Understanding Immigrants Mental Health and Well-Being and Reduce Disparities

在23财年，目标1旨在确定和了解影响移民心理健康和福祉的个人和结构性因素，我们利用了对5938名成年人进行的全国调查。该样本由77%的美国出生的人和23%的外国出生的人组成，调查时间为2021年5月13日至2022年1月9日。这项调查旨在探讨新冠肺炎疫情对美国人生活的影响。这项由116个项目组成的调查，评估了大流行期间在美国和外国出生的成年人中，社会和身体距离对身体和心理社会的影响。 在一项研究中，我们按出生地/出生地分类，考察了与新冠肺炎相关的食品不安全与不良心理健康结果之间的关联。研究结果显示，家庭食品安全度低和极低的人，无论是在美国出生的还是在外国出生的，都报告了焦虑和抑郁症状的高风险。然而，与在外国出生的人相比，在美国出生的人的风险明显更高。 在另一项研究中，我们分析了新冠肺炎大流行之前和期间按出生地分类的物质使用变化的程度。结果表明，无论是在美国出生的参与者还是在外国出生的参与者，饮酒量都有所增加。这一增加的范围从大流行前没有饮酒的人到每月饮酒一次到几次的人，从以前每周饮酒一次到几次的参与者，到每天饮酒到每天几次的人。虽然在酒精使用量增加方面观察到了显著变化，但也注意到了相反的趋势，这种下降在外国出生的参与者中更加明显。具体地说，在外国出生的个人中，从大流行前的一些酒精使用水平到大流行期间不饮酒的总体变化为5.1%，而在美国出生的个人的变化为4.3%。 此外，利用全国儿童健康调查，一项具有全国代表性的研究，我们检查了种族、民族和亲子出生与美国儿童和青少年心理健康状况之间的关系。我们发现，与第一代孩子相比，第三代以上的孩子患抑郁症的可能性更高。与第一代儿童相比，第三代、种族和少数民族儿童焦虑和行为/品行问题的可能性更高。 同样，我们使用了一项具有全国代表性的样本研究--全国健康访谈调查，考察了组织和社会政策，如获得带薪病假和定期护理场所，如何影响美国出生和非美国出生人口亚群中孕妇的心理健康。我们的发现表明，无论是在美国出生的孕妇还是非美国出生的孕妇，都更有可能报告产前抑郁；然而，在美国出生的女性的风险更大。同样，没有获得带薪病假的孕妇被发现报告产前抑郁的可能性增加，那些没有正规护理场所的孕妇也是如此。 目的2：为了从移民的文化角度理清心理健康和心理健康的含义，我们启动了一项研究，对加纳移民进行了90次定性访谈，从他们的角度了解心理健康(即焦虑、抑郁)。我们的目的是探索他们是否意识到或理解这些迹象、症状、警示信号、应对策略和心理健康服务的利用情况。

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.