Neighbourhood socioeconomic disadvantage and psychiatric disorders among refugees: a population-based, quasi-experimental study in Denmark.
Mental health
Neighbourhood disadvantage
Psychiatric disorders
Quasi-experimental design
Refugees
Journal
Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
27
08
2021
accepted:
05
05
2022
pmc-release:
01
05
2024
medline:
14
4
2023
pubmed:
22
5
2022
entrez:
21
5
2022
Statut:
ppublish
Résumé
Refugees are vulnerable to psychiatric disorders because of risk factors linked to migration. Limited evidence exist on the impact of the neighbourhood in which refugee resettle. We examined whether resettling in a socioeconomically disadvantaged neighbourhood increased refugees' risk of psychiatric disorders. This register-based cohort study included 42,067 adults aged 18 years and older who came to Denmark as refugees during 1986-1998. Resettlement policies in those years assigned refugees in a quasi-random fashion to neighbourhoods across the country. A neighbourhood disadvantage index was constructed using neighbourhood-level data on income, education, unemployment, and welfare receipt. Main outcomes were psychiatric diagnoses and psychiatric medication usage ascertained from nationwide patient and prescription drug registers, with up to 30-year follow-up. Associations of neighbourhood disadvantage with post-migration risk of psychiatric disorders were examined using Cox proportional hazards and linear probability models adjusted for individual, family, and municipality characteristics. The cumulative risk of psychiatric diagnoses and medication was 13.7% and 46.1%, respectively. Refugees' risk of psychiatric diagnoses and psychiatric medication usage was higher among individuals assigned to high-disadvantage compared with low-disadvantage neighbourhoods in analyses including fixed effects for assigned municipality (psychiatric diagnoses: hazard ratio (HR) = 1.14, 95% CI 1.04, 1.25; psychiatric medication: HR = 1.05, 95% CI 1.00, 1.11). Consistent results were found using linear probability models. Results for diagnostic categories and subclasses of medications suggested that the associations were driven by neurotic and stress-related disorders and use of anxiolytic medications. Resettlement in highly disadvantaged neighbourhoods was associated with an increase in refugees' risk of psychiatric disorders, suggesting that targeted placement of newly arrived refugees could benefit refugee mental health. The results contribute quasi-experimental evidence to support links between neighbourhood characteristics and health.
Identifiants
pubmed: 35597890
doi: 10.1007/s00127-022-02300-3
pii: 10.1007/s00127-022-02300-3
pmc: PMC9676407
mid: NIHMS1815350
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
711-721Subventions
Organisme : NIA NIH HHS
ID : R01 AG063385
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG063385
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG063385
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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