Abstract
Purpose
Recent studies have shown increased incidence of non-affective psychotic disorders (NAPD) among ethnic minorities compared to the native population, but not, or less so, in areas with a high own-group proportion. The aim is to investigate this ethnic density effect in Utrecht and whether this effect is due to higher rates of NAPD among Dutch persons in areas with high minority proportions. We also explore the geographical scale at which this effect occurs and the influence of social drift prior to NAPD.
Methods
NAPD cases in the Psychiatric Case Registry Middle Netherlands (N = 2,064) and living in Utrecht during 2000–2009 were analyzed in a Poisson model in relation to both individual-level and district- vs. neighborhood-level characteristics.
Results
With increasing minority density, especially of the neighborhood, the rate ratios of NAPD significantly decreased among both non-Western (from 2.36 to 1.24) and Western immigrants (from 1.63 to 1.01), in comparison with Dutch persons. This was partly explained by higher rates of NAPD among Dutch persons in areas with high minority density. But there was also a trend to lower NAPD rates among non-Western minorities in these areas (P = 0.074).This trend was significant among Surinamese/Antilleans (P = 0.001) and Moroccans aged 18–30 years (P = 0.046). Among the Dutch, a social drift to minority-dense neighborhoods prior to NAPD registration was found.
Conclusions
Our findings support the beneficial association with own-group presence at the smaller scale neighborhood level. Findings show also that this association is more pronounced in immigrant vs. native comparisons and is not found within all ethnic groups.
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Acknowledgments
The authors like to thank Statistics Netherlands (Centraal Bureau voor de Statistiek, CBS) for kindly providing the data necessary for the present analysis. Furthermore, the authors like to thank the participating psychiatric hospitals and services for providing all data for the Psychiatric Case Register. The authors thank Janneke Giele (Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht) for collecting the data, data management, and support in preparation of the analysis files.
Structural funding of the Psychiatric Case Registers was provided by the participating psychiatric hospitals and services and by the Ministry of Health, Welfare and Sport (VWS). Representatives of the participating psychiatric hospitals and services co-decided on research priorities. The VWS had no role in the study design, analysis, and interpretation of the data, in the writing of the present report, and in the decision to submit for publication.
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On behalf of all the authors, the corresponding author states that there is no conflict of interest.
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Termorshuizen, F., Smeets, H.M., Braam, A.W. et al. Neighborhood ethnic density and psychotic disorders among ethnic minority groups in Utrecht City. Soc Psychiatry Psychiatr Epidemiol 49, 1093–1102 (2014). https://doi.org/10.1007/s00127-014-0842-z
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DOI: https://doi.org/10.1007/s00127-014-0842-z