Serious psychological distress among non-Hispanic whites in the United States: the importance of nativity status and region of birth



Serious psychological distress (SPD) is an understudied health topic. When studied, estimates for minority groups are compared to that of non-Hispanic whites. Non-Hispanic whites are heterogeneous, and comprise individuals from Europe, North Africa or the Middle East. The objectives of this study are to estimate and compare the sex- and age-adjusted prevalence of SPD first by nativity status and then by region of birth (Europe, Middle East and Russia) while controlling for potential confounders.


The sample consisted of 196,483 participants, 18 years of age or older in the National Health Interview Survey (2000–2010). To measure SPD, Kessler’s K6 Likert scale was used. Individuals with scores greater than or equal to 13 were considered to have SPD.


The age- and sex- adjusted prevalence of SPD was 3 % for foreign-born non-Hispanic whites. Of this, estimates were 6 % for those from the Middle East, 3 % for Europe and 2 % for Russia (p = 0.00). In the fully adjusted multivariable model, foreign-born non-Hispanic whites from the Middle East were more likely (OR = 1.76; 95 % CI = 1.01, 3.04) to report SPD when compared to US-born non-Hispanic whites. Within the foreign-born population, non-Hispanic whites from the Middle East were more than twice as likely to report SPD (OR = 2.43; 95 % CI = 1.15, 5.14) compared to foreign-born non-Hispanic whites from Europe after controlling for confounders.


This study’s findings will help researchers understand which subgroups within non-Hispanic whites suffer most from SPD, which will facilitate tailored prevention intervention efforts.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Correspondence to Florence J. Dallo.

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Dallo, F.J., Kindratt, T.B. & Snell, T. Serious psychological distress among non-Hispanic whites in the United States: the importance of nativity status and region of birth. Soc Psychiatry Psychiatr Epidemiol 48, 1923–1930 (2013).

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  • Serious psychological distress
  • Region of birth
  • National Health Interview Survey
  • Middle East
  • Nativity status