1. Perceived mental health and well-being of immigrants Natalia Lapshina, Ph.D. Candidate March 13, 2014 Department of Psychology

2. March 13, 2014 Todays Agenda Presentation Title Here Factors that influence mental health of immigrants Healthy immigrant effect Present study Implications and recommendations for settlement agencies and employers

3. Objectives To examine the effect of immigrant status on: – mental health – life satisfaction – stress – sense of belonging – social support Whether this effect depends on the area of residence Whether mental health depends on visible minority status

4. Importance of Immigrant Status Stressors in immigrants: Pre-migration & Post-migration Healthy immigrant effect: – recent immigrants - in as good or better general health than non- immigrants, – established immigrants - decline in health towards Canadian health norms with time since immigration (McDonald & Kennedy, 2004).

5. Importance of Area of Residence & Visible Minority Status Area of Residence Toronto, Montréal and Vancouver (Chui, Tran, & Maheux, 2007) Reasons for settlement in TMV areas: – social support networks, – job prospects (Toronto), – language (Montréal) – climate (Vancouver) (Tremblay, Bryan, Perez, Ardern, & Katzmarzyk, 2006) Protective effect of neighborhoods with higher immigrant concentrations - (Menezes,Georgiades & Boyle, 2011) Visible Minority Status Lower likelihood of depression with increasing percentage of immigrants in the region among visible minority participants but not among Whites (Stafford, Newbold, & Ross, 2010)

6. Data Canadian Community Health Survey 2007-2008 – Annual Component (CCHS) – Data at the sub-provincial levels of geography health region or combined health regions – 131,061 respondents

7. Outcome Measures & Techniques of Analysis Self-perceived mental health 1- good to excellent 0- poor to fair Satisfaction with life in general 1 – satisfied to very satisfied 0- nether satisfied or dissatisfied to very dissatisfied Self-Perceived Life & Work Stress: 1- quite a bit to extremely stressful, 0- not at all to a bit Sense of belonging to local community: 1- strong 0- weak Perceived Social Support – Based 20 questions – Overall total score, 0-100 Analysis Hierarchical logistic regression ANOVA

8. Measure of Predictor Variables Predictor Immigrant status – non-immigrant – recent immigrant – established immigrant Area of residence – Toronto – Montreal – Vancouver – Rest of Canada Visible minority status -Visible minority -White Control Adjusted for demographics and SES (age, sex, highest level of education, income, marital status, employment status)

9. Perceived Mental Health by Immigrant Status Immigrant status Odds Ratio Non-immigrant (Ref) 1.00 Recent 1.28** Established.93 Note. * p <.05; ** p <.01; *** p <.001

10. Area of Residence Odds Ratio Rest of Canada 1.00 Montreal 1.49*** Toronto.90 Vancouver.75* Note. * p <.05; ** p <.01; *** p <.001 Perceived Mental Health by Area of Residence

11. Perceived Mental Health and visible minority status Cultural or Racial OriginOdds Ratio White1.00 Visible minority Non-immigrants.80** Recent immigrants1.29 Established immigrants.95 Note. * p <.05; ** p <.01; *** p < 001

12. Perceived Life Satisfaction Area of Residence Immigrant statusMontrealTorontoVancouverRest of Canada Odds Ratio Odds Ratio Odds Ratio Non-immigrants1.00 Recent immigrants.61**.34***.78.61*** Established immigrants.84.79*.92.73*** Note. * p <.05; ** p <.01; *** p <.001

13. Area of Residence Immigrant statusMontrealTorontoVancouverRest of Canada Odds Ratio Odds Ratio Odds Ratio Non-immigrants1.00 Recent immigrants.63***.84 1.13.89* Established immigrants.68***.82** 1.17.96 Perceived Life Stress

14. Area of Residence Immigrant statusMontrealTorontoVancouverRest of Canada Odds Ratio Odds Ratio Odds Ratio Odds Ratio Non-immigrant1.00 Recent immigrant.80.86.93.80*** Established immigrant.84.76***.88 1.00 Work stress

15. Area of Residence Immigrant statusMontrealTorontoVancouverRest of Canada Odds Ratio Odds Ratio Odds Ratio Odds Ratio Non-immigrants1.00 Recent immigrants 1.42**.61***.78.66*** Established immigrants 1.84***.79*** 1.13.95 Sense of Belonging

16. Perceived Social Support ** ** **

17. Summary of results Recent immigrants who choose to reside in Toronto reported less favourable outcomes in terms of perceptions of stress, life satisfaction, and sense of belonging The outcomes are more favourable in Montreal and other places in Canada. These results can be taken into account by employers and settlement agencies.

18. Practical implications Importance of non-medical factors contributing to mental health: Immigrant status Area of residence Perceived life stress (visible minorities, women, seniors) Perceived social support Cultural background Ethnic identity

19. Recommendations For settlement and service agencies: Planning support services for recent immigrants to reduce their chances of developing mental health problems later on. Encourage awareness, acknowledgement of emotional and mental problems, and getting professional help. For employers: Provide on-site support in terms of recognition of mental health problems and directing employees to services available on-site and in their community.

20. Acknowledgements Thank you! Zenaida R. Ravanera, Ph.D.Victoria M. Esses, Ph.D. Email: nlapshin@uwo.ca