Early-life parental income mobility and risk of depression and anxiety in adolescence and young adulthood among non-immigrants and second-generation immigrants

BACKGROUND: Little is known about the association between early-life income mobility patterns and the subsequent risk of depression/anxiety among immigrant populations. Understanding these associations may help identify persistent low income and declining income as potential risk factors for depression and anxiety in immigrant populations. We aimed to investigate whether parental income mobility patterns during childhood are associated with the risk of depression/anxiety during adolescence and young adulthood among non-immigrants and second-generation immigrants, and whether the association differs by immigrants' region of origin. METHODS: Swedish nationwide data on 1,194,015 non-immigrants and 315,793 second-generation immigrants who turned the age of 15 between 2001 and 2020 were used. Income mobility patterns were identified using group-based trajectory modeling based on annual parental income data when the study individuals were aged 0-14. Depression/anxiety was assessed using the National Patient Register (inpatient and outpatient) when the study individuals were aged 15-25. Cox proportional hazard models were used to examine the association between income mobility and depression/anxiety by immigrant status and region of origin. RESULTS: Five income mobility patterns were identified. Persistent low income was more common among second-generation immigrants than non-immigrants (32.2% versus 12.2%). Compared with persistent high income, persistent low income and downward mobility were associated with higher hazards of depression/anxiety in most groups. Associations were generally weaker among second-generation immigrants, particularly in those from the Middle East or North Africa (MENA). For persistent low income, adjusted hazard ratios (95% Cis) were 2.35 (2.27-2.43) and 2.23 (2.17-2.29) among non-immigrant males and females, versus 1.28 (0.98-1.66) and 1.29 (1.05-1.58) among their MENA counterparts. Among most second-generation immigrant groups, elevated hazards associated with persistent low income were attenuated or absent with upward low-middle mobility. CONCLUSIONS: The association between childhood economic disadvantage and later depression/anxiety varied by immigrant background, with weaker relative risks among second-generation immigrants from MENA. Upward mobility from low to middle income was associated with attenuated risk compared to persistent low income and downward mobility among most second-generation immigrant groups, suggesting that a change of childhood economic circumstances may be relevant to later mental health.