title: The contribution of perceived ethnic discrimination to the prevalence of depression.
abstract: BACKGROUND
  European research on the association between perceived ethnic discrimination (PED) and health is importantly lacking. It is also unknown how much PED contributes to disease prevalence. In this study, we quantified the contribution of PED to depression in five ethnic groups in a middle-size European city.
  
  
  METHODS
  We used cross-sectional data from the HELIUS study (Healthy Life in an Urban Setting), collected from January 2011 to June 2013 in Amsterdam, The Netherlands. We included a random sample of 1753 ethnic Dutch, 1143 South-Asian Surinamese, 1794 African Surinamese, 1098 Ghanaians and 850 Turks, aged 18-70 years. PED was assessed using the Everyday Discrimination Scale. Patient Health Questionnaire-9 was used for assessing depressive symptoms and major depressive disorder (MDD). We used logistic regression and calculated the contribution of PED to depressive symptoms and MDD using the population attributable fractions.
  
  
  RESULTS
  Depressive symptoms and MDD were most common in Turks and South-Asian Surinamese, and lowest in ethnic Dutch. PED had a positive association with depressive symptoms and MDD in only the ethnic minority groups. The contributions of PED to depressive symptoms and MDD were around 25% in both the Surinamese groups, and Turks, and ∼15% in Ghanaians.
  
  
  CONCLUSIONS
  We conclude that PED contributes considerably to depression in ethnic minority groups in a European context. As such, ethnic inequalities in depression could be reduced substantially if ethnic minority groups would not perceive any ethnic discrimination. We encourage more European research on the health impact of PED.
authors.affiliation: 1 Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands u.ikram@amc.uva.nl.
authors.forename: Umar Z
authors.initials: UZ
authors.lastname: Ikram
authors.affiliation: 1 Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marieke B
authors.initials: MB
authors.lastname: Snijder
authors.affiliation: 2 Municipal Health Service Amsterdam, Epidemiology, Documentation and Health Promotion, Amsterdam, The Netherlands.
authors.forename: Thijs J L
authors.initials: TJ
authors.lastname: Fassaert
authors.affiliation: 3 Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands 4 Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Aart H
authors.initials: AH
authors.lastname: Schene
authors.affiliation: 1 Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
authors.affiliation: 1 Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011287:Prejudice / Q000523:psychology* / Q000706:statistics & numerical data*; D015995:Prevalence; D055815:Young Adult