All other neighborhoods were defined as “low ethnic density.” Compared with native Dutch, the incidence of psychotic disorders for first and second generation immigrants from Morocco, Surinam, and Turkey living in The Hague was significantly increased in low ethnic density neighborhoods. Immigrant populations in these neighborhoods had psychotic disorders more than two times the rate of immigrants living in high ethnic density neighborhoods. While the findings were consistent for all three ethnic groups, Moroccans had the highest incidence of schizophrenia in both high and low density neighborhoods.

A landmark U.S. study in the 1930s reported higher hospital admission rates for schizophrenia among ethnic minorities who lived in neighborhoods with a low proportion of persons belonging to their own ethnic group. “It now appears they may have been right; it matters where you live,” said Ezra Susser, MD, DrPH, chair of the Department of Epidemiology at the Mailman School of Public Health, and research scientist at the New York State Psychiatric Institute and co-author of the study. “Increasingly, investigators suspected that the social experiences of immigrant groups after migration contribute to their elevated risk. However, until this body of research -- large enough to examine the incidence of psychotic disorders for immigrant groups within a single urban area -- few studies had the data to confirm that increased incidence of psychotic disorders among immigrants depended strongly on neighborhood context,” noted Dr. Susser.

The researchers also adjusted for single marital status, which has been associated with higher rates of schizophrenia, particularly in neighborhoods with fewer single-person households. “Results remained statistically significant, indicating that the ethnic density effect cannot be attributed to a greater probability of single marital status among individuals living in low-ethnic-density neighborhoods,” according to Hans Wijbrand Hoek, MD PhD, adjunct professor of Epidemiology at the Mailman School and senior author.

Neighborhood ethnic density was assessed and investigated at the time of first treatment contact. In future studies, the researchers suggest it might be feasible to collect data on neighborhood context in childhood and adolescence. This approach could be used to determine the developmental period during which neighborhood ethnic density is most important.

The only accredited school of public health in New York City, and among the first in the nation, Columbia University's Mailman School of Public Health provides instruction and research opportunities to more than 1000 graduate students in pursuit of masters and doctoral degrees. Its students and more than 300 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences. www.mailman.hs.columbia.edu

Founded in 1896, the New York State Psychiatric Institute (PI) continues to contribute importantly to knowledge about understanding and treating psychiatric disorder and is ranked among the best psychiatric research facilities in the world today. Noted for its research on depression and suicide, schizophrenia, anxiety and child psychiatric disorders, PI is also at the forefront of research dedicated to unraveling the brain's mysteries. Its scientists constitute the core of the Department of Psychiatry at Columbia University. In 2000, Dr. Eric Kandel was awarded the Nobel Prize in Physiology or Medicine for research in his labs at PI on the cellular basis of memory. www.nyspi.org