55 10 2159 -2178 https://doi.org/10.1177/0042098017708939
Wu Z., Hou F., and Schimmele C. M. 2011 Racial diversity and sense of belonging in urban neighborhoods City & Community 10 4 373 -392 https://doi.org/10.1111/j.1540-6040.2011.01374.x
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Canadian Journal of Community Mental Health
Volume 40 • Number 2 • July 2021
Pages: 23 - 48
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Scott D. Emerson, Lisa Ritland, and Martin Guhn. 2021. A Scoping Review of Associations Between Ethno-Cultural Context and Mental Health in Canada. Canadian Journal of Community Mental Health.
40(2): 23-48. https://doi.org/10.7870/cjcmh-2021-010
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