Understanding Immigrants Mental Health and Well-Being and Reduce Disparities

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In FY23, for Objective 1 aimed at identifying and understanding the individual and structural factors influencing the mental health and well-being of immigrants, we utilized a national survey of 5,938 adults. This sample consisted of 77% US-born and 23% foreign-born individuals and was conducted between May 13, 2021, and January 9, 2022. The purpose of this survey was to explore the impact of the COVID-19 pandemic on the lives of Americans. The survey, consisting of 116 items, assessed both the physical and psychosocial effects of social and physical distancing during the pandemic within a diverse population of US- and foreign-born adults. In one study, we examined the association between COVID-19-related food insecurity and poor mental health outcomes, categorized by place of birth/nativity. The findings revealed that individuals with low and very low household food security, whether U.S.-born or foreign-born, reported a high risk of anxiety and depressive symptoms. However, the risk was notably higher for U.S.-born individuals compared to their foreign-born counterparts. In another study, we analyzed the extent of changes in substance use categorized by nativity, both before and during the COVID-19 pandemic. The results demonstrated that both U.S.-born and foreign-born participants showed an increase in alcohol consumption. This increase ranged from those who had no alcohol consumption before the pandemic to those who consumed alcohol once to several times a month, and from participants who previously consumed alcohol once to several times a week, up to those who consumed alcohol every day to several times per day. While significant changes were observed in terms of increased alcohol use, the opposite trend was also noted, with this decrease being more pronounced among foreign-born participants. Specifically, a 5.1% overall shift from some level of alcohol use before the pandemic to no alcohol use during the pandemic was observed among foreign-born individuals, in contrast to a 4.3% change among U.S.-born individuals. Also, using the National Survey of Childrens Health, a nationally representative study, we examined associations between race, ethnicity, and parent-child nativity, and mental health conditions among U.S. children and adolescents. We found that 3rd+ generation children had increased likelihood of depression compared to their 1st-generation counterparts. 3rd+ generation, racial and ethnic minority children had increased likelihood of anxiety and behavior/conduct problems compared with their 1st-generation counterparts. Similarly, using a nationally representative sample study, the National Health Interview Survey, we examined how organizational and social policies, such as access to paid sick leave and a regular place of care, impact the psychological well-being of pregnant women within subgroups of the U.S.-born and non-U.S.-born populations. Our findings indicate that both U.S.-born and non-U.S.-born pregnant women were more likely to report prenatal depression; however, the risk was greater for U.S.-born women. Similarly, pregnant women without access to paid sick leave were found to have an increased likelihood of reporting prenatal depression, as were those without a regular place of care. Objective 2: To disentangle the meaning of mental health and mental well-being from immigrants' cultural perspectives, we have launched a study to conduct 90 qualitative interviews with Ghanaian immigrants to understand mental health (i.e., anxiety, depression) from their perspective. We aim to explore whether they are aware of or understand the signs, symptoms, warning signs, coping strategies, and mental health service utilization.