142nd APHA Annual Meeting and Exposition

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Mental health and risk behaviors among foreign-born high school students: Data from one school district

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 8:30 AM - 8:50 AM

Lisa Arsenault, PhD , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Kelly Washburn, MPH , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Renee Cammarata Hamilton, MSW, MPA , Community Affairs, Cambridge Health Alliance, Somerville, MA
Audio (mp3) recording Recorded Presentation (mp4)
Background:  Migration and acculturation greatly influence the health of adolescents.  As foreign-born make up substantial portions of the population in many school districts, identifying students' needs is vital to mitigating downstream effects of stress and reducing dropout rates among foreign-born students.   National and State-level YRBS data have established strong links between mental health and risk behavior of students, however the standard questionnaire does not include nativity.  It is unknown whether nativity alters these associations. 

Methods:  High School and Middle School student health surveys, modeled after CDC’s YRBS, were administered in a racially diverse (23% Black, 24% Asian, and 19% Hispanic) urban public school district near Boston, MA.  Foreign-born status was approximated by length of residence in the US (locally added question).  Poor mental health was defined as depression and/or suicidal ideation. Logistic regression models of risk behaviors were constructed with poor mental health, grade, race/ethnicity and sex as independent variables. Formal tests of interaction by nativity were conducted. 

Results:  2,661 students were surveyed (743 foreign-born).  Foreign-born were more likely to report poor mental health (29% vs. 24%, P=0.036).  Positive effect modification was evident for several risk behaviors (interaction P<0.05).  Poor mental health conferred a greater likelihood of current alcohol use among foreign-born (OR=6.8; 95% CI 3.3-14.1) than among US-born students (OR=2.6; 95% CI 1.6-4.3).  Stratified results for binge alcohol, carrying a weapon and physical fights showed similar mediating effect of nativity. 

Conclusion:  Foreign-born students experiencing poor mental health may be more vulnerable to certain risk behaviors compared to US-born students.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Discuss the influence of nativity on the mental and physical health of middle and high school age students

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Instructor of Medicine at Harvard Medical School and an Epidemiologist III at the Institute for Community Health. I lead analyses on a wide range of public health-related research projects, ranging from community-based interventions to clinical research involving electronic medical record data. I have worked directly with several communities and school districts on needs assessments, including the design and implementation of local-level YRBS studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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