© 1998 Oxford University Press
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A comparison of mental health among minority ethnic elders and whites in East and North London
Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine Rowland Hill Street London NW3 2PF, UK
Address correspondence to: E. Silveira. Fax: (+44) 171 794 1224. E-mail: pcps{at}rfhsm.ac.uk
OBJECTIVE:: minority ethnic groups, particularly elderly people, reported substantially more limiting long-term illness than the white population in the 1991 UK census. We aimed to compare the levels of and examine associations between disability, chronic medical diagnoses, mood and life satisfaction among Bengali, Somali, Gujarati and white elderly people living in North and East London.
DESIGN:: cross-sectional survey with participants drawn from age-sex registers of general practices, augmented byother sources.
SETTING:: East London (Somalis, Bengalis, whites) and North London (Gujaratis, whites).
SUBJECTS: 378 people aged 60+: 72 Somalis, 75 Bengalis and 127 whites from East London; 41 Gujaratis and 63 whites from North London.
MAIN OUTCOME MEASURES:: Symptoms of anxiety and depression scale (SAD), life satisfaction index (LSI).
MAIN RESULTS:: highest SAD scores were found among Bengalis; lowest LSI scores were found among Bengalis and Somalis. The prevalences of depression (SAD score 6+) were very variable: Somalis, 25%; Bengalis, 77%; East London whites, 25%; Gujaratis, 2%; North London whites, 5%. Chronic health problems and SAD scores were associated among Somalis (r=0.31, P=0.01), Bengalis (r= 0.38, P= 0.001) and East London whites (r=0.24, P= 0.007). Chronic health problems also related to lower LSI scores among Somalis (r= –0.25, P= 0.04) and East London whites (r= –0.22, P=0.0l6). Disability in activities of daily living was a strong correlate of SAD scores among Bengalis (r=0.39, P=0.001), LSI scores among Gujaratis (r= –0.4, P=0.01) and Bengalis (r= –0.29, P=0.01) and to a lesser extent, SAD and LSI scores among East London whites (r=0.18, P=0.043 and r= –0.18, P =0.046 respectively). Adjustment for the effects of health, age and income led to only small changes in the differences in SAD and LSI scores observed between ethnic groups.
CONCLUSION:: the marked variation in mental health between different ethnic groups may be a reflection of differences in perception of symptoms, expectations and motivations for taking part in surveys. Physical health was related to mental health but in inconsistent ways between ethnic groups. Income and physical health did not explain variation in mood and life satisfaction, although it is possible that the very large differences between North and East London reflect socio-economic differentials. Cross-cultural application of standardized assessment scales is not straightforward and further work is needed to examine such methods.
Keywords: elderly people, ethnicity, life satisfaction, mood
Received January 29, 1997;
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