title: Immigration, social integration and mental health in Norway, with focus on gender differences.
abstract: BACKGROUND
  Studies have shown that social integration may have a positive as well as a negative effect on the mental health of immigrants, depending on the social circumstances.
  
  
  OBJECTIVE
  To investigate the relationship between social integration and psychological distress in immigrants in Oslo, Norway, with focus on gender differences.
  
  
  METHODS
  The study was based on data from a community survey in Oslo (N = 15899), and included 1448 immigrants from non-Western and 1059 immigrants from Western countries. Psychological distress was measured by a 10 items version of Hopkins Symptom Check List (HSCL-10), and social integration was measured by an index based on four items: Knowledge of the Norwegian language, reading Norwegian newspapers, visits by Norwegians and receiving help from Norwegians. Information on paid employment, household income, marital status, social support and conflicts in intimate relationships was also included in the study.
  
  
  RESULTS
  The non-western immigrants showed a higher level of psychological distress than the immigrants from western countries. In men this could be explained by the combination of less social integration, less employment, lower income, less social support and more conflicts in intimate relationships among non-western compared to western immigrants. In women the difference in level of psychological stress could not be explained by these variables, even if it was reduced. A reason for this seemed to be that social integration in non-western immigrants had a different effect on mental health in men and women. In men, social integration showed a positive effect through employment and income, as well as a positive effect in other areas. Also in non-western women social integration showed a positive effect through greater access to employment and income, but this effect was levelled out by integration causing problems in other areas.
  
  
  CONCLUSIONS
  Unexpectedly, social integration in non-western immigrants was associated with good mental health in men, but not in women. A possible explanation for this might be that the traditional female role in these countries is more challenged by social integration into a Western country than the male role, resulting in conflicting norms, threat to the self and/or loss of identity.
authors.affiliation: Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway. odd.steffen.dalgard@fhi.no.
authors.forename: Odd Steffen
authors.initials: OS
authors.lastname: Dalgard
authors.forename: Suraj Bahadur
authors.initials: SB
authors.lastname: Thapa