Monday, September 12, 2022

Socioeconomic Status of Neighborhood Matters for Mental Health of Refugee Children, Adolescents

Refugee children and adolescents are known to be at heightened risk of psychiatric disorders. A study published today in JAMA Pediatrics suggests that the more limited the resources of the neighborhood into which young refugees are settled, the more likely they are to go on to be diagnosed with a psychiatric disorder.

“At a time when high numbers of refugee children are seeking asylum in high-income countries, our findings suggest that targeted placement of families in less disadvantaged areas and investments to improve disadvantaged neighborhoods may have a positive long-term impact on mental health among refugee children and adolescents,” wrote Else Foverskov, Ph.D., of Aarhus University in Denmark and colleagues.

Foverskov and colleagues used multiple Danish health and census registers to monitor the outcomes of 18,709 child and adolescent refugees (ages 0-16) who resettled in Denmark between 1986 and 1998. (The researchers limited the study group to refugees from Afghanistan, Iran, Iraq, Lebanon, Somalia, Sri Lanka, Vietnam, and the former Yugoslavia.) During this time, refugees were “dispersed in neighborhoods across the country in a quasi-random (in other words, arbitrary) fashion,” the researchers wrote. “This dispersal policy led to assignment of refugee families to neighborhoods with different levels of socioeconomic disadvantage… .”

Overall, 7.7% of the youth were diagnosed with a psychiatric disorder by the age of 30, Foverskov and colleagues reported. The greater a neighborhood’s calculated disadvantage (the authors based this on the median family income, educational attainment, unemployment rate, and welfare benefits of the neighborhood), the greater the risk of the youth receiving a psychiatric disorder diagnosis. This association between neighborhood status and psychiatric disorder risk did not differ based on the refugees’ sex, age at arrival, or family structure (single vs. two parents). The risk was similar whether the authors used an International Classification of Diseases diagnostic code or the prescription of a psychotropic drug as the marker for a psychiatric disorder.

“Neighborhood disadvantage is likely associated with multiple potential mediating risk factors underlying psychiatric disorders. The neighborhood context may be associated with socioeconomic opportunities, health behaviors, social support, and collective efficacy, which can affect psychiatric morbidity in susceptible children and adolescents either directly or through processes within the family, peer group, and local institutions,” the authors wrote. “Future studies are needed to clarify the underlying processes.”

To read more about this topic, see the Psychiatric News article “Children Separated From Families at Border Need Trauma-Informed Care, Says APA President.”

(Image: iStock/shironosov)

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