Contextual and individual determinants of mental health symptoms in US South Asians: The Mediators of Atherosclerosis in South Asians Living in America Study

BACKGROUND: Little is known about determinants of mental health in South Asians, who are the second fastest growing immigrant group in the United States (US). We determined the influence of contextual and individual factors on mental health symptoms in US South Asians.

METHODS: The sample consisted of 906 South Asians, 40-84 years, who participated in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Depression symptoms were measured using the Center for Epidemiologic Studies Depression (CES-D) scale and anxiety symptoms using the Spielberger Anxiety scale.  We performed multivariate linear regression analysis to investigate associations of perceived neighborhood social cohesion and individual-level social support with mental health, independent of other psychosocial factors.   

RESULTS: Greater perceived neighborhood social cohesion and higher levels of social support were associated with lower depression and anxiety scores. The association between higher social support with lower depression (beta-coefficient -0.67;  p-value <0.01) and  anxiety scores (-0.30; p=0.02) was of greater magnitude than that of neighborhood social cohesion with depression (-0.42; p=0.05) and anxiety (-0.24; p=0.09).  Among women, both social support and neighborhood social cohesion were protective against mental health symptoms, independent of socioeconomic status and percent life in US.  In men, social support was significantly associated with better mental health. The association between neighborhood cohesion and mental health in women was partly mediated by chronic stress burden.   

CONCLUSIONS: Contextual and individual factors are important to South Asian immigrants’ mental health, and these associations appear to differ by gender.