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Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes

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Abstract

Purpose

We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe.

Methods

This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as “advanced economy” by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables.

Results

In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65–1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57–1.13) and inclusive countries (0.60 and 0.36–0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries.

Conclusions

Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants’ health is shaped by integration policies in their host country.

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Acknowledgements

This research was supported by the European Community’s Seventh Framework Programme (FP7/2007–2013) under Grant agreement 278173 (SOPHIE project).

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Authors and Affiliations

  1. Agència de Salut Pública de Barcelona, IIB-Sant Pau, Plaça Lesseps, 1, 08023, Barcelona, Spain

    Davide Malmusi, Laia Palència & Carme Borrell

  2. Ciber de Epidemiología y Salud Pública, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029, Madrid, Spain

    Davide Malmusi, Laia Palència & Carme Borrell

  3. Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD, Amsterdam, The Netherlands

    Umar Z. Ikram & Anton E. Kunst

  4. Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003, Barcelona, Spain

    Carme Borrell

Authors
  1. Davide Malmusi
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  2. Laia Palència
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  3. Umar Z. Ikram
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  4. Anton E. Kunst
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  5. Carme Borrell
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Correspondence to Davide Malmusi.

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Malmusi, D., Palència, L., Ikram, U.Z. et al. Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes. Soc Psychiatry Psychiatr Epidemiol 52, 391–398 (2017). https://doi.org/10.1007/s00127-017-1348-2

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  • DOI: https://doi.org/10.1007/s00127-017-1348-2

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