The association of traumatic experiences, perceived discrimination and affective symptoms with substance use among Russian and Kurdish migrants in Finland: a population-based study
There is lack of consistent evidence on the associations between substance use and psychosocial risk factors among migrants. Especially traumatic events, perceived discrimination and current mental health problems have rarely been examined as psychosocial risk factors affecting substance use habits of migrant populations.
We examine whether pre-migration potentially traumatic experiences (PTEs), post-migration perceived discrimination (PD) and current affective symptoms are associated with substance use among migrants with voluntary (Russians) and forced (Kurds) migration backgrounds.
Cross-sectional interview and health examination data from the Finnish Migrant Health and Wellbeing Study (Maamu, n=1307) were used. The sample was drawn from the national population register using stratified random sampling by participants’ country of birth and native language. The data was collected from six cities in Finland during 2010-2012.
Data on PTEs was available for 53% of the Russian (n=529) and 51% of the Kurdish participants (n=507), on PD for 69% of the Russian (n=685) and 61% of the Kurdish participants (n=613), and on affective symptoms for 46% for Russians (n=457) and 50% for Kurds (n=500). Majority of Kurds had refugee background (75%) while Russians had mainly migrated for other reasons (99%).
The main outcome of the study, substance use, included self-reported binge drinking, daily smoking and lifetime cannabis use. PTEs and PD were self-reported in the interview. Affective symptoms and suicidal ideation were measured using Hopkins Symptom Checklist-25 (HSCL-25). Sociodemographic background and migration-related factors were adjusted for in the multivariate logistic regression analyses.
Among Kurds, PTEs were associated with binge drinking (OR 2.65, 95% CI 1.30-5.42), PD was associated with lifetime cannabis use (OR 3.89, 95% CI 1.38-10.97) also after adjusting for contextual factors. Affective symptoms associated with daily smoking (OR 1.6, 95% CI 1.02-2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6-14.5) among Kurds but not among Russians. Suicidal ideation (OR 2.4 95% CI 1.3-4.3) associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9-17.0) and Kurds (OR 5.5, 95% CI 1.9-15.6). Among Russians PTEs (OR 1.88, 95%CI 1.06-3.33) and PD (OR 1.60, 95%CI 1.01-2.54) were associated with daily smoking, and PTEs associated with lifetime cannabis use (OR 2.17, 95%CI 1.12-4.18), but these associations were somewhat attenuated after adjusting for contextual factors.
Pre-migration traumatic experiences and perceived discrimination in the new country of residence are associated with substance use both among Kurds with forced migration background and Russians with voluntary migration background. Current affective symptoms associated with substance use only among the Kurds. The findings of our study emphasize that substance use needs to be screened in all healthcare and mental healthcare patients regardless of the country of origin, and this cannot be neglected due to presumptions of habits of substance use based on culture. From public health perspective, our results imply the need for raising awareness of the harms of substance use and treatment possibilities among migrants.