Abstract
BACKGROUND: Immigrants and their communities face unique challenges that exacerbate their risk for psychological distress. For long-term immigrants, these challenges may intensify over time, leading to feelings of isolation, frustration, and marginalization, contributing to higher levels of stress. Neighborhood programs that support community-building and connection may be an effective solution, however, evidence to inform such interventions is sparse. The aim of this study was to examine associations between neighborhood characteristics and the levels of psychological distress among long-term California immigrants. METHODS: Using data from the biannual 2021-2022 California Health Interview Survey, we conducted a secondary analysis of responses from 4,595 immigrant participants who had lived in the U.S. for 15 years or longer. The primary outcome was psychological distress, as measured by scores on the Kessler 6 Psychological Distress Scale. We used Wilcoxon rank sum tests and separate simple linear regressions to test unadjusted associations between perceptions of four neighborhood-level characteristics (support, trust, safety, and getting along) and Kessler 6 scores. In a final multivariable linear regression model, we examined associations between all the neighborhood characteristics and Kessler 6 scores while controlling for relevant covariates. RESULTS: In the final fully adjusted model, perceptions of neighborhood trustworthiness (β = -1.13; 95% CI: -1.69, -0.57; P < 0.001), safety (β = -1.62; 95% CI: -2.50, -0.74; P < 0.001), and getting along (β= -0.74; 95% CI: -1.46, -0.03; P < 0.001) were independently and significantly associated with lower psychological distress scores. Perceptions of neighborhood support did not have significant associations in the model. CONCLUSIONS: Characteristics of neighborhood trust, getting along, and safety, are positively associated with lower psychological distress in a sample of long-term California immigrants. Community-driven interventions promoting social connectedness and inclusivity among neighborhood residents while also supporting structures of safety and resource accessibility may promote and sustain well-being among immigrant populations.