Alison Teyhan, Maria Maynard, Melissa Whitrow, Seeromanie Harding

1. Social and Public Health Sciences Unit www.msoc-mrc.gla.ac.uk Aspects of cultural identity and mental health in Black African origin adolescents in the DASH study OR Alison Teyhan, Maria Maynard, Melissa Whitrow, Seeromanie Harding MRC, Social and Public Health Sciences Unit, University of Glasgow, Scotland Introduction Studies in the US and in Australia have shown that increasing acculturation does not necessarily promote better health. Acculturation generally refers to the change in cultural norms arising from the interaction of different cultures. In Britain, very little is known about this process and its impact on health. We are using the MRC DASH (Determinants of Adolescent Social well-being and Health) study to examine the relationship between aspects of cultural identity and mental health in adolescence. We are also examining the role of gender, generational status and socio-economic circumstances (SES). We present preliminary results for Black Caribbeans and Black Africans, groups of similar African ancestry but of different historic experiences. Sample Characteristics N % Cultural identity factors & prevalence of poor mental health by ethnicity Ethnicity White UK 1236 18.6 Black Nigerian / Other Black Caribbean 946 14.3 White UK* Caribbean* Ghanaian* African* Nigerian/Ghanaian 621 9.4 % % % % Other African 487 7.3 Proportion of friends of same Indian 495 7.5 ethnicity Pakistani/Bangladeshi 631 9.5 Most 23.1 27.9 26.6 16.6 Mixed 848 12.8 Quite a lot 33.7 33.8 32.5 25.3 White Others 726 11.0 Some or none 37.9 27.9 32.1 43.5 All Others 642 9.7 Speaking English with family Proportion of friends of same ethnicity Most or all of the time 68.9 51.9 15.2 Most 1310 19.8 Quite a lot 4.2 17.4 16.0 Quite a lot 1988 30.0 Some or none Sometimes 5.0 11.9 33.1 2614 39.4 Speaking English with family Rarely or never 7.8 5.2 16.2 Most of the time 3154 47.6 Visiting place of worship Quite a lot of the time 735 11.1 >=1/week 8.6 37.7 75.0 52.0 Sometimes 1263 19.0 <1/week 29.8 37.4 12.2 25.1 Method Just over 6,600 pupils aged 11-13 years in 51 schools in 11 London boroughs took part in Wave 1. Information was collected on social circumstances, health behaviours and psychological well-being. Ethnicity was determined by self reported ethnic origin and consistent background of parents and grandparents. Africans were classified as those that have been migrating since the 1950s (Nigerians, Ghanaians) and those with relatively recent migration history (Ethiopians, Somalis, Eritreans etc). Cultural identity was measured by ethnic mix of friends, use of English with family and friends, and active membership of a religious congregation. The scales for these measures reflect increasing integration. For example ‘most friends of the same ethnicity’ reflect relative lack of integration as compared to those with ‘some or no friends of same ethnicity’. SES was measured by a combination of standard of living and economic activity of father. Mental health was measured using the strengths and difficulties questionnaire (SDQ) giving a total difficulties score (0-40). A score of >=17.5 was used to identify potential mental health problems. Little or no English 525 7.9 Never 55.2 12.7 2.4 9.2 Visiting place of worship SDQ Score >=17.5 13.2 11.8 10.5 8.0 Once a week or more 2389 36.0 *100% refers to sample size of ethnic group Less than once a week 1906 28.7 Never 1536 23.6 Cultural Identity, Socioeconomic Status and Mental Health: Odds ratios (OR), 95% confidence intervals from multiple regression analyses, boys (left panel), girls (right panel). a. Ethnicity of friends. OR OR 0 0.5 1.0 1.5 2.0 2.5 0 0.5 1.0 1.5 2.0 Black Caribbean White UK=1.00 Black Caribbean White UK=1.00 Nigerian/Ghanaian Nigerian/Ghanaian Other African Other African Unemployed Unemployed Father employed=1.00 Father employed=1.00 Absent father Absent father Other Other Least disadvantaged=1.00 Most disadvantaged Least disadvantaged=1.00 Most disadvantaged Born in UK =1.00 Born abroad Born in UK=1.00 Born abroad Friends of same ethnicity. Quite a lot=1.00 Most Friends of same ethnicity. Quite a lot=1.00 Most Some or none Some or none • Key points • Diversity in aspects of cultural identity • Diverse friendships were common in all groups, and greatest for Other Africans, among whom English was least used with family members. About one fifth of Black Caribbeans spoke ‘Patois’ with family members. About three quarters of Black Caribbeans and Nigerians/Ghanaians reported a Christian denomination while just under half of Other Africans reported that they were Muslims. Compared with the White UK group, weekly attendance at a place of worship was much higher for all 3 groups. • Protective effect of directly African ethnicity • Nigerian/Ghanaian ethnicity among boys and Other African ethnicity among girls appeared to be protective of mental health compared with their White UK counterparts, independent of cultural identity factors, SES or generational status. • Interplay between gender and cultural patterning of identity • The relationship between cultural identity and mental health is not straightforward and is gender specific. Among girls, the prevalence of mental health problems was greater among those who had either high or low proportion of friends of the same ethnicity, suggesting either extreme on this scale of acculturation is associated with an unfavourable effect; but very frequent attendance at a place of worship, a tradition in Black African and Caribbean communities, was associated with a protective effect. The unfavourable effect of having a low proportion of friends of the same ethnicity was strongest for White UK girls and that of no church attendance for Caribbean girls. • Work in progress • Work in progress addresses issues related to school and area of residence effects, and examines further the role of social support, particularly within different family types. b. Speaking English with family. OR OR 0 0.5 1.0 1.5 2.0 0 0.5 1.0 1.5 2.0 Black Caribbean White UK=1.00 White UK=1.00 Black Caribbean Nigerian/Ghanaian Nigerian/Ghanaian Other African Other African Father employed=1.00 Unemployed Father employed=1.00 Unemployed Absent father Absent father Other Other Least disadvantaged=1.00 Most disadvantaged Least disadvantaged=1.00 Most disadvantaged Born in UK =1.00 Born abroad Born abroad=1.00 Born in UK=1.00 Speak English with family most of the time=1.00 Quite a lot Speaking English with family. Most of the time=1.00 Quite a lot Sometimes Sometimes Rarely or never Rarely or never c. Attending place of worship. OR OR 0 0.5 1.0 1.5 2.0 2.5 0.2 0.6 1.0 1.4 1.8 2.2 Black Caribbean Black Caribbean White UK=1.00 White UK=1.00 Nigerian/Ghanaian Nigerian/Ghanaian Other African Other African Father employed=1.00 Unemployed Father employed=1.00 Unemployed Absent father Absent father Other Other Most disadvantaged Least disadvantaged=1.00 Most disadvantaged Least disadvantaged=1.00 Born in UK=1.00 Born abroad Born abroad Born in UK=1.00 Attend place of worship >=1/week=1.00 <1/week Attend place of worship >=1/week=1.00 <1/week Never Never