Abstract
We examine epidemiological evidence for the central role of inequalities (principally economic) in driving the onset of mental disorders, physical ill health and premature mortality. We locate the search for solutions in current UK contexts, and include known and likely effects of the COVID-19 pandemic. Prevention of mental disorders and adverse outcomes such as premature mortality must begin with efforts to mitigate rising poverty-inequality.
Highlights
We examine epidemiological evidence for the central role of inequalities in driving the onset of mental disorders, physical ill health and premature mortality
Prevention of mental disorders and adverse outcomes such as premature mortality must begin with efforts to mitigate rising poverty-inequality
Even if we receive the longpromised extra funding to treat people with mental disorders across their lifespan, our recent gains with #ChoosePsychiatry will not deliver the numbers of psychiatrists we will need, let alone the nurses and other health and social care professionals
Summary
Many would begin with adverse childhood experiences (ACEs). The original concept arose from a prospective study of childhood obesity,[4] but their wider predictive value merits study. Marteau and colleagues[10] studied the UK government’s ambitions to reverse this rising mortality: ‘the leading causes of years of life lost in England are tobacco use, unhealthy diet, alcohol consumption, and physical inactivity All of these behaviours are socioeconomically patterned’. The US and the UK have similar high levels of inequality, and their inhabitants can expect to lose 7–9 healthy years (free from physical disability) by the age of 50 if they are poor, compared with their fellow citizens at the least deprived end of the gradient.[12] All the evidence points to poor mental health, from common mental disorders through to SMI, as the means whereby poverty wrecks physical health
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