Employment status and income as potential mediators of educational inequalities in population mental health.

Srinivasa Vittal Katikireddi,Frank Popham,Claire L Niedzwiedz

doi:10.1093/eurpub/ckw126

Abstract

We assessed whether educational inequalities in mental health may be mediated by employment status and household income. Poor mental health was assessed using General Health Questionnaire ‘caseness’ in working age adult participants (N = 48 654) of the Health Survey for England (2001–10). Relative indices of inequality by education level were calculated. Substantial inequalities were apparent, with adjustment for employment status and household income markedly reducing their magnitude. Educational inequalities in mental health were attenuated by employment status. Policy responses to economic recession (such as active labour market interventions) might reduce mental health inequalities but longitudinal research is needed to exclude reverse causation.

Highlights

Mental health is socially patterned—the more disadvantaged in society consistently experience poorer outcomes.[1]
High-quality work delivers an income to buy necessities for living, it provides a sense of purpose and order to life, whereas poor mental health may lead to labour market exclusion
Poor mental health varied by employment status; the employed had lower GHQ caseness (10.7%) than those who were out of work due to ill health (50.1%) or unemployment (28.5%)

Summary

Introduction

Mental health is socially patterned—the more disadvantaged in society consistently experience poorer outcomes.[1] Social inequalities in common mental disorders, including anxiety and depression arise, at least in part, as a result of adverse socioeconomic circumstances. Major differences exist between social groups in employment status and its consequences for ill-health[4]; differences in employment status and income could contribute to health inequalities. Both employment status and income may be important potentially modifiable factors along the pathway between education level (a measure of early adulthood socioeconomic position) and later life.

Methods

Results

Conclusion