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Downward Social Mobility and Major Depressive Episodes among Latino and Asian American Immigrants to the United States Emily Nicklett University of Michigan

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Published by , 2016-01-12 00:00:08

Downward social mobility and major depressive episodes ...

Downward Social Mobility and Major Depressive Episodes among Latino and Asian American Immigrants to the United States Emily Nicklett University of Michigan

Downward Social Mobility and Major Depressive Episodes
among Latino and Asian American Immigrants
to the United States

Emily Nicklett

University of Michigan

Sarah Burgard

University of Michigan

Population Studies Center Research Report 09-668

A version of this paper was presented at the 2008 American Sociological Association meetings. The
authors were supported by grants from the John A. Hartford Foundation, the Agency for Healthcare
Quality and Research, and by center grants from NICHD and NIA to the Population Studies Center,
University of Michigan. We would like to thank Mary Haan, Daniel Eisenberg, and Katherine Hoggatt for
helpful feedback. Correspondence should be directed to the first author at: University of Michigan,
Department of Health Management & Policy, 109 South Observatory Street, Ann Arbor, MI 48109-2029,
E-mail: [email protected].

Social Mobility and Depression among Immigrants 2

ABSTRACT

Objectives: We analyzed the association between downward social mobility that occurs as a
result of immigration to the United States and the odds of major depressive episodes.

Methods: Using NLAAS data, we examined downward mobility by comparing immigrants’
subjective social status (SSS) in their country of origin with reported SSS in the U.S. The dependent
variable was a past-year major depressive episode using DSM-IV criteria. Logistic regression models
controlled for a variety of sociodemographic and immigration-related characteristics.

Results: The analyses suggest that downward mobility in SSS is associated with increased risk of
depressive episodes. The association is driven by individuals for whom employment was a very
important reason for immigrating. Other factors independently associated with greater odds of
depression included: Latino origin, female sex, longer residence in the U.S., and U.S. citizenship
status.

Conclusions: Our findings suggest that immigrants who experience downward social mobility
are at elevated risk of major depressive episodes. Policies or interventions focused only on
immigrants of low social status may miss another group at risk: those who experience downward
mobility from higher origin statuses.

Social Mobility and Depression among Immigrants 3

INTRODUCTION

Research on the mental health of immigrants to the United States has burgeoned recently,
spurred in part by the “epidemiologic paradox” of unexpectedly better physical health of immigrants
compared to their U.S.-born counterparts, despite immigrants’ lower average socioeconomic
resources (1, 2). Recent studies comparing immigrants to individuals born in the U.S. have also
shown lower risks of some mental health disorders among female Asian immigrants (3), male
Caribbean immigrants (4) and female and male Latino immigrants (5). However, relatively few
studies have examined variation in mental health outcomes among immigrants themselves. Some
individuals experience little change or an improvement in their social and economic circumstances
upon immigrating; however, others experience downward social mobility and may be at risk for
depression or other mental health disorders as a result. Previous studies have suggested that
downwardly mobile immigrants are at heightened risk of experiencing psychiatric disorders but have
focused on specific groups, such as Black Caribbean immigrants (4), Korean entrepreneurs (6), or
Vietnamese refugees (7), with few exceptions (8).

Recent studies suggest that the risk for depression or other mental health problems may differ
by immigrant group or by the circumstances related to migration. For example, studies conducted by
Alegria et al. (5) and Williams et al. (4) have found that third-generation immigrants have the highest
risk for mental health problems, while recent immigrants are at relatively lower risk. In other studies
drawing from the same data, however, nativity, English ability, and other factors were found to be
negatively associated with mental health problems (3). These mixed results suggest that the
immigration process may influence the mental health of specific groups of immigrants differently (9-
16). Other factors that may differentiate mental health outcomes across immigrants are perceived
incongruence between expectations before and outcomes after immigration (17) or experiences of
unemployment after arrival (18). These prior studies point to the potentially detrimental
consequences of a loss of perceived social standing; however, to our knowledge no studies explicitly
examine whether downward mobility in subjective social status (SSS) predicts depression among
immigrants or examine how this association may differ by immigrant characteristics.

Prospective studies have shown that downward mobility—indicated by such events as job
demotion, job loss, or inter- or intra-generational loss of occupational prestige—c an lead to negative
mental health outcomes (including depression) in the population overall (19-21). Further, drastic life-
changes—such as losing one form of employment and then gaining another—potentially challenge
positive mental health and have been associated with a higher prevalence of depression and other
mental health problems (22, 23). In contrast to these extant studies of downward mobility and mental
health that use samples including native-born and immigrant persons, we focus on social mobility
that occurred specifically as a result of immigration to the United States. We compare individuals’
reports of what their social standing had been in their countries of origin with their perceived current
standing in the United States. A decline in SSS, or “…the individual’s perception of his own position
in the social hierarchy” (24), may put immigrants at risk of depression. In prior studies, SSS has been
linked to psychological outcomes (25) and to self-rated health measures (26-28), even after
controlling for more objective measures of socioeconomic position. Researchers have explained
these findings by arguing that one’s perception of low status relative to the status of others leads to
stress and feelings of shame and mistrust. Stress and negative emotions could affect health directly

Social Mobility and Depression among Immigrants 4

through neuroendocrine pathways and indirectly via their influence on health outcomes and
behaviors (29, 30). Recent research has begun to address the associations between changes in
individuals’ SSS and their health outcomes, but such research is still in its infancy (31).

In this study, we examine whether downward mobility in SSS due to immigration to the U.S.
is associated with major depressive episodes. We use recently-collected data on U.S. immigrants
from a nationally-representative household sample of Latino and Asian Americans that captures a
broader sample than those used in the few prior studies that have examined the consequences of
downward mobility among immigrants. We also investigate whether those who immigrated to find
work show greater risk for depression if they are downwardly mobile, compared to those for whom
work was a less import reason for immigration.

METHODS

Data

We use data from the National Latino and Asian American Study (NLAAS), a nationally-
representative household survey of 2,554 Latinos (Puerto Ricans, Mexican Americans, Cubans and
other Latinos) and 2,095 Asian American respondents (Chinese, Vietnamese, Filipinos and other
Asians) conducted between 2002 and 2003 in the coterminous United States. Three elements
comprise the sampling design: (i) primary sampling units (metropolitan statistical areas and counties)
were selected using probability proportional to size, from which housing units and household
members were selected for interviews; (ii) a supplemental sample was drawn from census block-
groups with greater than 5% density of targeted ethnic groups; and (iii) second respondents were
sampled from households in which a primary respondent had already been interviewed. NLAAS
interviews were conducted in English, Spanish, Chinese (Mandarin), Tagalog and Vietnamese,
according to respondent’s preference. Most interviews were conducted in person, while about 1,000
were conducted by telephone. Weighted response rates were 75.5% for the Latino sample and 65.6%
for the Asian sample (34). We omitted 1,378 respondents from the analysis because they were not
first-generation immigrants, and omitted 215 respondents due to missing information on key
variables, resulting in a final analytic sample of 3,056 respondents.

Measures

A major depressive episode in the 12 months prior to interview was measured following
DSM-IV Major Depressive Episode criterion 296.2 (35). Although cultural differences have been
reported in diagnosing and classifying depression (36), prior studies have suggested that cultural
equivalence was reached on the standardized instruments used to assess depression for the NLAAS
(37). We measured downward social mobility by comparing respondents’ reports of what their social
standing would be in their country of origin with their current social standing in the United States,
using two survey items based on the MacArthur “ladder,” denoting response choices ranging from 10
(best off) to 1 (worst off) (25). Respondents were instructed: “Think of this ladder as representing
where people stand in our society. At the top of the ladder are the people who are the best off—those
who have the most money, most education and best jobs. At the bottom are the people who are the
worst off—who have the least money, least education, and the worst jobs or no jobs. The higher up

Social Mobility and Depression among Immigrants 5

you are on this ladder, the closer you are to the people at the very top and the lower you are, the
closer you are to the people at the very bottom. Please mark a cross on the rung of the ladder where
you would place yourself”.

We subtracted respondents’ reported SSS rank in the United States from their reported SSS
rank in their country of origin; those who reported a rank 2 or more steps lower in the U.S. than in
their origin country were classified as downwardly mobile, while those who reported equivalent
ranks or a higher rank in the U.S. than in their country of origin were classified as stable or upwardly
mobile. The estimated association with past year major depressive episode is slightly weaker if the
cut-point for downward mobility is one step or more lower, but the results here are unchanged if we
compare downwardly mobile respondents to separate groups of stable and upwardly mobile
respondents. To take account of the greater possibility of downward mobility for those in the middle
and top of the SSS distribution, in multivariate models we controlled for a categorical measure of
SSS in country of origin, coded so that 0 = rungs 3 though 8 on the ladder, 1 = rungs 1 or 2 (low
status) and 2 = rungs 9 or 10 (high status).

To adjust for objective social status, we also included an indicator estimating educational
attainment (0 = 13 years or more, 1 = 12 years or less). To assess the importance of extended
exposure to conditions in the United States, we included a measure of residence, categorized as: 0 = 5
years or more, 1 = less than 5 years. Citizenship status at the time of interview is coded so that: 0 =
U.S. citizen, 1 = not a citizen, and self-reported fluency in spoken English is coded as: 0 = good or
excellent, 1 = poor or fair. We also adjusted for whether employment was the designated motivation
for immigration, suspecting that downward mobility might be a particularly salient experience for
such individuals. Respondents were asked about a series of possible reasons for immigrating, and
rated the importance for themselves or their families. Importance of finding employment was coded
so that 0 = somewhat important, not at all important, or don’t know, and 1 = very important.
Multivariate analyses also controlled for sex (0 = female, 1 = male) and age in years as a continuous
variable.

Analyses

Survey weights were used in all analyses to account for the complex sampling design of the
NLAAS and make the estimates nationally representative (34). Stata software (version 10.0SE) was
used for all analyses. We used adjusted Wald tests to compare the prevalence of past year major
depressive episode across categories of predictors (Table 1). We estimated logistic regression models
that adjusted for the complex sampling design (Tables 2 and 3). Unless otherwise stated, we used
p<.05 as the level denoting statistical significance. There was a low level of data missingness in the
variables used. We replicated our analyses using multiply imputed datasets, and the results were
substantively unchanged from those presented here.

RESULTS

Figure 1 displays the interrelationship between SSS in the respondent’s origin country and
the possibility and likelihood of downward mobility. Based on our definition of downward mobility
(two or more steps downward on the ladder), it is not possible for those who rated themselves lowest

Social Mobility and Depression among Immigrants 6

in their origin country to be designated downwardly mobile. Moreover, respondents rating
themselves highest in their country of origin are more likely to be designated downwardly mobile in
SSS. To account for these floor and ceiling effects, we include the categorical measure of origin SSS
in all multivariate models.

Figure 1. Proportion of Respondents Downwardly Mobile 2+ Steps on the SSS 
Ladder, Comparing SSS in Country of Origin and SSS in U.S. Overall, National 

Latino and Asian American Study 2002‐2003, Immigrant Respondents.

1

0.9

0.8

0.7

0.6

0.5
Stable/ Upwardly Mobile

0.4 Downwardly mobile

0.3

0.2

0.1

0
1 (low) 2 3 4 5 6 7 8 9 10 
(high)

Table 1 presents the weighted descriptive characteristics of the NLAAS immigrant respondents and
prevalence of past year major depressive episode, overall and stratified by predictor variables.
Overall 6.4% of these respondents experienced a major depressive episode, with females (8.0%)
more likely than males (4.8%), Latinos (7.3%) more likely than Asian immigrants (4.4%), those who
had been in the U.S. longer than five years (7.1%) more likely than those residing in the U.S. for up
to five years (3.1%), and U.S. citizens (7.9%) more likely than non- citizens (5.3%) to have
experienced a major depressive episode. In these bivariate comparisons, variation in depressive
episode prevalence by SSS in country of origin is only marginally statistically significant (p=0.09),
and the difference between those who were downwardly mobile (7.1%) versus stable or upwardly
mobile (6.0%) was not significant.

Social Mobility and Depression among Immigrants 7

Table 1. Distribution of Sociodemographic and Immigration-related Factors among Immigrants in the
National Latino and Asian American Study 2002-2003.

Sample Distribution Major Depressive Adjusted Wald
Episode past 12 Test for

mo. Difference

Unwgtd. Wgtd. Wgtd. Unwgtd. Wgtd. F p value
N Prop./ SE N Prop. -- --
Mean
12 mo. Major Depressive Episode 3056 192 --
0.064

Downward Mobility 1.08 0.302
Stable/Upward
Downward 1887 0.635 -- 115 0.060
1169 0.365 -- 77 0.071

SSS in country of origin 2.49 0.091
Rung 1 - 2
Rung 3 - 8 373 0.108 -- 43 0.104
Rung 9 - 10 2042 0.704 -- 117 0.061
641 0.188 32 0.053

Sex 1411 0.506 -- 10.94 0.002
Male 1645 0.494 -- 68 0.048
Female 124 0.080

Ethnicity 9.46 0.003
Latino
Asian 1518 0.676 -- 130 0.073
1538 0.324 -- 62 0.044

Age (years) 3056 39.84 0.594 -- --

Educational Attainment 2.20 0.142
<=12 years
> 12 years 1547 0.619 -- 117 0.070
1509 0.381 -- 75 0.053

Time in United States 533 0.176 -- 11.51 0.001
<= 5 years 2523 0.824 -- 20 0.031
> 5 years 172 0.071

Citizenship Status 8.10 0.006
Not a U.S. Citizen
U.S. citizen 1437 0.584 -- 80 0.053
1619 0.416 -- 112 0.079

Spoken English Ability 1.56 0.215
Poor/Fair
Good/Excellent 1781 0.641 -- 129 0.070
1275 0.359 -- 63 0.053

Importance of Finding a Job 1.14 0.289

Very important 1868 0.665 -- 121 0.059
0.074
Somewhat Important/Not at all/DK 1188 0.335 -- 71

Note : All figures (except Ns) weighted to adjust for complex sampling design.

Social Mobility and Depression among Immigrants 8

Table 2. Odds Ratios (95% Confidence Intervals) from Logistic Regression Models of Major Depressive
Episode in Last 12 Months, National Latino and Asian American Study 2002-2003, Immigrant
Respondents.

Downward Mobility Model 1 Model 2
Stable/Upward OR (95% CI) OR (95% CI)
Downward
1.00 -- 1.00 --
SSS in country of origin 1.61 (1.11, 2.34) * 1.64 (1.18, 2.98) **
Rung 1 - 2
Rung 3 - 8 1.91 (1.12, 3.27) * 1.89 (1.11, 3.21) *
Rung 9 - 10 1.00 -- 1.00 --
0.71 (0.42, 1.21) 0.73 (0.42, 1.26)
Ethnicity
Latino 1.70 (1.15, 2.50) ** 1.72 (1.14, 2.58) *
Asian 1.00 -- 1.00 --

Sex 0.55 (0.40, 0.76) *** 0.57 (0.40, 0.80) **
Male 1.00 -- 1.00 --
Female 0.99 (0.97, 1.01)

Age (years) 1.00 (0.99, 1.02)

Educational Attainment -- -- 1.12 (0.66, 1.89)
<=12 years -- -- 1.00 --
> 12 years
-- -- 0.44 (0.23, 0.84) *
Time in United States -- -- 1.00 --
<= 5 years
> 5 years

Citizenship Status

Not a U.S. Citizen -- -- 0.55 (0.34, 0.90) **
1.00 --
U.S. citizen -- --

Spoken English Ability

Poor/Fair -- -- 1.41 (0.66, 2.98)
1.00 --
Good/Excellent -- --

Importance of Finding Employment

Very important -- -- 0.76 (0.47, 1.24)
1.00 --
Somewhat Important/Not at all/DK -- -- 3056
9.80
N 3056

F 4.43 ** ***

Note: ***p<.001, **p<.01, *p<.05, †p<.10.

Table 2 shows the adjusted odds ratios from logistic regression models predicting a major
depressive episode in the 12 months after controlling for other predictors. Model 1 adjusts only for
SSS in country of origin, ethnic group, sex, and age, while Model 2 adds covariates including
educational attainment, duration of residence in the U.S., citizenship, spoken English proficiency,
and whether immigration was employment-related. Results for Model 2 in Table 2 show that

Social Mobility and Depression among Immigrants 9

downwardly mobile immigrants had higher odds of past year major depressive episode (OR = 1.6;
95% CI = 1.2, 3.0), net of all controls. Other predictors show that low origin SSS is associated with
higher odds of depression, Latinos are significantly more likely than Asians and males are
significantly less likely than females to report a major depressive episode. Respondents who have
lived in the U.S. for five years or less and those who are not U.S. citizens have lower odds of a recent
depressive episode.

Table 3. Odds Ratios (95% Confidence Intervals) from Logistic Regression Models of Major Depressive
Episode in Last 12 Months by Importance of Finding a Job as a Reason for Immigrating, National Latino
and Asian American Study 2002-2003, Immigrant Respondents.

Very Important to Find Somewhat Important /Not At
Employment All/Don't Know

OR (95% CI) OR (95% CI)

Downward Mobility

Stable/Upward 1.00 -- 1.00 --
1.09 (0.51, 2.34)
Downward 2.11 (1.37, 3.26) **

SSS in country of origin

Rung 1 - 2 1.62 (0.962, 2.72) † 2.60 (0.94, 7.21) †
1.00 --
Rung 3 - 8 1.00 -- 0.71 (0.36, 1.38)

Rung 9 - 10 0.74 (0.33, 1.66)

Ethnicity 1.55 (0.69, 3.48) 2.05 (0.90, 4.71) †
Latino 1.00 -- 1.00 --
Asian
0.56 (0.32, 1.00) † 0.60 (0.30, 1.19)
Sex 1.00 -- 1.00 --
Male
Female 0.99 (0.96, 1.02)

Age (years) 0.99 (0.97, 1.01) 1.00 --
1.40 (0.67, 2.92)
Educational Attainment 1.00 -- 1.00 --

<=12 years 0.98 (0.53, 1.80)

> 12 years 1.00 -- 0.53 (0.19, 1.46)
Time in United States 1.00 --
0.38 (0.14, 1.01) †
<= 5 years 1.00 -- 0.83 (0.37, 1.85)
> 5 years 1.00 --
Citizenship Status 0.43 (0.26, 0.71) **
Not a U.S. Citizen

U.S. citizen 1.00 --

Spoken English Ability

Poor/Fair 1.91 (0.72, 5.05) 0.90 (0.42, 1.92)
-- 1.00 --
Good/Excellent 1.00 1188
2.84
N 1868

F 7.20 *** **

Note: ***p<.001, **p<.01, *p<.05, †p<.10.

Social Mobility and Depression among Immigrants 10

We tested for interactions between downward mobility and all other independent variables
and found support for stratifying models on the basis of the respondent’s reason for immigrating.
Table 3 presents results separately for those who reported that finding employment was a very
important reason for immigrating and those for whom it was less important. The results show that
downward mobility is a significant predictor of major depressive episodes only among individuals
for whom finding employment a strong incentive for immigrating (OR = 2.1; 95% CI = 1.4, 3.3),
with a p-value of 0.051 for the interaction term (not shown).

DISCUSSION

Measuring social mobility by comparing a respondent’s reports of his or her SSS avoids
some of the problems that arise with international comparisons of objective measures of
socioeconomic status, is more sensitive to subtle aspects of social standing, and incorporates an
individual’s perceptions of both current circumstances and future opportunities (27, 32). Measuring
objective downward mobility among international immigrants is challenging because hierarchies of
social position and associated rewards can vary between sending and receiving countries. For
example, a skilled medical professional may have to take a lower status job in the United States due
to differences in required professional credentials, but may earn a similar amount in real dollars as
she did in her country of origin. Comparisons of income pre- and post-migration would suggest no
social mobility, but such an individual may consider her status relatively worsened and could
experience mental health consequences. Further, it can be difficult to capture an individual’s own
sense of his career trajectory when using objective measures of socioeconomic position. Even if an
immigrant does experience objectively downward mobility upon arrival, as many migrants do (33),
he may view it as a temporary situation because of private knowledge about skills and plans that will
improve his situation in the future. When asked to rate his social position, he may thus report a
higher SSS than his objective situation would warrant and also may not experience any negative
mental health consequences of a temporary dip in objective status.

In this large, diverse sample of first-generation Latino and Asian immigrants residing in the
United States we found a positive association between downward social mobility and reports of a
major depressive episode in the past 12 months. Moreover, this association appeared to be driven by
those respondents for whom finding employment was a major motivation for immigrating. These
associations were evident in large samples meant to represent the variety of Latino and Asian
immigrants in the United States and were robust to controls for racial/ethnic group, sex, age,
educational attainment, duration in the U.S., citizenship status, and spoken English ability. Our
findings are also consistent with the few studies that have examined the consequences of
occupational mobility among immigrants. Others have suggested or shown that downward mobility
following migration can increase vulnerability for depression or other mental health problems, but
past studies have focused on very specific immigrant groups and have not used SSS to measure
social mobility (4, 6, 7).

Limitations

While the NLAAS sample is large and diverse, our analytic sample is limited to first-
generation immigrants from Asian and Latin American countries. Although beyond the scope of this

Social Mobility and Depression among Immigrants 11

analysis and these data, additional studies should consider extending the study population to include
individuals of different immigrant generations and ethnic groups. Samples including multiple
immigrant generations would allow exploration of how intergenerational mobility operates to
moderate depressive symptoms within families as they become more integrated into their local labor
markets and communities and how this may vary for different ethnic groups. Additionally, the
conditions under which individuals immigrate—as refugees or as immigrants in search of improved
economic opportunities, for example—are likely important for both subsequent social mobility and
the likelihood of developing mental health outcomes. Our results suggest that economic motivations
for immigration may make downward mobility particularly difficult, but future studies should
examine reasons for immigration in more detail.

Additionally, the NLAAS data are cross-sectional; therefore, it is not possible to assess
whether the association between downward mobility and major depressive episodes is causal. We
have focused on major depressive episodes in the past 12 months to ensure that for the vast majority
of our respondents, immigration clearly preceded the episode. Although our results remain robust if
we eliminate respondents who arrived within the five years preceding the survey, this does not
eliminate the possibility that a recent depressive episode could influence reports of one’s current or
prior SSS. Some studies have shown that for specific mental disorders (particularly schizophrenia),
the direction of causation is the reverse of that proposed here, leading from early life mental health
problems to downward social mobility over the life course (38, 39). However, our use of migrants
helps to reduce concerns about reverse causality since most immigrants tend to be positively selected
on health, with the exception of some refugee groups (40). While immigrant health advantages are
proposed to be reduced with acculturation (41-43), acculturation is a construct that remains difficult
to capture in surveys and secondary data analyses (44, 45).

Another limitation is that we cannot distinguish between short-stayers (those intending to
migrate back to their country of origin) and those who will settle in the U.S. permanently. The
NLAAS cannot capture short-stayers from previous cohorts, as they have returned to their country of
origin. This sampling error could bias our results toward or against the null hypothesis, depending
whether immigrants experiencing higher levels of success stayed in the United States or returned to
their countries of origin. We have controlled for duration in the U.S., but future studies would benefit
from collecting data at multiple time points to enable examination of trajectories of migration
experiences, SSS and mental health over the life course.

Potentially omitted variables could confound the results presented here. The individual
circumstances leading to the decision to immigrate might result in negative selection. For example, if
downwardly mobile immigrants were more likely to have immigrated because of difficult personal
and/or societal circumstances in their country of origin, this could bias our estimates toward a greater
likelihood of finding the hypothesized relationship. As another example, individuals’ unmeasured
adaptability and resiliency might affect their likelihood to immigrate, risk of downward mobility, and
mental health—confounding the relationships explored here.

There are also limitations of the indicators of social position that we used here. First, the
accuracy of reports about origin SSS is likely to vary by time since immigration and by the frequency
with which individuals return to their country of origin. Further empirical clarification would be
useful, as would an assessment of whether higher and lower status individuals consider different
contexts when they report on their “community.” Finally, some researchers have debated the degree

Social Mobility and Depression among Immigrants 12

to which SSS adds to our understanding of the relationship between objective social position and
health (46, 47). While we have included a measure of education to mark objective social status, our
indicators of SSS may still be capturing some elements of objective status not reflected in
educational attainment. However, in models not shown here we also controlled for household income
and employment status or experience with unemployment in the past year, but results were
substantively unchanged. A study of SSS in an elderly English sample, a population very different
from the one studied here, showed that while objective and subjective measures are related, as
expected, correlations between SSS and education, income and wealth were never greater than 0.45,
and that SSS provided additional important information in models predicting physical and mental
health (31).

Implications

While previous research found that immigrants tend to be healthier than native born U.S.
residents (at least shortly after arrival), these findings suggest that immigrants experiencing
downward mobility may be in need of mental health services. Some studies have shown that
immigrants (48, 49) and individuals of lower socioeconomic position (50-52) are at-risk for under-
utilization of mental health services. The downwardly mobile immigrant respondents in our sample
may be particularly unlikely to obtain these services if they experience a decline in socioeconomic
resources. Moreover, policies focused only on immigrants of low objective or subjective social status
may miss important risk groups: those who were downwardly mobile from a higher origin status and
in particular, those for whom employment motivated them to immigrate. Downwardly mobile
immigrants may be at risk even if they have not fallen into poverty. Subsequent research focusing on
risk and protective factors for depression among immigrants are needed to further identify
populations in need of mental health services, as well as which preventive efforts and interventions
are most effective for these groups.

Social Mobility and Depression among Immigrants 13

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