Ethnic Integration May Not Always Benefit Mental Health

Recent research has found that being a member of an ethnic minority and living in an area in which that ethnic group is the minority population appears to be a risk factor for psychosis (Psychiatric News, October 10).

Now a new finding, reported online October 21 in the British Medical Journal, seems to complement the earlier finding: When people live among those who are of the same ethnic background, it may help safeguard their mental health.

The study was headed by Jayati Das-Munshi, M.D., a Medical Research Council fellow/lecturer at the Institute of Psychiatry, King's College, London.

The study included more than 4,000 subjects who were members of England's main ethnic groups—Irish, white English, black Caribbean, Bangladeshi, Indian, and Pakistani—and who lived in almost 900 different geographic areas of England. Subjects were evaluated with the Clinical Interview Schedule–Revised for current anxiety and depressive disorders. They were also questioned to determine whether they were the victims of discrimination in their communities and whether they had social networks and support in those communities.

The prevalence of current anxiety and depressive disorders was 16 percent in the white English group, 19 percent in the Irish group, 17 percent in the black Caribbean group, 13 percent in the Bangladeshi group, 18 percent in the Indian group, and 20 percent in the Pakistani group.

After adjusting for age, gender, marital status, educational level, and social class, the researchers assessed whether there was a significant link between living in an area with many people who share one's ethnicity and a reduced chance of having a current anxiety or depressive disorder.

They did find such a link for the sample as a whole, and as Das-Munshi told Psychiatric News, “The associations were strongest and most marked for Irish and Bangladeshi people within the survey,” with the relationship to lower levels of anxiety or depressive disorder reaching statistical significance.

There was also a trend in this direction for black Caribbean, Indian, and Pakistani subjects, although it did not reach statistical significance.

The researchers likewise found that for some of the groups, living in areas of higher own-group density was associated with a reduction in the reporting of discrimination and with improved social support and stronger social networks. However, none of these factors fully explained the protective effect on mental health for subjects living in areas of higher own-group density.

This finding surprised her and her colleagues, Das-Munshi told Psychiatric News, since other studies have found a link between social support in ethnically dense neighborhoods and mental health. For example, social support was found to be a critical protective factor against depression for Irish-born immigrants to London.

Whether less discrimination and more social support explain the psychic-shelter function of ethnically dense neighborhoods, other factors are undoubtedly involved as well, Das-Munshi and her colleagues believe. One possibility, they speculated, could be cultural identity. For instance, although most of the Irish in their study had migrated to England a long time ago, and their level of ethnic density was not as high as for some other ethnic groups, they still experienced the protective mental health benefits of living among people of their ethnic group who shared much of the same cultural identity including religion, group history, and other factors.

The study was funded by the U.K. Medical Research Council.

“Understanding the Effect of Ethnic Density on Mental Health: Multi-Level Investigation of Survey Data From England” is posted at <www.bmj.com/content/341/bmj.c5367.full>.