Immigration Effects on Substance Abuse, Mental Health and Treatment Gaps

描述（由申请人提供）：在过去的三十年里，美国的外国出生人口增加了两倍多。过去的研究表明，许多移民到美国的人在长期滥用药物和精神疾病方面的风险更大，而且不太可能为这些与健康有关的问题寻求治疗。为了更好地了解移民对成年人药物滥用、心理健康和治疗差距的影响，我们将调查：(1)(a)过度和有问题的酒精使用，(b)非法药物使用，(c)酒精和药物使用障碍，以及(d)精神疾病是否以及如何因出生（外国出生身份）和移民特征（在美国的时间和难民身份）而异；(2)物质使用与精神障碍的共病是否以及如何因出生和移民特征而变化；(3) (a)寻求酒精和药物使用问题治疗和(b)寻求精神健康问题治疗是否以及如何因出生地和移民特征而异；(4)获得或从(a)过度和有问题的酒精使用、(b)非法药物使用、(c)酒精和药物障碍或(d)精神障碍中恢复的发生率是否以及如何在三年期间因出生和移民特征而异。我们分别考虑六个种族-民族群体的这些关系：非洲人、亚洲/太平洋岛民、欧洲人、墨西哥人、波多黎各人和其他西班牙裔/拉丁裔人。我们的分析将使用全国酒精及相关疾病流行病学调查（NESARC）的第一和第二波数据，其中包括与健康相关的结果的足够详细的数据，以便我们能够测量结果的时间。拟议的研究将提供根据关键混杂因素（如社会和经济特征、感知到的歧视、创伤性事件和感知到的压力）进行调整的患病率和发病率。拟议的研究将为政策制定者提供他们需要的信息，以制定更有效和有针对性的服务和干预计划，旨在改善美国移民的健康和福祉。公共卫生相关性：拟议研究的目的是增加对移民在过度饮酒、非法药物使用、物质使用和精神疾病、这些疾病之间的合并症以及解决这些不利健康相关问题的治疗差距方面的差异的了解。这项研究将分别调查六个种族-民族群体（非洲人、亚洲人/太平洋岛民、欧洲人、墨西哥人、波多黎各人和其他西班牙裔/拉丁裔人）的移民差异，同时考虑到社会支持、文化适应、歧视和压力的差异。

DESCRIPTION (provided by applicant): The foreign-born population in the United States has more than tripled in the last thirty years. Past research indicates that many immigrants to the United States experience greater risks overtime for substance abuse and psychiatric disorders, and are less likely to seek treatment for these health-related problems. To better understand the impact of immigration on substance abuse, mental health, and treatment gaps among adults, we will investigate: (1) whether and how (a) excessive and problematic alcohol use, (b) illegal drug use, (c) alcohol and drug use disorders, and (d) psychiatric disorders vary by nativity (foreign-born status) and immigrant characteristics (years in the United States and refugee status); (2) whether and how comorbidity between substance use and psychiatric disorders vary by nativity and immigrant characteristics; (3) whether and how (a) seeking treatment for alcohol and drug use problems and (b) seeking treatment for mental health problems vary by nativity and immigrant characteristics; and, (4) whether and how the incidence of acquiring or recovering from (a) excessive and problematic alcohol use, (b) illegal drug use, (c) alcohol and drug disorders, or (d) psychiatric disorders over a three-year period varies by nativity and immigrant characteristics. We consider these relationships separately for six racial-ethnic groups: African, Asian/Pacific Islander, European, Mexican, Puerto Rican, and other Hispanics/Latinos. Our analysis will use the first and second waves of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) that include sufficiently detailed data on the health-related outcomes that we are able to measure the timing of the outcomes. The proposed study will provide prevalence and incidence rates that are adjusted for key confounding factors, such as social and economic characteristics, perceived discrimination, traumatic events, and perceived stress. The proposed study will give policy makers information they need to develop more effective and targeted services and intervention programs aimed at bettering the health and well being of immigrants in the United States. Public Health Relevance: The goal of the proposed study is to increase understanding of immigrant differences in excessive alcohol use, illicit drug use, substance use and psychiatric disorders, comorbidity between those disorders, and treatment gaps in addressing these adverse health-related problems. The study will investigate these immigrant differences separately for six racial-ethnic groups (African, Asian/Pacific Islander, European, Mexican, Puerto Rican, and other Hispanics/Latinos) taking into account variation in social support, acculturation, discrimination, and stress.