An Examination of the Demographic, Social, and Environmental Predictors of Risk for Schizophrenia in Afro-Caribbean Immigrants Living in the United States

The pioneering work of Ödegaard (1932) was the first to link migration and
schizophrenia by reporting rates in Norwegian immigrants in Minnesota as twice that of
native Minnesotans and of Norwegians in Norway. However, only in recent decades has
an interest in migration and schizophrenia been rekindled as a result of reports of elevated
rates of schizophrenia in Afro-Caribbean immigrants in the United Kingdom in the mid-
1960s (Hutchinson & Haasen, 2004). Later studies reported elevated rates in secondgeneration
Afro-Caribbean immigrants compared to first-generation (Harrison, Owens,
Holton, Neilson, & Boot, 1988).
In the United States, Blacks were diagnosed with schizophrenia 2.4 times more
often than Whites (Olbert, Nagendra, & Buck, 2018). However, mental health researchers
in the United States generally combine all individuals of African descent as African-
Americans. This practice obscures the nuances of culture and ethnicity within the Black
subgroups as well as the immigrant status of Afro-Caribbeans. This research focused on the Afro-Caribbean immigrants and factors that predict risk for schizophrenia within this
population.
The process of migration is a complex enterprise that produces stressors and
challenges, the effects of which are multifaceted. The social and environmental forces
that parallel the process of migration may predispose individuals to severe psychiatric
disorders such as schizophrenia. Socio-political dynamics in the host country that
marginalize others of different cultural and/or racial persuasions can compound the
negative effects of post-migration. Therefore, migration is considered a social
determinant of health.
Empirical evidence has substantiated that socio-environmental factors such as
urbanicity, discrimination or socio-economic deprivation, social support, and goal
striving stress are potential contributing factors to the development of psychotic disorders
in immigrants. Moreover, evidence has supported that the darker the skin color of the
immigrant the greater the risk (Cantor-Graae, 2007). The findings of this study confirmed
that for Afro-Caribbean immigrants stressors in the post-migration phase such as
discrimination, limited social support, and economic hardship that can be compounded by
the number of dependent children were identified as possible predictors of risk for
schizophrenia. This risk increased with length of residency and continued into the
second-generation.