IDEAS home Printed from https://ideas.repec.org/a/oup/geronb/v78y2023i9p1555-1571..html
   My bibliography  Save this article

Inequities in Mental Health Care Facing Racialized Immigrant Older Adults With Mental Disorders Despite Universal Coverage: A Population-Based Study in Canada

Author

Listed:
  • Shen (Lamson) Lin
  • Markus Schafer

Abstract

ObjectivesContemporary immigration scholarship has typically treated immigrants with diverse racial backgrounds as a monolithic population. Knowledge gaps remain in understanding how racial and nativity inequities in mental health care intersect and unfold in midlife and old age. This study aims to examine the joint impact of race, migration, and old age in shaping mental health treatment.MethodsPooled data were obtained from the Canadian Community Health Survey (2015–2018) and restricted to respondents (aged ≥45 years) with mood or anxiety disorders (n = 9,099). Multivariable logistic regression was performed to estimate associations between race–migration nexus and past-year mental health consultations (MHC). Classification and regression tree (CART) analysis was applied to identify intersecting determinants of MHC.ResultsCompared to Canadian-born Whites, racialized immigrants had greater mental health needs: poor/fair self-rated mental health (odds ratio [OR] = 2.23, 99% confidence interval [CI]: 1.67–2.99), perceived life stressful (OR = 1.49, 99% CI: 1.14–1.95), psychiatric comorbidity (OR = 1.42, 99% CI: 1.06–1.89), and unmet needs for care (OR = 2.02, 99% CI: 1.36–3.02); in sharp contrast, they were less likely to access mental health services across most indicators: overall past-year MHC (OR = 0.54, 99% CI: 0.41–0.71) and consultations with family doctors (OR = 0.67, 99% CI: 0.50–0.89), psychologists (OR = 0.54, 99% CI: 0.33–0.87), and social workers (OR = 0.37, 99% CI: 0.21–0.65), with the exception of psychiatrist visits (p = .324). The CART algorithm identifies three groups at risk of MHC service underuse: racialized immigrants aged ≥55 years, immigrants without high school diplomas, and linguistic minorities who were home renters.DiscussionTo safeguard health care equity for medically underserved communities in Canada, multisectoral efforts need to guarantee culturally responsive mental health care, multilingual services, and affordable housing for racialized immigrant older adults with mental disorders.

Suggested Citation

  • Shen (Lamson) Lin & Markus Schafer, 2023. "Inequities in Mental Health Care Facing Racialized Immigrant Older Adults With Mental Disorders Despite Universal Coverage: A Population-Based Study in Canada," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 78(9), pages 1555-1571.
    • Handle: RePEc:oup:geronb:v:78:y:2023:i:9:p:1555-1571.
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1093/geronb/gbad036
    Download Restriction: Access to full text is restricted to subscribers.
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Veenstra, Gerry, 2009. "Racialized identity and health in Canada: Results from a nationally representative survey," Social Science & Medicine, Elsevier, vol. 69(4), pages 538-542, August.
    2. Yoo, Hyung Chol & Gee, Gilbert C. & Takeuchi, David, 2009. "Discrimination and health among Asian American immigrants: Disentangling racial from language discrimination," Social Science & Medicine, Elsevier, vol. 68(4), pages 726-732, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Dušan Drbohlav & Dagmar Dzúrová, 2017. "Social Hazards as Manifested Workplace Discrimination and Health (Vietnamese and Ukrainian Female and Male Migrants in Czechia)," IJERPH, MDPI, vol. 14(10), pages 1-16, October.
    2. Monk, Ellis P., 2020. "Linked fate and mental health among African Americans," Social Science & Medicine, Elsevier, vol. 266(C).
    3. Jang, Sou Hyun, 2016. "First-generation Korean immigrants’ barriers to healthcare and their coping strategies in the US," Social Science & Medicine, Elsevier, vol. 168(C), pages 93-100.
    4. Esme Fuller-Thomson & Monica Chi, 2012. "Older Asian Americans and Pacific Islanders with Activities of Daily Living (ADL) Limitations: Immigration and Other Factors Associated with Institutionalization," IJERPH, MDPI, vol. 9(9), pages 1-16, September.
    5. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:oup:geronb:v:78:y:2023:i:9:p:1555-1571.. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Oxford University Press (email available below). General contact details of provider: https://academic.oup.com/psychsocgerontology .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.