Open Access Research article

Psychosocial factors and distress: a comparison between ethnic Norwegians and ethnic Pakistanis in Oslo, Norway

Hammad Raza Syed12*, Odd Steffen Dalgard3, Ingvild Dalen4, Bjørgulf Claussen1, Akthar Hussain1, Randi Selmer5 and Nora Ahlberg2

Author Affiliations

1 Department of International Health, Institute of General Practice and Community Medicine, University of Oslo, Norway

2 National Centre for Minority Health Research, (NAKMI), Ullevaal University Hospital, Oslo, Norway

3 Department of Mental Health, Norwegian Institute of Public Health, Oslo, Norway

4 Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway

5 Department of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway

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BMC Public Health 2006, 6:182  doi:10.1186/1471-2458-6-182

Published: 10 July 2006



In the Norwegian context, higher mental distress has been reported for the non-Western immigrants compared to the ethnic Norwegians and Western immigrants. This high level of distress is often related to different socio-economic conditions in this group. No efforts have been made earlier to observe the impact of changed psychosocial conditions on the state of mental distress of these immigrant communities due to the migration process. Therefore, the objective of the study was to investigate the association between psychological distress and psychosocial factors among Pakistani immigrants and ethnic Norwegians in Oslo, and to investigate to what extent differences in mental health could be explained by psychosocial and socioeconomic conditions.


Data was collected from questionnaires as a part of the Oslo Health Study 2000–2001. 13581 Norwegian born (attendance rate 46%) and 339 ethnic Pakistanis (attendance rate 38%) in the selected age groups participated. A 10-item version of Hopkins Symptom Checklist (HSCL) was used as a measure of psychological distress.


Pakistanis reported less education and lower employment rate than Norwegians (p < 0.005). The Pakistani immigrants also reported higher distress, mean HSCL score 1.53(1.48–1.59), compared to the ethnic Norwegians, HSCL score 1.30(1.29–1.30). The groups differed significantly (p < 0.005) with respect to social support and feeling of powerlessness, the Pakistanis reporting less support and more powerlessness. The expected difference in mean distress was reduced from 0.23 (0.19–0.29) to 0.07 (0.01–0.12) and 0.12 (0.07–0.18) when adjusted for socioeconomic and social support variables respectively. Adjusting for all these variables simultaneously, the difference in the distress level between the two groups was eliminated


Poor social support and economic conditions are important mediators of mental health among immigrants. The public health recommendations/interventions should deal with both the economic conditions and social support system of immigrant communities simultaneously.