'The Healthy Migrant Effect' for Mental Health in England: Propensity-score Matched Analysis Using the EMPIRIC Survey

J Immigr Minor Health. 2018 Aug;20(4):799-808. doi: 10.1007/s10903-017-0570-z.

Abstract

Evidence has demonstrated that immigrants have a mental health advantage over the indigenous population of developed countries. However, much of the evidence-base demonstrating this mental health advantage is susceptible to confounding and inadequate adjustment across immigrant and non-immigrant groups preventing a rigorous assessment of a 'healthy migrant effect'. To compare the risk of common mental disorders in the immigrant population compared to the non-immigrant population in ethnic minority groups in England. A propensity-score matched analysis was carried out to adequately balance immigrant and non-immigrant groups for known confounders using the EMPIRIC national survey of Black-Caribbean, Indian, Pakistani and Bangladeshi groups. The mental health of participants was assessed using the validated Revised Clinical Interview Schedule tool. Immigrant participants were significantly less likely to have a common mental disorder than non-immigrant participants; OR = 0.47, (95% CI 0.40, 0.56). The results from this study demonstrate that a mental health advantage exists in ethnic minority immigrants compared to non-immigrants when balancing the two groups for confounding factors. This may be due to immigrants possessing certain personality traits, such as "psychological hardiness", that the migration process may select for.

Keywords: Healthy migrant effect; Immigrants; Mental health; UK.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Asian People / psychology
  • Black People / psychology
  • Cross-Sectional Studies
  • Emigrants and Immigrants / psychology*
  • England / epidemiology
  • Ethnicity / psychology*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders / ethnology*
  • Mental Health / ethnology*
  • Middle Aged
  • Minority Groups / psychology*
  • Propensity Score
  • Sex Factors
  • Socioeconomic Factors
  • Young Adult