Ethnic disparities in mental health problems in New Caledonia and French Polynesia

Author:

Sebbane Déborah12ORCID,Wathelet Marielle345,Amadeo Stéphane678,Goodfellow Benjamin9,Roelandt Jean-Luc12,Dourgnon Paul1011,Chevreul Karine21213

Affiliation:

1. WHO Collaborating Centre for Research and Training in Mental Health (WHO CC) – EPSM Lille-Métropole, Lille, France

2. ECEVE, UMR 1123, Inserm, Université Paris Cité, Paris, France

3. Lille Neuroscience & Cognition – U 1172, CHU Lille, Inserm, Université de Lille, Lille, France

4. Centre national de ressources et de résilience (CN2R), Lille, France

5. Fédération régionale de recherche en psychiatrie et santé mentale (F2RSM Psy), Saint-André, France

6. University Hospital Center (CHU) of Martinique, University Service of Psychiatry, Medical Psychology and Psychotraumatology, Fort-de-France, Martinique, FWI

7. Suicide Prevention Center & SOS Suicide Association, Punaauia, French Polynesia (CPSPF)

8. Team MOODS, CESP, Inserm Unit UMR 1178, Université Paris-Saclay – UVSQ, Le Kremlin-Bicêtre, France

9. Specialized Hospital Center of New Caledonia (CHS), Nouméa, New Caledonia

10. UCLA Center for Health Policy Research, Los Angeles, CA, USA

11. French Research and Information Center on Health Economics, Paris, France

12. Unité de Recherche Clinique en Économie de la Santé (URC-Eco), Assistance Publique-Hôpitaux de Paris, Paris, France

13. Unité D’épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France

Abstract

Objectives: Indigenous people experience poorer mental health compared to the general population. Socioeconomic gaps partly explain these disparities. However, there is variability between populations and French overseas territories are understudied. This study examines the prevalence of mental health problems among Indigenous people in New Caledonia and French Polynesia, describing and comparing it with that of their counterparts while considering associated factors. Methods: We used the data from the cross-sectional Mental Health in the General Population survey in the only 3 sites for which information on indigenous status was available: Noumea (2006) and the ‘Bush’ (2008) in New Caledonia, and French Polynesia (2015–2017). Current mental health issues were screened using the Mini-International Neuropsychiatric Interview. In multivariable analyses, we considered the following factors: gender, age, education level, marital status, occupational activity and monthly income. Results: Overall, 2294 participants were analysed. Among the 1379 indigenous participants, 52.3% had at least one mental health issue. The prevalence of depressive disorder (18.0% vs 11.7%), alcohol use disorder (16.7% vs 11.7%) and suicide risk (22.3% vs 16.7%) were higher among indigenous participants compared to non-indigenous participants. After adjustment, the association between indigenous status and these mental health issues did not persist, except for alcohol use disorder. Conclusion: We found higher prevalence of depressive disorder, alcohol use disorder and suicide risk among indigenous people of French Polynesia and New Caledonia compared to their counterparts. These differences seemed largely explained by socioeconomic disparities. Future studies could explore the use of and access to healthcare by indigenous populations.

Publisher

SAGE Publications

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