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Neighborhood ethnic diversity and behavioral and emotional problems in 3 year olds: results from the Generation R
Ilse J E Flink1, Rick G Prins, Johan J P Mackenbach
1The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands. i.flink@erasmusmc.nl
Insights
Ethnic inequalities in child behavioral issues are most pronounced in ethnically homogeneous neighborhoods. Neighborhood diversity may buffer these disparities, highlighting the importance of diverse communities for child mental health.
Area of Science:
- Public Health
- Sociology
- Developmental Psychology
Background:
- Neighborhood ethnic diversity is a potential factor in understanding ethnic disparities in mental health.
- Ethnic inequalities in child mental health require further investigation regarding neighborhood context.
Purpose of the Study:
- To examine if neighborhood ethnic diversity moderates the link between ethnic minority status and child behavioral/emotional problems.
- Investigate the role of neighborhood composition in ethnic mental health inequalities.
Main Methods:
- Utilized data from 3076 preschoolers in the Generation R Study (Rotterdam, Netherlands).
- Assessed child behavioral and emotional problems using the Child Behavior Checklist (CBCL) at age 3.
- Employed multi-level logistic regression and the Racial Diversity Index to analyze individual and neighborhood-level data, assessing interaction effects.
Main Results:
- Ethnic minority status was associated with increased child behavioral and emotional problems.
- Ethnic inequalities were significantly larger in low-diversity neighborhoods compared to medium and high-diversity neighborhoods.
- A trend towards negative interaction was observed, suggesting diversity may mitigate inequalities.
Conclusions:
- Ethnic inequalities in child behavioral and emotional problems appear greatest in ethnically homogeneous neighborhoods.
- Neighborhood ethnic diversity may play a protective role in reducing ethnic disparities in child mental health.
Background:
Studies suggest that neighborhood ethnic diversity may be important when it comes to understanding ethnic inequalities in mental health. The primary aim of this study was to investigate whether neighborhood ethnic diversity moderated the association between the ethnic minority status and child behavioral and emotional problems.
Methods:
We included 3076 preschoolers participating in the Generation R Study, a birth cohort study in Rotterdam, the Netherlands. At child age 3-years, parents completed the Child Behavior Checklist (CBCL/1,5-5). Individual-level data, assessed with questionnaires, was combined with neighborhood-level data. Multi-level logistic regression models predicted the Odds Ratios for the CBCL total problems score as a function of maternal ethnic background and neighborhood ethnic diversity, computed with the Racial Diversity Index and categorized into tertiles. Interaction on the additive scale was assessed using Relative Access Risk due to Interaction.
Results:
Being from an ethnic minority was associated with child behavioral and emotional problems in unadjusted (OR 2.76, 95% CI 1.88-4.04) and adjusted models (OR 2.64, 95% CI 1.79-3.92). Residing in a high diversity neighborhood was associated with child behavioral and emotional problems in unadjusted (OR 2.03, 95% CI 1.13-3.64) but not in adjusted models (OR 0.89, 95% CI 0.51-1.57). When stratifying by the three levels of neighborhood ethnic diversity, ethnic inequalities in behavioral and emotional problems were greatest in low diversity neighborhoods (OR 5.24, 95%CI 2.47-11.14), smaller in high diversity neighborhoods (OR 3.15, 95% CI 1.66-5.99) and smallest in medium diversity neighborhoods (OR 1.59, 95% CI 0.90-2.82). Tests for interaction (when comparing medium to low diversity neighborhoods) trended towards negative on both the additive and multiplicative scale for the maternal-report (RERI: -3.22, 95% CI -0.70-0.59; Ratio of ORs: 0.30, 95% CI 0.12-0.76).
Conclusion:
This study suggests that ethnic inequalities in child behavioral and emotional problems may be greatest in ethnically homogeneous neighborhoods.
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