title: Serious psychological distress among non-Hispanic whites in the United States: the importance of nativity status and region of birth.
abstract: OBJECTIVE
  Serious psychological distress (SPD) is an understudied health topic. When studied, estimates for minority groups are compared to that of non-Hispanic whites. Non-Hispanic whites are heterogeneous, and comprise individuals from Europe, North Africa or the Middle East. The objectives of this study are to estimate and compare the sex- and age-adjusted prevalence of SPD first by nativity status and then by region of birth (Europe, Middle East and Russia) while controlling for potential confounders.
  
  
  METHODS
  The sample consisted of 196,483 participants, 18 years of age or older in the National Health Interview Survey (2000-2010). To measure SPD, Kessler's K6 Likert scale was used. Individuals with scores greater than or equal to 13 were considered to have SPD.
  
  
  RESULTS
  The age- and sex- adjusted prevalence of SPD was 3 % for foreign-born non-Hispanic whites. Of this, estimates were 6 % for those from the Middle East, 3 % for Europe and 2 % for Russia (p = 0.00). In the fully adjusted multivariable model, foreign-born non-Hispanic whites from the Middle East were more likely (OR = 1.76; 95 % CI = 1.01, 3.04) to report SPD when compared to US-born non-Hispanic whites. Within the foreign-born population, non-Hispanic whites from the Middle East were more than twice as likely to report SPD (OR = 2.43; 95 % CI = 1.15, 5.14) compared to foreign-born non-Hispanic whites from Europe after controlling for confounders.
  
  
  CONCLUSIONS
  This study's findings will help researchers understand which subgroups within non-Hispanic whites suffer most from SPD, which will facilitate tailored prevention intervention efforts.
authors: Wellness, Health Promotion and Injury Prevention, School of Health Sciences, Oakland University, Rochester, MI, 48309-4428, USA, dallo@oakland.edu.
authors: Florence J
authors: FJ
authors: Dallo
authors: Tiffany B
authors: TB
authors: Kindratt
authors: Tracy
authors: T
authors: Snell
mesh_terms: D000293:Adolescent; D000328:Adult; D015986:Confounding Factors, Epidemiologic; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005060:Europe / Q000208:ethnology; D005260:Female; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000208:ethnology; D015999:Multivariate Analysis; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012426:Russia / Q000208:ethnology; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
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