Perceived discrimination at work for being an immigrant: a study on self-perceived mental health status among immigrants in Italy

BACKGROUND: exposure to discrimination is widely understood as a social determinant of psychophysical health and a contributing factor to health inequities among social groups. Few studies exist, particularly in Italy, about the effects of discrimination among immigrants at workplace. OBJECTIVES: to analyse the association between perceived discrimination at work for being an immigrant and mental health status among immigrants in Italy. SETTING AND PARTICIPANTS: a sub-sample of 12,408 immigrants residing in Italy was analysed. MAIN OUTCOME MEASURES: data came from the survey "Social conditions and integration of foreign citizens in Italy", carried out in 2011-2012 by the Italian National Institute of Statistics (Istat). Self-perceived mental health status was measured through mental component summary (MCS) of SF-12 questionnaire, assuming as worse health status MCS score distribution <= 1st quartile. In order to evaluate the probability of poor health status, a multivariate log-binomial model was performed assuming: discrimination at work for being an immigrant as determinant variable; age, gender, educational level, employment status, area of origin, residence in Italy, length of stay in Italy, self-perceived loneliness and satisfaction about life as potential confounding variables. RESULTS: among immigrants, 15.8% referred discrimination at his/her workplace in Italy for being an immigrant. Higher probability of poor mental health status was observed for immigrants who referred discrimination at workplace (Prevalence Rate Ratio - PRR: 1.16) who arrived in Italy since at least 5 years (PRR: 1.14), for not employed subjects (PRR: 1.31), and for people from the Americas (PRR: 1.14). Lower probability of poor mental health status was found in immigrants from Western-Central Asia (PRR: 0.83) and Eastern-Pacific Asia (PRR: 0.79). Compared to immigrants residing in North-Eastern Italy higher probability of worse mental health status was observed in people who resided in Northern-Western (PRR: 1.30), Central (PRR: 1.26), and Southern (PRR: 1.15) Italian regions. CONCLUSIONS: our findings confirm that discrimination at workplace for being an immigrant is a risk factor for self-perceived mental health among immigrants in Italy, suggesting that an overall public health response is essential in addition to work-based interventions. Improving working conditions, promoting organisational strategies to support coping behaviours, and challenging discrimination can improve mental health status of immigrants.