Perceived Discrimination and Health among Immigrants in Europe According to National Integration Policies.
BACKGROUND
Discrimination harms immigrants' health. The objective of this study was to analyze the association between perceived discrimination and health outcomes among first and second generation immigrants from low-income countries living in Europe, while accounting for sex and the national policy on immigration.


METHODS
Cross-sectional study including immigrants from low-income countries aged ≥15 years in 18 European countries (European Social Survey, 2012) (sample of 1271 men and 1335 women). The dependent variables were self-reported health, symptoms of depression, and limitation of activity. The independent variables were perceived group discrimination, immigrant background and national immigrant integration policy. We tested for association between perceived group discrimination and health outcomes by fitting robust Poisson regression models.


RESULTS
We only observed significant associations between perceived group discrimination and health outcomes in first generation immigrants. For example, depression was associated with discrimination among both men and women (Prevalence Ratio-, 1.55 (95% CI: 1.16-2.07) and 1.47 (95% CI: 1.15-1.89) in the multivariate model, respectively), and mainly in countries with assimilationist immigrant integration policies.


CONCLUSIONS
Perceived group discrimination is associated with poor health outcomes in first generation immigrants from low-income countries who live in European countries, but not among their descendants. These associations are more important in assimilationist countries.
Agència de Salut Pública de Barcelona, Barcelona 08023, Spain. cborrell@aspb.cat.|Ciber de Epidemiología y Salud Pública, 28029, Spain. cborrell@aspb.cat.|Universitat Pompeu Fabra, Barcelona 08003, Spain. cborrell@aspb.cat.|Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona 08025, Spain. cborrell@aspb.cat.
Carme
C
Borrell
Agència de Salut Pública de Barcelona, Barcelona 08023, Spain. lpalenci@aspb.cat.|Ciber de Epidemiología y Salud Pública, 28029, Spain. lpalenci@aspb.cat.|Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona 08025, Spain. lpalenci@aspb.cat.
Laia
L
Palència
Agència de Salut Pública de Barcelona, Barcelona 08023, Spain. xbartoll@aspb.cat.|Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona 08025, Spain. xbartoll@aspb.cat.
Xavier
X
Bartoll
Academic Medical Center, University of Amsterdam, Amsterdam 1100 DD, the Netherlands. u.ikram@amc.uva.nl.
Umar
U
Ikram
Agència de Salut Pública de Barcelona, Barcelona 08023, Spain. dmalmusi@aspb.cat.|Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona 08025, Spain. dmalmusi@aspb.cat.
Davide
D
Malmusi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D016012:Poisson Distribution; D012044:Regression Analysis; D057566:Self Report; D063508:Social Discrimination / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
depression; discrimination; immigrant generation; low income countries; national immigrant integration policy; perceived health