title: Depression, somatic symptoms, and perceived neighborhood environments among US-born and non-US-born free clinic patients.
abstract: OBJECTIVE
  The study's purpose was to examine the impact of somatic symptoms and perceived neighborhood environment on depression using a comparison among US-born and non-US-born free clinic patients.
  
  
  METHODS
  US-born English speakers (n = 99), non-US-born English speakers (n = 89), and non-US-born Spanish speakers (n = 158) 18 years old or older (N = 346) were surveyed at a free clinic that provides primary care to people without health insurance. Depression, somatic symptoms, and perceived neighborhood environment were measured using standardized instruments.
  
  
  RESULTS
  US-born English speakers reported higher levels of depression and a greater number of somatic symptoms than non-US-born Spanish speakers and non-US-born English speakers. Non-US born English speakers reported lower levels of depression and fewer somatic symptoms than Spanish speakers. Somatic symptoms and perceived neighborhood satisfaction were related to depression.
  
  
  CONCLUSIONS
  Developing mental health services for patients in a free clinic setting is needed; however, because of limited financial and human resources, providing mental health services in a free clinic setting often is difficult. Community-based health promotion programs as supplements to efforts within clinical settings would be valuable in improving the mental health of free clinic patients. Future studies should implement collaborative pilot programs and evaluate health outcomes.
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kamimura
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Nancy
authors.initials: N
authors.lastname: Christensen
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tabler
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Prevedel
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Usha
authors.initials: U
authors.lastname: Ojha
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Silvia P
authors.initials: SP
authors.lastname: Solis
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hamilton
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Ashby
authors.affiliation: From the Departments of Sociology, Family and Preventive Medicine, and Health Promotion and Education, University of Utah, the Maliheh Free Clinic, Salt Lake City, Utah, and the University of North Carolina, Wilmington.
authors.forename: Justine J
authors.initials: JJ
authors.lastname: Reel
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003866:Depressive Disorder / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017057:Medically Uninsured / Q000208:ethnology / Q000523:psychology; D008875:Middle Aged; D012111:Residence Characteristics; D012931:Social Environment; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000208:ethnology*; D014481:United States; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data