TY - JOUR
T1 - Explaining ethnic variations in adolescent mental health: a secondary analysis of the Millennium Cohort Study
AU - Ahmad, Gargie
AU - McManus, Sally
AU - Becares, Laia
AU - Hatch, Stephani
AU - Das-Munshi, Jayati
N1 - Funding Information:
GA is currently supported by an ESRC studentship (ES/P000703/1). JD is supported by the Health Foundation working together with the Academy of Medical Sciences, for a Clinician Scientist Fellowship, by the ESRC in relation to the SEP-MD study (ES/S002715/1), and by the King’s College London and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. SH and JD are partly supported by the Economic and Social Research Council Centre for Society and Mental Health at King’s College London [ES/S012567/1], and by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. SM is supported by UK Research and Innovation (MR-VO49879/1). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care, ESRC, UKRI, or King’s College London.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/10/24
Y1 - 2021/10/24
N2 - Purpose: The relationship between ethnicity and adolescent mental health was investigated using cross-sectional data from the nationally representative UK Millennium Cohort Study. Methods: Parental Strengths and Difficulties Questionnaire reports identified mental health problems in 10,357 young people aged 14 (n = 2042 from ethnic minority backgrounds: Mixed n = 492, Indian n = 275, Pakistani n = 496, Bangladeshi n = 221, Black Caribbean n = 102, Black African n = 187, Other Ethnic Group n = 269). Univariable logistic regression models investigated associations between each factor and outcome; a bivariable model investigated whether household income explained differences by ethnicity, and a multivariable model additionally adjusted for factors of social support (self-assessed support, parental relationship), participation (socialising, organised activities, religious attendance), and adversity (bullying, victimisation, substance use). Results were stratified by sex as evidence of a sex/ethnicity interaction was found (P = 0.0002). Results: There were lower unadjusted odds for mental health problems in boys from Black African (OR 0.15, 95% CI 0.04–0.61) and Indian backgrounds (OR 0.42, 95% CI 0.21–0.86) compared to White peers. After adjustment for income, odds were lower in boys from Black African (OR 0.10, 95% CI 0.02–0.38), Indian (OR 0.40, 95% CI 0.21–0.77), and Pakistani (OR 0.49, 95% CI 0.27–0.89) backgrounds, and girls from Bangladeshi (OR 0.18, 95% CI 0.05–0.65) and Pakistani (OR 0.63, 95% CI 0.41–0.99) backgrounds. After further adjustment for social support, participation, and adversity factors, only boys from a Black African background had lower odds (OR 0.16, 95% CI 0.03–0.71) of mental health problems. Conclusions: Household income confounded lower prevalence of mental health problems in some young people from Pakistani and Bangladeshi backgrounds; findings suggest ethnic differences are partly but not fully accounted for by income, social support, participation, and adversity. Addressing income inequalities and socially focused interventions may protect against mental health problems irrespective of ethnicity.
AB - Purpose: The relationship between ethnicity and adolescent mental health was investigated using cross-sectional data from the nationally representative UK Millennium Cohort Study. Methods: Parental Strengths and Difficulties Questionnaire reports identified mental health problems in 10,357 young people aged 14 (n = 2042 from ethnic minority backgrounds: Mixed n = 492, Indian n = 275, Pakistani n = 496, Bangladeshi n = 221, Black Caribbean n = 102, Black African n = 187, Other Ethnic Group n = 269). Univariable logistic regression models investigated associations between each factor and outcome; a bivariable model investigated whether household income explained differences by ethnicity, and a multivariable model additionally adjusted for factors of social support (self-assessed support, parental relationship), participation (socialising, organised activities, religious attendance), and adversity (bullying, victimisation, substance use). Results were stratified by sex as evidence of a sex/ethnicity interaction was found (P = 0.0002). Results: There were lower unadjusted odds for mental health problems in boys from Black African (OR 0.15, 95% CI 0.04–0.61) and Indian backgrounds (OR 0.42, 95% CI 0.21–0.86) compared to White peers. After adjustment for income, odds were lower in boys from Black African (OR 0.10, 95% CI 0.02–0.38), Indian (OR 0.40, 95% CI 0.21–0.77), and Pakistani (OR 0.49, 95% CI 0.27–0.89) backgrounds, and girls from Bangladeshi (OR 0.18, 95% CI 0.05–0.65) and Pakistani (OR 0.63, 95% CI 0.41–0.99) backgrounds. After further adjustment for social support, participation, and adversity factors, only boys from a Black African background had lower odds (OR 0.16, 95% CI 0.03–0.71) of mental health problems. Conclusions: Household income confounded lower prevalence of mental health problems in some young people from Pakistani and Bangladeshi backgrounds; findings suggest ethnic differences are partly but not fully accounted for by income, social support, participation, and adversity. Addressing income inequalities and socially focused interventions may protect against mental health problems irrespective of ethnicity.
UR - http://www.scopus.com/inward/record.url?scp=85117834547&partnerID=8YFLogxK
U2 - 10.1007/s00127-021-02167-w
DO - 10.1007/s00127-021-02167-w
M3 - Article
SN - 0933-7954
JO - Social Psychiatry and Psychiatric Epidemiology
JF - Social Psychiatry and Psychiatric Epidemiology
ER -