Depression and the U.S. foreign-born population

Introduction: Stressors associated with migration and post-migration experiences may increase the risk of depression among the foreign-born, potentially offsetting any “healthy immigrant” selection effect. This study tested the hypothesis that the mental health advantage of immigrants is smaller among those not occupying two major social roles indicative of integration than among those who are married and employed. Methods: Data are from the Collaborative Psychiatric Epidemiology Surveys (CPES) 2001-2003, three cross-sectional U.S. national probability samples of 15,680 adults 18 years and older. The dependent variable in logistic regression analysis is whether the respondent met diagnostic criteria for Major Depressive Episode (MDE). Results: U.S. natives have higher odds of MDE than the foreign born, but this difference is conditional. The difference is greater among the employed than the unemployed. For the foreign-born, employment status is not associated with MDE. The effect of nativity status on MDE is mediated by marital status; U.S. natives are more likely to be married and marriage protects against MDE. Conclusion: Even though the migration experience generally is characterized by multiple stressors, results show that being foreign-born is beneficial to mental health. Findings support the healthy immigrant effect; and the magnitude of this effect does not depend on the immigrant's employment status.