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A boy cries as he recuperates after surgery during "Operation Smile" at a hospital in Manila's Makati financial district October 26, 2009. Operation Smile aim to provide free surgery for about a hundred children inflicted with cleft lips, cleft palates, and other facial deformities over a period of five days in Makati.  REUTERS/Cheryl Ravelo

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    Downward mobility tied to depression in immigrants

    Wed Sep 23, 2009 4:43pm EDT

    NEW YORK (Reuters Health) - Immigrants to the U.S. may face an increased risk of depression if they feel they've lost the social standing they once had in their native land, a new study finds.

    Health

    Using data from a national survey of more than 3,000 Asian and Latin American immigrants, researchers found that so-called downward mobility was linked to a heightened risk of major depression.

    Men and women who felt they had been pushed several rungs down the social ladder were three times as likely to have had a bout of major depression in the past year as immigrants who felt they had retained their social standing.

    The findings add to the understanding of how U.S. immigrants are faring as far as mental health, the researchers report in the American Journal of Epidemiology.

    Past studies have found that, overall, certain immigrant groups -- including Latin Americans and Asian women -- tend to have a lower risk of mental health disorders than U.S. natives of the same ethnicity.

    However, the current findings suggest that certain immigrants are at elevated risk, according to Emily J. Nicklett and Sarah A. Burgard of the University of Michigan in Ann Arbor.

    People who had a relatively high social status in their native countries -- because of their jobs, incomes and education -- may see their standing decline once they arrive in the U.S., the researchers explain.

    And that, they write, may lead to frustration, uncertainty and chronic stress -- enough, in some cases, to lead to depression.

    The findings are based on a survey of 3,056 U.S. immigrants who were assessed for any depression symptoms over the past year. They also completed a measure of social mobility; using an image of a social ladder, participants indicated how many "rungs" they felt they had climbed or descended since arriving in the U.S.

    Overall, just over 6 percent of study participants had suffered a bout of major depression in the past year. The risk was three times higher among immigrants who felt they had dropped at least three steps on the social ladder versus those who felt their status was the same as it was in their home country.

    A particular concern, the researchers note, is that these downwardly mobile immigrants may be especially unlikely to seek professional health, as they may lack the money and resources.

    "Moreover," they write, "policies focused only on immigrants of low objective or subjective social status may miss an important risk group: persons who are downwardly mobile from a higher-origin status, whether or not they have fallen into poverty."

    SOURCE: American Journal of Epidemiology, September 15, 2009.



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