The Social Determinants of Mental Health: An Overview and Call to Action

Abstract

Mental disorders are among the most prevalent, chronic, and disabling health conditions; they touch the lives of all Americans in some way.1 Although these disorders clearly have biological correlates, they are also substantially influenced by modifiable social, economic, and environmental conditions that affect not only individuals, but whole communities, neighborhoods, and populations. Historically, many theories have been postulated to help explain the origins of disease. During the 19th century, miasma theory attributed the causes of disease epidemics to “bad air” and led to a focus on public health interventions to improve living conditions of populations as a means of effectively limiting the incidence and prevalence of disease.2 This theory, although later supplanted by the germ theory of disease, was one of the earliest conceptualizations supporting the role of social factors in causing and sustaining illnesses. Furthermore, miasma theory led to important public health interventions, such as urban sanitation Ruth Shim, MD, MPH, is Associate Professor, Department of Psychiatry and Behavioral Sciences; Associate Director, National Center for Primary Care, Morehouse School of Medicine. Carol Koplan, MD, is Adjunct Assistant Professor, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University. Frederick J.P. Langheim, MD, PhD, is Joint Director, Consultation and Liaison Psychiatry, St. Mary’s Hospital; Staff Psychiatrist, Dean Health System; Clinical Adjunct Assistant Professor, University of Wisconsin, Madison. Marc W. Manseau, MD, MPH, is Public Psychiatry Fellow, Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute. Rebecca A. Powers, MD, MPH, is Adjunct Clinical Associate Professor of Psychiatry, Stanford University School of Medicine. Michael T. Compton, MD, MPH, is Chairman, Department of Psychiatry, Lenox Hill Hospital; Professor, Department of Psychiatry, Hofstra North Shore – LIJ School of Medicine at Hofstra University. Address correspondence to: Ruth Shim, MD, MPH, National Center for Primary Care, Morehouse School of Medicine, 720 Westview Drive, Atlanta, GA 30310; email: rshim@msm. edu. Disclosure: The authors have no relevant financial relationships to disclose. doi: 10.3928/00485713-20140108-04 The Social Determinants of Mental Health: An Overview and Call to Action