When Shervin Assari first came to the U.S. in 2010 as an international student, he was struck by the country’s demographic diversity. Since then, Assari, who holds an MD as well as an MPH (’11) from SPH and is a former postdoctoral fellow at the U-M Center for Research, Ethnicity and Health, has carved out a research niche for himself by comparing perceptions of health and well-being among residents of more than a dozen different countries. Now a faculty member in the U-M Department of Psychiatry, Assari is chiefly interested in how cultural and social contexts, notably socioeconomic status, affect health—with a particular focus on chronic medical conditions, including depression.
His findings are illuminating. In the U.S., for example, income is a far more significant determinant of both chronic disease and perception of well-being than in poorer countries. In most countries in the world, women report worse perceived health and well-being than men. But whereas in Costa Rica, Argentina, Barbados, Cuba, Uruguay, and Puerto Rico, existing medical conditions explain the gender disparity, in other countries medical conditions do not. Overall, says Assari, “my research suggests that the social determinants of health work differently across different populations, and that who we are and where we live shape both our vulnerability and our resilience.”
Siobán Harlow, professor of epidemiology and director of the U-M Center for Midlife Science, has launched a new BioMed Central journal, Women’s Midlife Health, featuring articles and reviews on the physical and mental health of women during midlife, with a focus on aging, reproductive aging (including menopause), and their interrelationship. The journal is interdisciplinary and open-access.
Findings from Qatar and Lebanon
Students at select universities in Qatar and Lebanon appear to have a higher prevalence of mental health issues—including depression and anxiety—than students at U.S. universities, according to early findings in a study by Qatar-based psychiatrist Ziad Kronfol and SPH Professor Daniel Eisenberg. Eisenberg, who also directs the U-M Healthy Minds Study, says he and his colleagues don’t yet know how to interpret their findings, but it’s possible that stigma, which can affect a young person’s decision to seek help for mental health issues, is a factor. Proximity to conflict in the Middle East may also be a factor. Cross-comparison global studies of mental health can be revealing, Eisenberg says, particularly in assessing the impact of changing attitudes and treatment options. He soon hopes to expand his work on the mental health of young people to include studies in China.
International Student Health
Nearly one million international students study in U.S. colleges and universities, more than in any other country in the world. (U-M is among the top 15 schools nationwide in terms of international student enrollment.) International students face a number of unique challenges, including cultural adjustments, which create an increased risk for depression, anxiety, and other mental health problems.
According to data from the Healthy Minds Study, an annual national mental health survey run out of U-M SPH, 44.4 percent of international students in the U.S. screen positive for mental health problems (versus 41.9 percent of U.S. students). The most glaring difference between international and U.S. students is in mental health service utilization: just 28.3 percent of international students with significant symptoms receive mental health treatment, as compared to 44.9 percent of U.S. students. Levels of stigma surrounding mental illness are much higher among international students. Nearly 30 percent indicate that they would “think less of a person who has received mental health treatment,” as compared to just 6.9 percent of U.S. students.
These findings raise important questions for policymakers and postsecondary institutions, about whether and how to invest more in mental health services and programs to support large and growing populations of international students at U.S. colleges and universities.
—Sarah Ketchen Lipson