Meghan Woo

Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups

OBJECTIVE Although widely reported among Latino populations, contradictory evidence exists regarding the generalizability of the immigrant paradox, i.e., that foreign nativity protects against psychiatric disorders. The authors examined whether this paradox applies to all Latino groups by comparing estimates of lifetime psychiatric disorders among immigrant Latino subjects, U.S-born Latino subjects, and non-Latino white subjects. METHOD The authors combined and examined data from the National Latino and Asian American Study and the National Comorbidity Survey Replication, two of the largest nationally representative samples of psychiatric information. RESULTS In the aggregate, risk of most psychiatric disorders was lower for Latino subjects than for non-Latino white subjects. Consistent with the immigrant paradox, U.S.-born Latino subjects reported higher rates for most psychiatric disorders than Latino immigrants. However, rates varied when data were stratified by nativity and disorder and adjusted for demographic and socioeconomic differences across groups. The immigrant paradox consistently held for Mexican subjects across mood, anxiety, and substance disorders, while it was only evident among Cuban and other Latino subjects for substance disorders. No differences were found in lifetime prevalence rates between migrant and U.S.-born Puerto Rican subjects. CONCLUSIONS Caution should be exercised in generalizing the immigrant paradox to all Latino groups and for all psychiatric disorders. Aggregating Latino subjects into a single group masks significant variability in lifetime risk of psychiatric disorders, with some subgroups, such as Puerto Rican subjects, suffering from psychiatric disorders at rates comparable to non-Latino white subjects. Our findings thus suggest that immigrants benefit from a protective context in their country of origin, possibly inoculating them against risk for substance disorders, particularly if they emigrated to the United States as adults.

Correlates of Past-Year Mental Health Service Use Among Latinos: Results From the National Latino and Asian American Study

OBJECTIVES We examined correlates and rates of past-year mental health service use in a national sample of Latinos residing in the United States. METHODS We used data from the National Latino and Asian American Study, a national epidemiological household survey of Latinos. RESULTS Cultural factors such as nativity, language, age at migration, years of residence in the United States, and generational status were associated with whether or not Latinos had used mental health services. However, when the analysis was stratified according to past-year psychiatric diagnoses, these associations held only among those who did not fulfill criteria for any of the psychiatric disorders assessed. Rates of mental health service use among those who did not fulfill diagnostic criteria were higher among Puerto Ricans and US-born Latinos than among non-Puerto Ricans and foreign-born Latinos. CONCLUSIONS Rates of mental health service use among Latinos appear to have increased substantially over the past decade relative to rates reported in the 1990s. Cultural and immigration characteristics should be considered in matching mental health services to Latinos who need preventive services or who are symptomatic but do not fulfill psychiatric disorder criteria.

Looking Beyond Nativity: The Relation of Age of Immigration, Length of Residence, and Birth Cohorts to the Risk of Onset of Psychiatric Disorders for Latinos

Past studies have yielded inconsistent results regarding risk of psychopathology for U.S. Latinos by nativity possibly due to differences across immigrants in their age of arrival to the United States, their length of residence in the United States, or birth-cohort differences. In this article, we seek to document the relation of age of arrival, time in the United States, and cohort effects on the risk of onset of psychiatric disorders using a nationally representative sample of 2,554 Latinos in the coterminous United States. We assessed risk of onset of psychiatric disorders using the World Health Organization Composite International Diagnostic Interview (Kessler & Us-tun, 2004). Findings indicate that Latino immigrants have lower risks of onset for some psychiatric disorders in their country of origin, but once in the United States, Latino immigrants appear to experience similar risks of onset as U.S.-born Latinos of the same age. The longer Latino immigrants remain in their country of origin, the less cumulative risk of onset they experience, resulting in lower lifetime rates of disorders. These findings could potentially be due to variation in cultural and social norms and expectations across geographical contexts, differences in family structure and gender roles, as well as artifactual-level explanations.

Health insurance coverage for vulnerable populations: contrasting Asian Americans and Latinos in the United States.

This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the United States. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupations, and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the United States, and regional differences in safety-net coverage. Policy implications are discussed.

Psychology of Latino Adults: Challenges and an Agenda for Action

In 2004, Latinos in the United States numbered 41 million, with 31% under the age of 16. Over the period from 2000 to 2004, Latino population growth represented half the total growth in the United States (The National Academies 2007). Part of this considerable increase includes immigration from Latin America, some who confront major challenges in integrating into the country, such as lack of English proficiency and different norms and lifestyle circumstances (Guarnaccia et al. 2007). These new immigrants also sustain strong ties with their home communities, interacting by phone and email, which contributes to the maintenance of language and culture (Levitt et al. 2003; Viruell-Fuentes 2006). These transnational dynamics pose complex challenges of how best to provide services, given Latinos’ circumstances (U.S. Department of Health and Human Services 2001).