Association between immigration status and anxiety, depression, and use of anxiolytic and antidepressant medications in the Hispanic Community Health Study/Study of Latinos

Purpose: The purpose of this study was to investigate the association between undocumented immigration status and anxiety, depression, and use of anxiolytic or antidepressant medications in the Hispanic Community Health Study/Study of Latinos. Methods: Cross-sectional analysis of data collected between 2014 and 2017. Participants were categorized as U.S.-born citizens, naturalized citizens, documented noncitizens, or undocumented noncitizens. We calculated prevalence and prevalence ratios for anxiety, depression, and use of anxiolytic or antidepressant medication, by immigration status. Results: Of 9257 participants, 1403 (15%) were undocumented noncitizens, 2872 (31%) were documented noncitizens, 3766 (41%) were naturalized citizens, and 1216 (13%) were U.S.-born citizens. Prevalence of anxiety was lower among undocumented than documented noncitizens (9 vs. 15%, P <.0001) but not significantly different in adjusted analyses. Prevalence of depression was similar among undocumented and documented noncitizens (20 vs. 24%, P =.07) and not significantly different in adjusted analyses. Among participants with depression, 7% of undocumented and 27% of documented noncitizens reported use of antidepressants (adjusted prevalence ratio 0.49, 95% CI 0.27–0.87). Conclusions: Undocumented noncitizens had similar likelihood of anxiety and depression, but lower likelihood of antidepressant use, compared with documented noncitizens. These results may reflect the resilience of an undocumented population facing multiple stressors but suggest that this group may be undertreated for depression.