Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society
Volume 1 Issue S1 Abstract 29
F. Termorshuizen, Julius Center, UMC Utrecht, Utrecht, the Netherlands
H.M. Smeets, Julius Center, UMC Utrecht, Utrecht, the Netherlands
A.W. Braam, Altrecht Institute for Mental Healthcare, Utrecht, the Netherlands
W. Veling, Parnassia Psychiatric Institute, The Hague, the Netherlands
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 so-called ethnic density effect on NAPD in Utrecht and whether this effect is due to higher rates of NAPD among Dutch persons in areas with high minority proportions. Also, to explore the geographical scale at which this effect occurs and the influence of social drift prior to NAPD.
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.
With increasing own-group minority density, especially of the neighborhood, the Incidence 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 among Moroccans aged 18-30 years (P=0.046). Among minorities, no social drift prior to NAPD registration was found.
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 native
vs. immigrant comparisons and is not found within all ethnic groups.
Published: 06 Jun, 2013