Depression paradox for immigrant women in California

One in eight California women experience current depression according to recently published research using data from the California Women’s Health Survey (CWHS). The study examined prevalence of depression according to immigrant status, and found that recent immigrants were half as likely to report current depression as compared to their counterparts born in the United States. As immigrant women stayed longer in the US, the odds of reporting current depression increased and the prevalence rate approached that of US-born women.

As found in previous research, our study found that as immigrants live longer in the US, depression becomes more common and that this phenomenon is taking place among women in California. Most immigrants move to the US for improved economic opportunities, but it seems that unexpected health consequences accompany migration – after 15 or more years in the US, prevalence rates of depression among immigrant women mirror those of the US-born.

Mental health services should target recent immigrants to teach coping skills that may help prevent depression later in life. Since California has the highest number of foreign-born Hispanic residents of any state in the US, a population which is projected to continue increasing, and 84% of Hispanics in California have Mexican heritage, mental health services, including prevention and treatment, should be linguistically and culturally appropriate for this population.  

One major factor common among immigrants that may trigger depression is stress, since immigration is a complex process that involves many potential stressors, including traumatic events, discrimination, and documentation requirements. Public health interventions should aim to teach coping strategies to reduce stress and public health policies should act to reduce stressors, such as lack of health insurance, which may trigger depression. 

Although the border is fluid, resources for mental health interventions are often tied to country-specific funding agencies. Mental health resources should focus on addressing current depression among women, and specifically among women who are most at risk, whom we identified in our study as those with disabilities, poor health status, immigrants who have been in the US for 15 years or longer, and those who smoke or binge drink. Resources invested may prevent future suicide mortality, a main objective of Healthy People 2020.

For the purposes of this study, current depression was measured by the 8-item Patient Health Questionnaire (PHQ-8) standardized questionnaire for screening depression. The CWHS has been conducted annually since 1997. CWHS allows tracking of important health issues that affect California women, and serves as a catalyst for interventions and policy change. CWHS administration and data collection is conducted by the Survey Research Group in collaboration with programs and funding from the California Department of Public Health and the Office of Women’s Health.

To learn more about this study, please visit http://new.paho.org/journal/ to access: Ryan-Ibarra S, J F Epstein, M Induni, M Wright. “Current depression among women in California according to residence in the California-Mexico border region.” Pan American Journal of Public Health (in press).

 

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