Can we compare “mental health” of “foreign-born immigrants” with “Canadians” using one question?

I read a very interesting research paper published by Bukola Salami and her team in the Canadian Journal of Public Health in 2017. 

This paper is based on the responses to the following questions of the Canadian Health Measures Survey. The questions are as follows;

  1. In general, would you say your mental health is excellent, very good, good, fair, or poor?
  2. Do you have a mood disorder such as depression, bipolar disorder, mania, or dysthymia?
  3. Did you work at a job or a business in the previous 12 months?
  4. How would you describe a sense of belonging to your local community? The response categories were “very strong”, “somewhat strong”, “somewhat weak” and “very weak”.

They have compared responses to these questions among “Canadian-born” and “foreign-born”. The immigration status was categorized as Canadian, recent immigrants (0-5 years), 6-10, more than 10 years.

Have a close look at one of their findings.

  1. Recent immigrants were four times more likely to report better mental health than non-immigrants (I am not sure who these non-immigrants are; to me, except the First Nations, all are immigrants).
  2. The diagnosis of mood disorders is less likely to report by recent immigrants.

In their, abstract, they mention that immigrants do not have worse mental health in general.

How valid is this?

Mental health is a construct, not like diabetes or hypertension. As Brandon A Kohrt and his team mentions in their paper, if we are going to compare prevalence based on the responses to this single question, we assume that the respondents from different cultures share the same meaning. We know it is not. For example, South Asians like me do not visit a physician to say that I have depression or poor mental health. However, I might explain my worries, persistent headache, stomach ache etc. In some cultures, mental health issues are equivalent to witchcraft and “spirits”. And, these issues are severely stigmatized than in western cultures. Moreover, if the question is asked in English, how immigrants with varying English competencies understand its meaning?




Author: Prasantha De Silva

A specialist in Community Medicine board-certified in Sri Lanka and a research analyst in Canada

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