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Ethnic Density Protects Mental Health; Recent scientific study finds more evidence
Topic Started: Oct 26 2010, 03:20 PM (60 Views)
AQH
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http://www.medscape.com/viewarticle/731023

From Medscape Medical News
More Evidence Ethnic Density Protects Mental Health
Megan Brooks
Authors and Disclosures
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October 22, 2010 — A new study from the United Kingdom confirms that living in areas where higher proportions of people of the same ethnic background live offers protection against common mental disorders, but it remains unclear why this is so.

For some ethnic groups, living in areas surrounded by people of the same background was associated with better perceived social support and fewer reported experiences of discrimination, but these effects failed to explain the protective effect on mental health, the study team reports in the October 22 issue of the British Medical Journal.

Jayati Das-Munshi, MBBS, MRCPsych, MSc, from the Institute of Psychiatry, King's College London, United Kingdom, and colleagues analyzed data on 4281 adults of Irish, black, Caribbean, Indian, Pakistani, Bangladeshi, and white British ethnicity randomly sampled from 892 areas in England. They were between 16 and 74 years old and participated in the Ethnic Minorities Psychiatric Illness Rates in the Community Survey in England in 2000.

The most ethnically dense areas were also the poorest, the researchers found. Despite this, they say for each 10–percentage point increase in own-group ethnic density, there was evidence of a decreased risk for anxiety and depression for all ethnic minority groups combined (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.89 - 0.99; P = .02). This was the case after they adjusted for a priori confounders.

The mental health benefits of living among people of the same ethnic background were most evident for Bangladeshi people (OR, 0.75; 95% CI, 0.62 - 0.91; P = .005) and Irish people (OR, 0.21; 95% CI, 0.06 - 0.74; P = .01). For all other ethnic groups in the study, except the white British group, there seemed to be a protective effect of living in areas of higher own-group density, but the evidence was "very weak," the investigators report.

Association Clear, But Not Mechanism

"For some groups, living in areas of higher own-group density was associated with a reduction in the reporting of discrimination and with improved social support and improved social networks," Dr. Das-Munshi and colleagues found. However, none of these factors seem to mediate the protective effects of ethnic density on mental health.

The notion of there being a protective effect of living in a high-own-ethnic-group-density area is not new, Helen Lester, MB, ChB, MD, FRCGP, from the National Institute for Health Research School for Primary Care Research, University of Manchester, United Kingdom, notes in an accompanying editorial. "The association is clear but the underlying mechanisms are not."

This study "leaves us more convinced of the effect, but further research is needed to clarify the scope and size of the effects, including the 'tipping point' or degree of density needed to exert a protective effect on health. Above all, it highlights the need for further hypotheses about underlying mechanisms," Dr. Lester writes.

The fact that the study findings are based on data collected 10 years ago "reduces its relevance a little in that the ethnic profile of England has changed slightly," Dr. Lester points out in her commentary.

Dr. Das-Munshi and colleagues agree. "The landscape of migration in England and the settlement of ethnic minority communities has changed over this time, and it is possible that the effects reported here may no longer be relevant to the groups included in this study, or to some of the more recent migrant groups to England."

An advantage of the study, they say, is that mental health outcomes were systematically assessed using structured clinical assessments. Previous research examining ethnic density associations has tended to use service contract data to determine rates of mental disorders, which could introduce selection bias, they note.

Still, although this analysis provides more evidence in support of a potential "psychic shelter" function of ethnically diverse neighborhoods, "there were no neat conclusions," the study team notes.

"Despite attempting to examine the role of racism, social support, or social networks in mediating these effects, we were not able to definitively unpack the meaning of ethnic density," they point out.

Dr. Das-Munshi and colleagues think future studies should look at other possible mediators, "such as interactional effects with poverty, social capital, cultural identify, and acculturation, and the role of social support not limited to immediate personal relationships."

The authors and editorialist have disclosed no relevant financial relationships.

BMJ. Published online October 21, 2010.

SEE ALSO:

http://www.bmj.com/content/341/bmj.c5367.full

I'm not surprised, as it aligns with other studies too:

http://en.wikipedia.org/wiki/Robert_D._Putnam#Diversity_and_trust_within_communities
Edited by AQH, Oct 26 2010, 03:22 PM.
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Wigone
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The mental health benefits of living among people of the same ethnic background were most evident for Bangladeshi people (OR, 0.75; 95% CI, 0.62 - 0.91; P = .005) and Irish people (OR, 0.21; 95% CI, 0.06 - 0.74; P = .01). For all other ethnic groups in the study, except the white British group, there seemed to be a protective effect of living in areas of higher own-group density, but the evidence was "very weak," the investigators report.

No doubt they will be after another grant for further study.

Oh just saw this at the end....yeah research scientist and dr's always need to do 'further study'

Dr. Das-Munshi and colleagues think future studies should look at other possible mediators, "such as interactional effects with poverty, social capital, cultural identify, and acculturation, and the role of social support not limited to immediate personal relationships."

Edited by Wigone, Oct 26 2010, 03:26 PM.
They don't like it up 'em.
Don't tell them your name Pike.
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It stands too reason; people go out of their way to form clubs to be with others

who are like them, it's been known for donkeys years that people who have similar handicaps for instance

gain confidence and enjoy being with others who are similarly handicapped.

It goes against human nature to expect people to integrate when there are established ghettos where they will

literally feel at home, that's how we human being operate, like it or not.
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AQH
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Putnams finds are revealing:

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Although only a single study and limited to American data, it claims to put into question both contract theory and conflict theory in inter-ethnic relations.

According to conflict theory, distrust between the ethnic groups will rise with diversity, but not within a group.

According to contact theory, distrust will decline as members of different ethnic groups get to know and interact with each other.

Putnam describes people of all races, sex and ages as "hunkering down" and going into their shells like a turtle.

For example, he did not find any significant difference between 90 year olds and 30 year olds.

-Low trust with high diversity not only affects ethnic groups, but is also associated with:

-Lower confidence in local government, local leaders and the local news media.

-Lower political efficacy – that is, confidence in one's own influence.

-Lower frequency of registering to vote, but more interest and knowledge about politics and more participation in protest marches and social reform groups.

-Less expectation that others will cooperate to solve dilemmas of collective action (e.g., voluntary conservation to ease a water or energy shortage).

-Less likelihood of working on a community project.

-Less likelihood of giving to charity or volunteering.

-Fewer close friends and confidants.

-Less happiness and lower perceived quality of life.

-More time spent watching television and more agreement that "television is my most important form of entertainment".
Edited by AQH, Oct 26 2010, 03:37 PM.
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