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Socioeconomic Gradients in Children's Mental Health: Moderating Effects of Immigrant Background

Fri, March 22, 7:45 to 9:15am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Canada holds one of the highest proportions of immigrants in the world with 22.0% of its population being foreign-born (Statistics Canada, 2016). However, recent immigrant families in Canada are disproportionately exposed to economic adversity, with over 30% living below the poverty line (Beiser & Hou, 2002). It has been demonstrated that socioeconomically disadvantaged children are 2-3 times more likely to develop mental health problems during childhood, and this may increase with longer exposure to impoverished conditions (Dearing et al., 2006). Understanding socioeconomic inequalities in children’s mental health is essential for informing social policy interventions.

The objectives of this paper are to examine socioeconomic gradients in children’s mental health and to determine the extent to which these gradients differ as a function of: 1) immigrant background (immigrant vs. non-immigrant); and 2) class of mental health problems (externalizing vs. internalizing).

Data come from a representative sample of 1,449 students in grades 5-8 in Ontario, Canada. Students were enlisted using a two-stage (school, student) stratified random sampling approach. Students were then classified as living in an immigrant or non-immigrant family.

Face-to-face structured interviews were conducted with youth and their primary caregiver, separately in their home or school. Externalizing and internalizing behaviour problems were measured using the psychometrically valid ‘Achenbach System of Empirically Based Assessment’ (Achenbach et al., 2007). Youth completed the ‘Youth Self-Report’ (YSR/11-18), while parents completed the ‘Child Behavior Checklist’ (CBCL/6-18). A 2-level multivariate response model was conducted to examine associations between immigrant background, household income, and parental education, as well as their interactions on parent- and youth-reported internalizing and externalizing behaviour problems.

Table 1 presents socio-demographic and economic characteristics by immigrant background. Significant differences, in the expected direction, exist between children living in immigrant families compared to non-immigrant families. Table 2 presents results from the multivariate response model by informant. Results reveal clear income gradients for parent-reported externalizing and internalizing behaviour problems among non-immigrant children. In contrast, the association between income and parent-reported externalizing problems is attenuated among children living in immigrant families, and rendered non-significant. This is not the case for parent-reported internalizing problems, whereby a similar association exists for immigrant and non-immigrant children. The pattern of findings are similar for youth-reported outcomes with one exception; there is no income gradient for internalizing problems for both immigrant and non-immigrant children.

These findings highlight the significance of addressing the negative impacts of poor socioeconomic conditions on children’s mental health through social policy interventions aimed at reducing inequalities.

Given the importance of scientific replication and extension (Ioannidis, 2005), similar analyses will be conducted in a provincially representative sample of 10,803 children aged 4-17 across Ontario, Canada (Statistics Canada, 2014). This will allow us to test the generalizability of our findings using different methodologies and across different geographical contexts.

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