Adolescent risk behaviours and psychological distress across immigrant generations.
Research suggests that as immigrants become more acculturated, they adopt the attitudes, social norms, and behaviours of the mainstream or a social reference group within their new country. (2,3) Whether increased acculturation results in positive or negative outcomes, however, remains unknown to a large extent because of inconsistent findings. Some early studies indicated that the foreign-born were at increased risk for psychological and behavioural difficulties, (4-7) suggesting that with time and increased acculturation, such difficulties would decline to that of the mainstream. More recent studies, however, have often challenged that view with findings that foreign-born children are often at similar (8,9) or reduced risk of psychological and behavioural difficulties relative to their native-born counterparts. (10-14) A more nuanced view coincides with indications that health and behavioural differences between foreign and native-born children are complex and thus may vary, for example, across health outcomes and between multiple immigrant generations.
The main objective of this study is to examine differences in psychological distress symptoms, hazardous and harmful drinking, illicit drug use, and general delinquency between three immigrant generations. The study focuses on adolescent students in Ontario, the province of residence for 54.9% of the foreign-born population in Canada and 38% of the overall Canadian population. (15) This study also examines the moderating effects of age and sex in the association between immigrant generation and each outcome given that norms associated with adolescent behaviour are often driven by age and sex. This may be particularly so for first-generation youth who are often from countries with more traditionally defined roles. Alternatively, sex and age differences may be more evident among second and later generations because of greater acculturative influences.
Data were derived from the 2005 Ontario Student Drug Use Survey (OSDUS), a province-wide survey of 7th to 12th grade students with in regular public or Catholic schools. (16) The survey was administered in classrooms through anonymous, student-completed questionnaires. Conducted every odd year since 1977, OSDUS employs a two-stage cluster design involving a random selection of classes from within a random selection of schools (probability proportional to size) stratified by region and school type (elementary/middle or secondary). The 2005 total sample was 7,726 students from 42 school boards, 137 schools, and 445 classrooms. Completion rates were 94% and 72% for schools and students, respectively. Absenteeism (12%) and lack of parental consent (16%) were among the reasons for non-completion. Specific items important to this analysis (e.g., delinquency) were only asked of a random half sample of 4,078 students, and thus this half sample is the basis for analyses. A total of nine respondents who were younger than 12 or older than 19 years of age were excluded from analyses. The Research Ethics Board of the Centre for Addiction and Mental Health approved this study. Further details regarding the study design are available at: http://www.camh.net/research/population_ life_course.html (16) (Accessed March 17, 2008).
Health risk behaviours examined are hazardous and harmful drinking, illicit drug use, and delinquency. Hazardous and harmful drinking is based on the Alcohol Use Disorders Identification Test (AUDIT), an instrument developed by the World Health Organization. (17) AUDIT assesses drinking behaviour that increases the likelihood of current or future physical health problems (e.g., accidents, alcohol-related injuries). Psychological distress is based on the General Health Questionnaire, a general measure of emotional distress or malaise. (18)
The independent measure, immigrant generation, is represented by dummy variables contrasting three groups. First-generation immigrants are foreign-born youth. Second-generation immigrants are native-born youth (i.e., Canadian-born) with at least one foreign-born parent. Third- and later-generation immigrants are native-born youth with native-born parents.
Analyses control for biological sex, respondents' age, family structure, parental education, and urbanicity. "Don't know" responses on parental education are included because they represent 10% of the sample. Analysis indicates that don't know respondents on this measure tend to be younger (61% are age 12-14 and 73.5% are age 12-15) than those who know their parents' education. Further descriptions of variables used in analyses are provided in the appendix.
Given the complex sample design, Taylor series methods within Stata are used to compute unbiased variances, standard errors, and point estimates. (19) Analyses are weighted to adjust for the unequal probability of selection. (16) Ordinary least squares (OLS) regression is used to examine the relationship between immigrant generation and each of hazardous and harmful drinking, delinquency, and psychological distress. Logit regression is used to examine the relationship between immigrant generation and illicit drug use. Separate multiplicative interactions involving immigrant generation and age, and immigrant generation and sex are examined for each outcome. Only significant interactions are presented in the regression table.
Both linear and quadratic age terms are included in the OLS models to control for the possible nonlinear effect of age on the dependent variables. Age variables are centered in order to reduce the correlation between the linear, quadratic, and interaction terms. (20) OLS regressions are based on square-root transformations of drinking and delinquency scores.
Descriptives of the sample are provided in Table 1. First-, second-, and third-generation immigrant youth represent 16.3%, 30.9%, and 52.8% of the sample, respectively. A greater proportion of the first-generation sample resides in urban rather than rural areas, and has parents with a university degree.
Table 2 outlines the mean or percentage level of harmful drinking, drug use, delinquency, and distress by immigrant generation and control variables. There are statistically significant variations in hazardous and harmful drinking and illicit drug use across the three immigrant generations. First-generation youth report less harmful drinking on average and are less likely to use illicit drugs than second-generation youth, while second-generation youth report less drinking and drug use than their third-generation counterparts. In contrast, the main difference in delinquency and distress across immigrant generations is between first and second generations, with no significant difference between second-generation and third-generation youth. However, whereas mean delinquency is lower, symptoms of psychological distress are greater among first-generation than second-generation youth.
Results from multivariate regression analyses are outlined in Table 3. Results for harmful drinking indicate significant differences between immigrant generations in levels of drinking after adjustments for select socio-demographic factors. Such differences, however, are moderated by age as evident by the statistically significant coefficient for the age by first-generation interaction term. An illustration of this interaction (Figure 1) shows there are increasing differences in drinking between generations with increasing age, particularly between first and second generations. The curvilinear nature of the relationship is also evident as there is some tapering off in drinking in late adolescents, particularly among the first generation.
As with harmful drinking, the odds of illicit drug use increase across immigrant generations. Compared to second-generation youth, the odds of drug use are actually 1.5 times greater among third and later generations and .51 times less among first-generation youth after adjusting for socio-demographic factors. Unlike harmful drinking, however, the relationship between immigrant generation and drug use did not significantly vary by age, although age has an influence on drug use.
Results for delinquency and distress indicate that first-generation youth engage in less delinquent activities and report greater symptoms of psychological distress than second-generation youth, controlling for socio-demographic characteristics. In addition, there are no significant differences in delinquency or distress between second- and third-generation youth. Neither age nor sex is a significant moderator.
The main objective of this study was to examine differences in psychological and behavioural outcomes among adolescents of diverse immigrant generations in Ontario. A particular strength of this study is that the data represent a school-based sample of adolescent students in a region with the highest concentration of immigrants (approximately 55%) in Canada. Given the high concentration of immigrants within the country, and particularly the province of Ontario, the well-being of first- and second-generation immigrant students is of particular importance on multiple levels. Results of this study highlight the complex nature of the relationship between immigrant generation and health and behavioural outcomes. Although foreign-born adolescents, relative to their native-born counterparts, report more symptoms of psychological distress, they report fewer health risk behaviours. This suggests that the nature of differences between foreign- and native-born adolescents varies across outcomes. Also significantly, results indicate that psychological and behavioural outcomes do not consistently improve or deteriorate across immigrant generations.
Findings with regard to symptoms of psychological distress are consistent with some earlier studies that found greater psychological distress among the foreign-born. (9,21) There are other studies, however, that found less distress among the foreign-born (10,11,14,22) or no difference in distress between foreign- and native-born.8 Although studies by both Ali (22) and Beiser et al. (10) involved Canadian data on a national level, the ages of the sample were different, with the former focusing on individuals 15 and older and the latter focusing on 4-11 year olds.
Findings indicating greater delinquent activities among the native-born are generally consistent with earlier studies, (8,12,23) although this study indicates little difference in delinquency between native-born youth, specifically those with foreign-born compared to native-born parents. Results with regard to substance use are generally consistent with other studies indicating greater prevalence rates of substance use among the native-born. (24-27)
Important limitations of the study should be noted. First, data are unavailable on respondents' length of residence or age at arrival in Canada, thus an important aspect of acculturation cannot be considered in analyses. Second, data are unavailable on the race or ethnicity of the sample. The ethnic diversity of the population, especially in urban areas of the province, and the likely differences in racial and ethnic composition of the different immigrant generations suggest that unobserved differences in composition may account for some of the generational differences reported. Third, the sample was restricted to students within the regular school systems and, therefore, does not represent approximately seven percent of students. (16) Additionally, the student non-completion rate due to absenteeism and lack of parental consent may have biased the sample to some degree.
The increasing proportion of first- and second-generation immigrant youth in middle and high schools means an increase in the proportion of students adapting to a new country, struggling with identities, and struggling between old and new values and ways of life, at the same time that they are challenged by the usual barrage of issues encountered during the adolescent years. Given that a successful transition into adulthood is dependent on successfully maneuvering through adolescence, it is important to acquire knowledge about the adjustment levels of these two important population groups. Such knowledge is necessary to develop policies and programs aimed at curbing and preventing maladjustment and promoting the health of individuals, families, and the systems upon which they depend.
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Appendix Description of variables used in analyses Variable Description Coding Immigrant First generation Dummy variable generation (1=yes, 0=no) Second generation Reference category Third and higher Dummy variable generation (1=yes, 0=no) Age Age in years (12-19) Mean centred Sex Biological sex Female=1, male=0 Family structure Current living arrangements Two biological/ adoptive parents=1, other=0 Parental At least 1 parent with a Dummy variable education (1=yes, 0=no) university degree Reference category No parent with a Dummy variable university degree (1=yes, 0=no) Don't know education of parents Urbanicity Residence in urban Rural residence=1, or rural area urban=0 Dependent measures Hazardous and Alcohol Use Disorders Summed responses harmful Identification Test used to 10 items (0-34, drinking to identify problem drinkers median=1) with the least severe alcohol use. Higher scores indicate more harmful drinking Illicit Use of any of 11 illicit Use of at least 1 drug use drugs (excluding inhalants, illicit drug meds, and club) during (1=yes, 0=no) a 12-month period Delinquency Participation in 13 Score derived by delinquent acts (e.g., averaging responses damaged property, theft, across at least 7 assault, breaking and of 13 delinquency entering, carrying a items weapon). Higher scores indicate greater delinquency Psychological 12-item General Health Responses to at distress Questionnaire. Higher scores least 6 items indicate higher distress were averaged to derive a score
Received: April 11, 2008
Accepted: January 9, 2009
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Hayley A. Hamilton, PhD, [1,2] Samuel Noh, PhD,[1,2] Edward M. Adlaf, PhD [1-3]
[1.] Centre for Addiction and Mental Health, Toronto, ON
[2.] Department of Psychiatry, University of Toronto, Toronto, ON
[3.] Dalla Lana School of Public Health, University of Toronto, Toronto, ON
Correspondence and reprint requests: Hayley Hamilton, Social Equity and Health Research, Centre for Addiction and Mental Health, 455 Spadina Ave., Suite 300, Toronto, ON M5S 2G8, E-mail: email@example.com
Table 1. Variable Means/Percentages, Overall and by Immigrant Generation First Second Third Overall Generation Generation Generation Sample Age 15.2 (a) 14.8 (b) 14.9 14.9 (14.7-15.6) (14.6-15.1) (14.8-15.1) (14.8-15.1) Female 46.4 47.0 50.7 48.9 (39.3-53.7) (42.5-51.6) (47.4-54.0) (45.8-52.0) Two biological 73.3 74.0 69.4 71.5 parents (67.2-78.6) (70.1-77.6) (66.4-72.3) (69.1-73.7) Urban residence 99.3 (a) 93.8 (b) 75.5 (c) 85.0 (97.7-99.8) (90.0-96.2) (67.4-82.2) (79.3-89.4) Parental education University 55.6 (a) 38.1 (b) 38.2 (c) 41 degree (48.5-62.5) (33.9-42.5) (34.6-42.0) (37.6-44.5) Less than 33.1 47.5 52.8 48.0 university (27.5-39.2) (43.5-51.5) (49.2-56.4) (44.8-51.1) Don't know 11.3 14.4 8.9 11.0 (8.2-15.2) (11.9-17.4) (7.4-10.8) (9.6-12.6) N 564 1130 2322 4016 Note: 95% confidence intervals are shown in brackets below means. Across a single row, means and percentages with different superscript letters indicate a statistically significant group (generation) difference at p<0.05 level. Table 2. Variable Means/Percentages by Adolescent Outcomes Harmful Illicit Delinquency Distress Drinking Drug Use Mean Mean Mean (95% CI) % (95% CI) (95% CI) (95% CI) Immigrant generation 1st 1.9 (a) 17.1 (a) .06 (a) .20 (a) generation (1.4-2.3) (13.2-21.7) (.04-.07) (.18-.23) 2nd 2.7 (b) 24.7 (b) .08 (b) .17 (b) generation (2.3-3.1) (20.7-29.1) (.07-.09) (.15-.18) 3rd& later 4.1 (c) 33.2 (c) .08b .16 (b) generation (3.6-4.5) (30.5-36.0) (.07-.09) (.15-.17) Age 15 3.3 30.8 0.09 0.17 (2.8-3.8) (27.0-34.7) (.07-.11) (.15-.19) Sex Female 3.1 27.4 .09 (a) .22 (a) (2.8-3.5) (24.6-30.3) (.08-.11) (.20-.23) Male 3.4 28.5 .06 (b) .13 (b) (2.9-3.9) (25.0-32.2) (.05-.07) (.12-.14) Parental structure Two 3.0 (a) 25.4 (a) .07 (a) .16 (a) biological (2.7-3.4) (23.0-27.9) (.06-.08) (.15-.17) parents Other 3.9 (b) 34.3 (b) .10 (b) .21 (b) (3.2-4.5) (29.5-39.4) (.09-.12) (.19-.22) Area of residence Urban 3.2 27.6 0.08 0.17 (2.7-3.6) (24.5-31.0) (.07-.09) (.16-.18) Rural 3.9 29.8 0.08 0.17 (3.3-4.5) (24.3-36.0) (.07-.10) (.14-.19) Parental education University 3.0 (a) 24.5 (a) .07 (a) .16 (a) degree (2.5-3.4) (20.9-28.4) (.06-.08) (.14-.17) Less than 3.9 (b) 34.7 (b) .09 (b) .19 (b) university (3.4-4.3) (31.4-38.1) (.08-.10) (.17-.20) Don't know 1.6 (c) 11.3 (c) .05 (c) .15 (a) (1.2-2.0) (8.5-15.6) (.03-.06) (.12-.17) N 3882 4012 3938 3999 Note: Within a given column and category of predictor variable (e.g., sex), means and percentages with different superscript letters indicate a statistically significant group difference at p<0.05 level. Table 3. Psychological and Behavioural Outcomes Regressed on Immigrant Generation and Socio-demographic Factors Hazardous Illicit Delinquency Psychological and Harmful Drug Use (a) Distress Drinking (a) (n=4012) (n=3938) (n=3999) (n=3882) O.R. (95% b (s.e.) b (s.e.) b (s.e.) CI) (b) Immigrant generation (c) 1st -.343 *** .51 -.038 ** .035 ** generation (.067) (.37-.71) (.014) (.012) 3rd & later .328 *** 1.5 .015 -.013 generation (.070) (1.2-1.8) (.009) (.009) Female -.027 .93 -.061 *** .089 *** (.053) (.78-1.1) (.009) (.010) Age (d) .287 *** 1.6 .016 *** .018 *** (.022) (1.5-1.7) (.002) (.003) Age (d)-squared -.021 ** -.005 *** -.003 * (.006) (.001) (.001) Two biological -.171 ** .70 -.050 *** -.045 *** parents Parental (.059) (.59-.83) (.011) (.009) education (e) University -.047 .79 -.017 -.021 * (.050) (.65-.96) (.010) (.010) Don't know -.326 *** .40 -.055 *** -.016 (.055) (.28-.56) (.013) (.015) Interactions Age x 1st -.113 ** generation (.035) Age x 3rd .044 generation (.028) Constant 1.429 .253 .182 [R.sup.2] .261 .064 .073 *** p<0.001; ** p<0.01; * p<0.05. Rural residence is non-significant and is excluded from table. Unstandardized coefficients. (a) Square root transformed measures. (b) Odds ratios with 95% confidence intervals in brackets. (c) Reference category is second generation. As such, the hazardous and harmful drinking predicted score of 15 year old students is .12 (.3432) less among first-generation than second-generation youth adjusting for socio-demographic factors. (d) Age is centered. (e) Reference category is less than university education.
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|Title Annotation:||QUANTITATIVE RESEARCH|
|Author:||Hamilton, Hayley A.; Noh, Samuel; Adlaf, Edward M.|
|Publication:||Canadian Journal of Public Health|
|Article Type:||Clinical report|
|Date:||May 1, 2009|
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