Method: Using a convenience method, 201 Karen ethnic adult refugees from Burma were interviewed in Karen language. Depression was assessed using Kessler Psychological Distress Scale (Kessler et al., 2002; range 10-50). We conducted linear regression analysis to examine SDMH factors associated with the level of depression based on the Social Determinants of Mental Health framework. We included demographic information including age (range 18-65), sex (female=1), marital status (married =1), employment (employed=1) and years of education (0-16). As immigrant-related factors, we included years lived in the United States (range 1-15) and English language proficiency (range: 1-5). As health correlates, we included trauma (RHS 15; screen-in=1), the number of chronic health conditions (range: 0-6), and self-rated physical health (SRPH; 1-5). As social integration factors, we included social support and religious participation. Social support was measured by Lubben Social Network Scale (Lubben, 1988; range 0-30) and religious participation was measured by a question asking how often individuals participated in religious services in the past 12 months (0=none thru6=daily).
Results: Descriptive analysis showed that 20.4% of the sample scored 20 or higher in depression. About 64% were women, 53% employed, 81% married and 32% did not receive any formal education. Linear regression analysis results showed that depression is associated with being younger (p<0.05) in demographic factors, having trauma (p<0.001), less healthy (p<0.01), and more chronic health conditions (p<0.05) in health factors, and more religious participation (p <0.01) in social integration factor. The final regression model explained approximately 39% of the variance for depression symptoms in the sample.
Conclusion and Implication: The results suggest that trauma and health conditions are important factors of depression among Karen ethnic refugees. In demographic characteristics, younger participants, who might be more acculturated, tend to be more depressed. The results of this study highlighted the importance of examining the unique social determinants in mental health, depending on specific refugee groups in a specific environment.