Race/ethnicity, nativity, and lifetime risk of mental disorders in US adults

Soc Psychiatry Psychiatr Epidemiol. 2019 May;54(5):553-565. doi: 10.1007/s00127-018-1644-5. Epub 2018 Dec 13.


Purpose: There has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity.

Methods: Survival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys.

Results: Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent.

Conclusions: Parental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences.

Keywords: Mental disorder prevalence; Mental health disparities; Nativity; Race/ethnicity.

MeSH terms

  • Adolescent
  • Adult
  • Asian People / psychology
  • Asian People / statistics & numerical data
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data*
  • Female
  • Health Surveys
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / ethnology*
  • Middle Aged
  • Parents / psychology
  • Prevalence
  • Racial Groups / psychology
  • Racial Groups / statistics & numerical data*
  • Risk Factors
  • United States / epidemiology
  • White People / psychology
  • White People / statistics & numerical data
  • Young Adult