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Current research identifies gender, age, and ethnic patterns for the healthy immigrant effect related to mental health, but little research explores what determines immigrants’ mental health and how mental health deterioration occurs. This dissertation investigates the ‘what’ and the ‘how’ questions by applying the Social Determinants of Health (SDOH) Perspective and the Stress Process Model. To answer the ‘what’ question, this dissertation draws on the SDOH framework to examine potential social determinants—in the form of structural conditions, behavioral risks and psychosocial demands—affecting long-term immigrants’ lower mental health status. To approach the ‘how’ question, it employs the Stress Process Model to investigate the differential exposure to behavioral risks and psychosocial demands between recent and long-term immigrants. The analysis of the data from the Canadian Community Health Survey-Mental Health 2012 and the General Social Survey-Social Identity 2013 indicates that structural conditions, behavioral risks, and psychosocial demands co-influence immigrants' mental health to some extent. Behavioral risks have independent contributions to mental health, but the contributions are small. Psychosocial resources and demands, however, have the greatest impact on mental health. An examination of the relationships between length of migration and psychosocial resources indicates that, compared to recent immigrants, long-term immigrants are in the state of 'high support and high strain,’ and the differences in these psychosocial resources and demands translate into mental health differences (the so-called healthy immigrant effect) between long-term and recent immigrants. / Thesis / Doctor of Philosophy (PhD)

Extensive research documents the deleterious effects of being victimized by peers on adolescents’ mental health. In contrast, the impact of peer victimization on physical health remains largely unexplored. Studies suggest that peer victimization is a salient interpersonal stressor for adolescents that interferes with discrete aspects of physical health. However, past studies typically collapse the various forms of victimization together (i.e., physical, relational); examine single health indicators; and fail to test the effects of victimization prospectively. A limited understanding of the nature and course of physical health across adolescence and young adulthood also hinders the existent research. The present study tests the structure, stability, and patterns of change in a multidimensional model of physical health among a large, representative sample of young people across a six-year period and four waves of data. It then examines the concurrent and prospective associations between physical and relational victimization and physical health outcomes (physical symptoms, subjective well-being, health-risk behaviours, and health-promoting behaviours) across adolescence and young adulthood. Data from the Healthy Youth Survey (HYS) were collected four times between 2003 and 2009. Participants were 662 young people (aged 12 to 18 years at Time [T] 1; 342 girls). By T4, participants were 18 to 25 (n = 459). Age at T1 and SES were covariates, and models compared effects for males and females. Latent growth curve modeling was performed. Confirmatory Factor Analysis supported the structure of five distinct health outcomes that were invariant over time and by sex. Univariate latent growth curve modeling established linear patterns of change in each health outcome across time. Peer victimization was examined as a time-varying covariate of health, whereby the repeated victimization measures predicted concurrent and longitudinal health outcomes over and above the average growth trajectory of that outcome. Each time-varying covariate model fit the data well. As expected, physical and relational victimization were associated with poorer physical health both within and across time; however, effects varied by victimization type, by sex, and by health outcome. Relational and physical victimization were associated with more concurrent physical symptoms, but only relational victimization predicted more symptoms at subsequent time points. Relational and physical victimization predicted poorer subjective health and fitness within and across time. Physical victimization was associated with poorer nutrition for the whole sample. Findings suggest that peer victimization puts adolescents at risk of several immediate and long-term physical health difficulties. This study highlights the unique effects of physical and relational victimization and that males and females respond differently to victimization experiences. / Graduate / 0622 / 0620 / ahager23@uvic.ca