LATINOS’ EXPERIENCES IN THE US: ACCULTURATION, DISCRIMINATION, STRESS, SOCIAL COHESION AND PSYCHIATRIC DISORDER
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Date
2018-06-26
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Johns Hopkins University
Abstract
Background: Latinos are the largest foreign-born group and one of the fastest growing minority groups in the United States. As such, they will increasingly contribute to the burden of mental and behavioral disorders. Acculturation and other related experiences are associated with the development of mental disorder in US-residing Latinos, however most studies treat Latinos as a homogeneous group. This obscures meaningful between-group differences and hinders the elucidation of potential mechanisms contributing to the association between acculturation and mental health outcomes. Further, despite its importance, acculturation has been measured insufficiently and inconsistently. This is especially problematic due to the complex nature of these constructs. To understand the mechanism by which acculturation impacts mental health, novel methods are needed. Latent variable methods are one such approach that has been recommended as a way to capture nuance of complex constructs such as acculturation.
Methods: Data come from the National Latino and Asian American Study, a nationally-representative, cross-sectional survey of 2,554 Latinos in the United States.
Results: The six scales of acculturation (English and Spanish language preference and proficiency, ethnic identity) and related experiences (discrimination, acculturative stress, neighborhood context, family context) had good construct validity. No scales achieved full measurement invariance, but some scales were more variant across subgroups than others. Four latent classes of Latinos’ acculturative experiences emerged: Positive Experiences (n=1,743, 69%), Cohesive-Conflict (n=424, 17%), Marginalized Conflict (n=237, 9%), and Marginalized (n=137, 5%). These classes were highly associated with all three categories of DSM-IV disorder: depressive, anxiety, and substance use disorders after adjusting for sociodemographic characteristics, subethnicity and generational status. The Positive Experiences class had the lowest lifetime prevalence of all three disorders (14.8%, 13.6% and 7.1%, respectively). The class associated with the highest disorder prevalence (34.0%, 26.6%, and 22.5%, respectively) was those Latinos with a Marginalized Conflict experience. After accounting for acculturative experiences, direct associations between subethnicity and generational status and disorder varied. There were no significant direct effects between subethnicity and substance use disorder prevalence, but a strong dose-response relationship of generational status. Conversely, subethnicity was directly related to depressive and anxiety disorder prevalence, but generational status was not.
Conclusions: Acculturation and other experiences related to immigrant and minority status in the US are complex constructs and should be treated as such. Latent variable methods help account for measurement variance by subgroup and the unobserved nature of the constructs. Latinos have varied acculturative experiences in the US, which are highly personal and not fully accounted for by observed characteristics such as country of origin.
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acculturation, immigration, Latino health, mental disorder, behavioral disorder, psychiatric epidemiology