Absence of protective ethnic density effect on Ecuadorian migrants' mental health in a recent migration setting: a multilevel analysis.
OBJECTIVE
We aimed to study the association between the Ecuadorians' ethnic density (EED) of the areas of residence (AR) with the mental health of Ecuadorians in Spain.


METHODS
Multilevel study of 568 Ecuadorian adults in 33 AR randomly selected from civil registries and interviewed at home. Possible psychiatric case (PPC) was measured by scoring ≥5 in General Health Questionnaire-28. Ecuadorians' ethnic density was dichotomized in high and low EED (<6 %). Multilevel logistic regression was used to estimate odds ratios (OR) and 95 % confidence intervals (CI).


RESULTS
Prevalence of PPC, 24 % (95 %CI 20-28 %), varied by area of residence. Ecuadorians' ethnic density varied by area of residence ranging from 0.9 to 19.5 %. PPC prevalence in High Ecuadorians' ethnic density AR was 29.5 and 20.4 % in low EED AR (p 0.013). Ecuadorians from High EED AR had higher odds of PPC than those from Low EED AR (OR 1.65 95 %CI 1.01-2.72). Adjusting for individual confounders (largely self-perceived discrimination), OR decreased to 1.48 (95 %CI 0.87-2.55). The final model, adjusted by area of residence and educational level, yielded an OR 1.37 (95 %CI 0.78-2.40).


CONCLUSIONS
No protective association between the Ecuadorians' ethnic density of the Area of residence and Ecuadorian migrants' mental health was found. Mechanisms underlying beneficial ethnic density effects may be absent in recent migration settings.
National Center of Epidemiology, Instituto de Salud Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain. ijarrin@isciii.es
Inma
I
Jarrín
Ana
A
García-Fulgueiras
Vicente
V
Ibáñez-Rojo
Débora
D
Alvarez
Rocío
R
García-Pina
Alberto
A
Fernández-Liria
Visitación
V
García-Ortúzar
Domingo
D
Díaz
Maria Angeles
MA
Rodríguez-Arenas
Lucía
L
Mazarrasa
Maria Victoria
MV
Zunzunegui
Alicia
A
Llácer
Julia
J
Del Amo
D000293:Adolescent; D000328:Adult; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000523:psychology; D008603:Mental Health / Q000208:ethnology* / Q000706:statistics & numerical data; D008875:Middle Aged; D055361:Multilevel Analysis; D016017:Odds Ratio; D011156:Population Density; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012931:Social Environment; D013030:Spain / Q000208:ethnology; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult