Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults

Dec 15, 2018Social psychiatry and psychiatric epidemiology

How race, ethnicity, and birthplace relate to lifetime chances of mental health disorders in US adults

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Abstract

Asians had a lifetime prevalence of mental disorders of 23.5%, the lowest among the racial/ethnic groups studied.

Blacks had a lifetime prevalence of 37.0%, Latinos 38.8%, and Whites 45.6%.
Asians and Blacks exhibited lower lifetime risk of mental disorders than Whites, even after accounting for nativity.
Latinos and Whites showed similar levels of risk after adjusting for nativity.
Foreign-born respondents reported the lowest risk of disorder onset in the years prior to migration.
Significant interactions between race/ethnicity and nativity were observed for mood and substance use disorders.
The odds of mood disorder onset increased for Whites with at least one US-born parent, while substance use disorder onset was more common among US-born Asians and Latinos with at least one US-born parent.

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PURPOSE: There has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity.

METHODS: Survival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys.

RESULTS: Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent.

CONCLUSIONS: Parental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences.

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Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults

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