Abstract
Background: Despite increased ethnic diversity in more economically developed countries it’s unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes.
Methods: We systematically searched Medline, PsychInfo, Sociological Abstracts, Web of Science from inception to March 31st, 2016. We obtained additional data from study authors. We conducted random effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences and psychosis.
Results: We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences (OR:0.82(95% CI:0.76-0.89) and suicidal ideation (OR:0.88(95% CI:0.79-0.98) for each 10 percentage-point increase in own ethnic density. For CMD, depression and anxiety, associations were indicative of protective effects of own ethnic density however results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis.
Conclusions: The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.
Methods: We systematically searched Medline, PsychInfo, Sociological Abstracts, Web of Science from inception to March 31st, 2016. We obtained additional data from study authors. We conducted random effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences and psychosis.
Results: We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences (OR:0.82(95% CI:0.76-0.89) and suicidal ideation (OR:0.88(95% CI:0.79-0.98) for each 10 percentage-point increase in own ethnic density. For CMD, depression and anxiety, associations were indicative of protective effects of own ethnic density however results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis.
Conclusions: The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.
| Original language | English |
|---|---|
| Journal | Psychological Medicine |
| Early online date | 14 Dec 2017 |
| DOIs | |
| Publication status | Published - 2017 |
Research Beacons, Institutes and Platforms
- Cathie Marsh Institute
