A comparison of mental health among minority ethnic elders and whites in East and North London

Age and Ageing,  May, 1998  by Ellen R.T. Silveira,  Shah Ebrahim

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East London whites

Prevalence of chronic health problems was the sole predictor of SAD scores (b= + 1.41, SE=0.36, P= 0.0001), accounting for 14% of the total variance and also of LSI scores (b= - 0.95, SE=0.40, P=0.02), accounting for 7% of the total variance.

Gujaratis

None of the variables were significant predictors of SAD scores. Disability was the only predictor of LSI scores (b=- 4.9, SE: 1.8, P=0.01), accounting for 18% of the total variance.

North London whites

None of the variables studied were significant predictors of SAD or LSI scores.

Discussion

We have found higher levels of reported chronic health problems and disability among Bengali elders compared with Somalis and East London whites, with thc lowest rates among Gujaratis and North London whites. In all populations health problems increased with age; however, comparisons between age groups revealed thc smallest differences for Bengalis. Disability was how among old Somalis, although ideas that disability constituted moral weakness or lack of faith in God may have led to under-reporting according to our interpreter. Thc method of sampling was not uniform between ethnic groups owing to thc different living patterns of the groups: Somalis were widely scattered but had a strong kin network, permitting identification of all known Somalis in the area. By contrast, Bengalis were concentrated in one area and were readily accessible through their general practitioners. It is possible that selection bias has resulted in sicker Somali and Bengali people taking part in the survey, but the differential findings between these groups makes this unlikely:

Depressed mood and overall low life satisfaction was a common finding in East but not North London elders. A more pessimistic outlook about the future was expressed by Bengalis and Somalis. Symptoms of anxiety and depression were more frequent among Bengalis compared with all groups but may be related to physical illness, including undiagnosed health problems such as cardiovascular disease rather than anxiety and depression. This may explain some of the excess reporting of neck pain, breathlessness and pounding in the heart. It is possible that the SAD scale over-estimates the prevalence of depression among elderly Bengalis, pointing to the need fi)r a more culturally refined instrument or perhaps a higher cutoff point. It is also possible that false reporting of depressive symptoms occurred more often in the Bengali groups but it is difficult to see what advantage might be obtained by such behaviour and it is improbable that only Bengalis would do this.

Although `somatization' is likely to happen in all cultures [20] it seems to be a more prevalent trait among Bengalis. Our results support findings from a previous study of expression of distress predominantly through bodily complaints by working-class `South Asians' [21]. Bengali general practitioners from Tower Hamlets (East London) also report increased likelihood of `somatization' and high level of mental distress among Bengali patients [22].