Social Determinants of Mental Health: The Moderating Effects of Bullying Behavior on Immigrant Youth

Background

Within the U.S school setting, 50% of children experience a form of bullying and peer victimization. The links between bullying and poor health outcomes have been investigated, with studies showing its connection to depression, suicidality, and substance abuse. Studies show that immigrant youth face mental health challenges that may be exacerbated by family situations, neighborhood factors, and even economic issues. The scope of this paper is to examine the relationship between social determinants of health and mental health diagnosis while moderating for perpetration and victimization through bullying among immigrant youth compared to domestic youth in the United States. The paper seeks to understand differences based on the racial groups within the immigrant sample, to better highlight the experience of black immigrants due to the informational gap that exists in the literature concerning how black immigrant youth are impacted by these factors.

Methods

Data on school-aged children were obtained from the National Survey of Children's Health (NSCH). The NSCH is an annual, nationally representative study examining the well-being of children. The sample (N=30,364) reflects children between the ages of 6-17 who attended school. The dependent variable was mental health diagnosis, which was measured by diagnosis of either ADHD, depression, anxiety, or conduct disorder. The independent variables included economic factors, neighborhood factors, family factors, school factors, and protective factors, controlling for sociodemographic factors. Two models of negative binomial regression were completed to highlight relationships between independent variables and dependent variables. One model used bullying as a moderator, and the second model used being bullied as a moderator.

Results

The total sample consisted of 51% male participants and 20% immigrants. Among all children, 44% reported experiencing bullying, while 17% reported engaging in bullying behavior. Additionally, 9,080 children aged 6- 17 years had a diagnosed mental health condition. In the bullying model, there was a significant relationship (F(14, 9369) = 61.11, p < .001) between mental health and all the independent variables except neighborhood factors. In the interaction model, there was a significant (F(14, 9369) = 47.01, p < .001), positive relationship with the interaction of bullying and school factors and a significant negative relationship between the interaction of bullying and protective factors. Similarly, in the bullied model, there was a significant relationship (F(14, 9384) = 61.11, p < .001) between mental health and all the independent variables except neighborhood factors. In the interaction model, there was a significant positive interaction F (14, 9369) = 46.93, p < .001), between being bullied and school factors, and a negative relationship between being bullied and protective factors.

Conclusions and Implications

The results indicate that the same factors impacting the perpetration of bullying still impact the victimization of individuals by bullies. Given that protective factors lower the chances of both perpetration and victimization, social work practitioners and policymakers should focus their resources on strengthening protective factors in school settings. Finally, further research is needed to investigate the nature of these relationships and other factors contributing to lower diagnosis rates among immigrant groups compared to domestic youth.