Gall-Ojurongbe, Sandra

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.

Aim: This meta-synthesis explores the potential for schizophrenia in at risk Afro-Caribbeans living in the
United States U.S. Background: African Americans are diagnosed with schizophrenia 9 to 32 more than
Caucasians. However, this percentage does not distinguish the percentage of schizophrenia in Afro-
Caribbeans from the Afro-Caribbean population. Extensive studies conducted in the United Kingdom
U.K. reported higher rates of schizophrenia in Caribbean Blacks in Britain when compared to White British citizens. However, there is a paucity of information about schizophrenia in Caribbean Blacks
living in the U.S. Method: A review of literature conducted between 1990 and 2014, using a qualitative
approach, identified four journal articles; the results of which were analyzed with the aid of NVivo
software, using thematic synthesis. Results: The analysis identified six themes; racism and drug use
were themes consistent with those identified in some of the primary studies. However, four new themes
emerged: Effects of migration; disintegration of family; powerlessness and a rush to
diagnose; all were acknowledged as significant factors that may have contributed to the onset of
schizophrenia.Discussion: The themes unveiled by this review exposed a number of complex
sociopolitical and economic factors that can possibly potentiate schizophrenia. However, these studies
were the experiences of Afro-Caribbeans in the U.K. There is a great need for research in the U.S. to
further explore the risk factors for schizophrenia in Afro- Caribbean communities.