Socioeconomic Inequalities In Mental Health Research Articles

Socioeconomic mental health disparities and income mobility in Australia: A longitudinal factor decomposition analysis

In recent years mental health disparity has been rising in Australia. The contributing factors to this rising disparity are not well understood. We investigated this by measuring and decomposing socioeconomic mental health inequality in Australia using the Household, Income and Labour Dynamics in Australia (HILDA) panel survey datasets between 2009 and 2017 employing the longitudinal factor decomposition method. In this research, we decompose the Income-Related Health Mobility (IRHM) and the Health-Related Income Mobility (HRIM) index. The IRHM index reflects the effect of the relationship between relative health changes at a constant income level, and the HRIM index represents changes in income ranking or income mobility with a fixed health outcome over time. Our findings suggest that poorer individuals cannot procure private health insurance, experience more long-term health conditions and have larger exposure to life shocks than richer individuals. Thus, long-term health conditions, private health insurance coverage, and number of life disruptions are the primary factors that negatively impact the IRHM index, thereby contributing to an increase in socioeconomic inequality in mental health in Australia. Moreover, the HRIM index exhibits a more pronounced adverse impact from labour force status compared to the relatively weaker positive effects observed in the IRHM index, resulting in a net negative effect from labour force status in this period. To address this, Australian governments should focus on implementing cost-effective intervention policies targeting disadvantaged populations to maximise health system resources and minimise mental health disparity by addressing the socioeconomic determinants of mental health.

Socioeconomic inequalities in child and adolescent mental health in Australia: the role of parenting style and parents' relationships.

Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. This study utilized data from the Longitudinal Study of Australian Children (Waves 1-7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population.

Neighbourhood characteristics and socioeconomic inequalities in child mental health: Cross-sectional and longitudinal findings from the Growing Up in Ireland study

This study examined the role of neighbourhood characteristics in explaining socioeconomic inequalities in child mental health (the total difficulties score from the Strengths and Difficulties Questionnaire) using data from Cohort ’08 of Growing Up in Ireland Waves 3 (age 5; baseline) and 5 (age 9; follow-up). Twenty neighbourhood items were grouped into neighbourhood safety, built environments, cohesion, interaction, and disorder. Data were analysed using regression, single and multiple mediation, and network psychometric analyses. We found that neighbourhood safety, cohesion, interaction, and disorder were associated with child mental health. These four domains separately (by up to 18 %) or in concert (by up to 23 %) partially explained socioeconomic inequalities in child mental health. Built environments may explain socioeconomic inequalities in mental health in urban children only. Findings from network analysis indicated that specific concerns over “people being drunk or taking drugs in public” and “this is a safe neighbourhood” had the strongest connections with child mental health. Improving neighbourhood characteristics may be important to reduce socioeconomic inequalities in child mental health in Ireland.

The relation between economic stressors and higher education students' mental health during the initial outbreak of the COVID-19 pandemic.

The COVID-19 pandemic has had a large impact on the financial situation of higher education students, disproportionately affecting students with a low socioeconomic status (SES). This raises the question of whether economic stressors related to COVID-19 have aggravated existing socioeconomic inequalities in mental health. This study examined the relationship between economic stressors and students' depressive symptoms, and the role of students' SES and countries' socioeconomic conditions. Data from the COVID-19 International Student Well-being Study was used for multilevel analyses, with depressive symptoms as dependent variable. Three indicators measured SES: educational level of the parents, ability to borrow money from their social network, and struggling with financial resources prior to COVID-19. Students with a low SES had more depressive symptoms, and those not able to borrow money and with parents without higher education were more exposed to a deterioration in their financial situation. Both economic stressors (reduction in working hours and a deterioration of their financial situation) were positively related to depressive symptoms. In addition, the positive relationship between a decrease in working hours and depressive symptoms was stronger in countries with a higher unemployment rate. We observed socioeconomic inequalities in students' mental health, which, in part, can be ascribed to a larger exposure to the economic stressors related to COVID-19 among students' with a low SES. The macroeconomic context also played a role, as the impact of a reduction in working hours on depressive symptoms was stronger in countries with poor economic conditions.

Mental health inequalities during the second COVID-19 wave among Millennials who grew up in England: Evidence from the Next Steps cohort study

BackgroundThere is relatively little evidence on socioeconomic inequalities in mental health among young adults after the end of the first COVID-19 wave in the UK, despite this group having faced the worse mental health and economic shocks across age groups at the start of the pandemic. MethodsWe examined differences in mental health across two points - September 2020 and February 2021 - in a cohort of 4167 Millennials aged 30–31 using life dissatisfaction, psychological distress (GHQ-12), anxiety (GAD-2), and depressive symptoms (PHQ-2). We report adjusted prevalence ratios (aPR) from random-intercept models, testing differences by educational attainment and time-varying conditions (relationship status, living arrangements with adults and children, work status, and financial changes compared with before the outbreak), adjusting for baseline covariates at ages 13–14 and health covariates at ages 25–26. ResultsOnly dissatisfaction with life changed between time points (PR = 1.26, 95%CI 1.02–1.55). Educational attainment was not significantly associated with mental health. Being single (aPRs from 1.36 to 1.89) and being financially worse off since the start of the pandemic (aPRs from 1.58 to 1.76) were each associated with worse mental health. These associations did not further vary by educational attainment. ConclusionAmong Millennials who grew up in England, educational attainment was not associated with mental health whereas negative social and financial conditions were associated with worse mental health during the second COVID-19 wave. Mental health inequalities in this generation are likely to have continued increasing after the end of the first COVID-19 wave.

Socio-economic inequalities in mental health: a new framework and analysis across 113 countries

Abstract Background Socio-economic inequalities in common mental health disorders (CMDs) cut across each step in the cascade of care: (1) Less affluent individuals have a higher prevalence of CMDs, (2) are less likely to utilise treatment and (3) might benefit less from treatment when they do receive it. Here, we propose a new framework for distinguishing between these three types of inequalities in CMDs and test if such ‘triple inequalities’ exist globally and how they vary across countries. Methods We use the Wellcome Global Monitor 2020 (N = 119,088 in 113 countries) to test if socio-economic factors, psychological factors (stigma and trust) and country-level factors (GDP, GINI and health expenditure) predict CMD lifetime prevalence, utilisation and perceived helpfulness of talking therapy and medication. Multi-level logistic regression models were used. Results As predicted, people with higher household income are less likely to experience anxiety or depression (OR = 0.90 for each income quintile, p < 0.01), more likely to talk to a mental health professional (OR = 1.05; OR = 1.34 for higher education, p < 0.01) and more likely rate this treatment as very helpful (OR = 1.06, p = 0.02) across countries. In contrast, income is not linked with utilisation (OR = 0.99, p = 0.18) and helpfulness of ‘taking medication’ for CMDs (OR = 1.02, p = 0.26). In LMICs, the highly educated take less medication (OR = 0.74, p < 0.01). Local stigma reduces utilisation (OR = 0.95) and helpfulness of talking therapy (OR = 0.77), while trust in health practitioners increases both (OR = 1.07 util. and OR = 1.31 helpf., p < 0.01 in all cases). Conclusions Three types of socio-economic inequalities for CMDs (in prevalence, talking therapy utilisation and helpfulness) deepen disadvantages for the less affluent across 113 countries. For pharmacological treatment, inequalities in utilisation and helpfulness are weaker and have a different social gradient in LMICs. Here, less educated people are more likely to take medication. Key messages • Three types of socio-economic inequalities in common mental health disorders (in prevalence, talking therapy utilisation and helpfulness) exacerbate disadvantages for less affluent individuals. • These Inequalities in CMD treatment utilisation and helpfulness are stronger for talking therapies than for medication, and depend on country contexts, stigma and trust in health practitioners.

Neighbourhood greenspace quantity, quality and socioeconomic inequalities in mental health

There is tentative evidence suggesting that socioeconomically disadvantaged groups may benefit more from access to neighbourhood greenspace and therefore could be a lever for narrowing socioeconomic inequalities (‘equigenesis’) in mental health, although studies are equivocal. One potential explanation for this inconsistency is differences in study designs, particularly how greenspace is measured. Most previous studies are from high income countries, and there has been no investigations into equigenic environments in China. Using survey data collected from 26 neighbourhoods in Guangzhou, China, this study examines whether local greenspaces may narrow socioeconomic inequalities in health (i.e. equigenesis) in the Chinese context. The study is the first to explore the contribution of greenspace in reducing socioeconomic inequalities in mental health in the Chinese context. It uses Normalized Difference Vegetation Index (NDVI), Street View Greenness (SVG) and self-reported neighbourhood greenness quality as estimates of residential greenness exposure Results show that SVG-quantity, SVG-quality and self-reported greenspace quality narrow the neighbourhood socioeconomic inequalities in mental health. Our findings demonstrate the importance of improving equity in local green infrastructure for promoting health equity through urban planning and design, including improving access to green spaces, and providing more street trees in socioeconomically disadvantaged neighbourhoods.

Longitudinal evidence on the development of socioeconomic inequalities in mental health due to the COVID-19 pandemic in Norway

The economic and health consequences of the COVID-19 pandemic are unequally distributed. A growing literature finds evidence that those with low socioeconomic status have carried a greater burden in terms of both unemployment and infection risk. Against this background, it is natural to also expect increasing socioeconomic inequalities in mental health. We report from a population-based longitudinal study, assessing the mental health of more than 100,000 Norwegian adults during a period of more than 20 years, and into the COVID-19 pandemic. We find substantial, and equally high, increases in depressive symptoms across socioeconomic status. In addition, we show that the increase was particularly strong among women and those with lower levels of depressive symptoms prior to COVID-19.

The Covid-19 pandemic and its impact on socioeconomic inequality in psychological distress in the United Kingdom: An update.

This paper extends earlier on socioeconomic inequality in mental health, measured by the General Health Questionnaire, to include the second national lockdown up to March 2021.

The Covid-19 Pandemic and its Impact on Socioeconomic Inequality in Psychological Distress in the UK: An Update

This paper extends the earlier work of Davillas and Jones (2021) on socioeconomic inequality in mental health, measured by the General Health Questionnaire (GHQ), to include the second national lockdown up to March 2021.

The Moderating Role of Resilience in the Personality-Mental Health Relationship During the COVID-19 Pandemic.

Background: Associations between personality traits and mental health outcomes (depression, anxiety, loneliness, and stress) have rarely been assessed in a population-representative sample of a high-income country during the COVID-19 pandemic. Additionally, as far as we know, the role of health and social behaviors as well as resilience in the personality-mental health relationship has yet to be explored.Methods: A representative sample of 1,828 residents of Luxembourg filled in validated scales to assess personality traits and resilience, depressive symptoms, generalized anxiety, loneliness, and stress, indicating mental health, in mid-April 2020.Results: Approximately 21% of the participants scored above the cut-off for moderate depression and moderate loneliness. Moderate anxiety and moderate stress were present in 6.2 and 0.3% of the participants, respectively. Higher-educated respondents and those living in higher-value housing reported better mental health. Agreeableness and conscientiousness were most consistently associated with better mental health; neuroticism was most consistently associated with worse mental health. Spending more time on social media was also associated with elevated levels of all four mental health outcomes. Social and health behaviors did not change the personality-mental health relationships. Resilience moderated some of the personality-mental health associations, most consistently in neuroticism.Conclusions: Findings suggest educational and socioeconomic inequalities in mental health in a nationally representative sample during the COVID-19 confinement measures. Personality traits, particularly agreeableness, conscientiousness, and low neuroticism were associated with mental health. The moderating role of resilience in the personality-mental health relationship suggests intervention potential to improve mental health during periods of confinement.

Decomposition and changes in socio-economic inequalities in mental health in Barcelona between 2006 and 2016

Purpose This study aims, firstly, to analyse the contribution of socio-economic determinants to mental health (MH) inequalities before the economic crisis, in 2006, and again in a year during recovery, 2016, and secondly, to analyse the changes in these contributions between the two points in time in Barcelona city. Design/methodology/approach The concentration index (CI) was calculated for MH inequalities for the population aged 16 or older using the Barcelona Health Surveys for 2006 and 2016. MH was measured with the 12-item General Health Questionnaire. The CI was broken down for each year and gender based on a set of socio-economic determinants plus social support and the presence of chronic diseases. The contribution of each factor to variation in MH inequality between the two points in time was analysed with Oaxaca decomposition. Findings Income inequalities in MH increased for men and women (a CI from −0.06 in 2006 to around −0.16 in 2016). Employment status and social class are the main contributors to MH inequalities (more than 50%), except for women in 2006 that is chronic disease. The main contribution to increases in MH inequality between 2006 and 2016 was due to unemployment (26.5% men, 23.8% women), being a student (22.8% men, 20.7% women), homemaker in women (30.7%) and men in the manual class (31.6%). Originality/value MH inequalities have been amplified between the two years among the economically vulnerable population or for those who are out of the labour market with unexpected changes for women.

Mental health in higher education students and non-students: evidence from a nationally representative panel study.

Despite increasing policy focus on mental health provision for higher education students, it is unclear whether they have worse mental health outcomes than their non-student peers. In a nationally-representative UK study spanning 2010–2019 (N = 11,519), 17–24 year olds who attended higher education had lower average psychological distress (GHQ score difference =  − 0.37, 95% CI − 0.60, − 0.08) and lower odds of case-level distress than those who did not (OR = 0.91, 95% CI 0.81, 1.02). Increases in distress between 2010 and 2019 were similar in both groups. Accessible mental health support outside higher education settings is necessary to prevent further widening of socioeconomic inequalities in mental health.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00127-021-02032-w.

Longitudinal relationship of diabetes and depressive symptoms in older adults from Mexico: a secondary data analysis

IntroductionSeveral studies have argued a causal relationship between diabetes and depression, while others have highlighted that their association is a result of common risk factors. Because Mexico is a country...

Socioeconomic Inequalities in Mental Health in Mongolia

Abstract Background Promotion of mental health and well-being is recently recognized as a health priority at the global level. In Mongolia, mental health issues have been on the rise. However, less is known on socioeconomic inequality in mental health in the country. The aim of this study is to examine socioeconomic inequality in mental health in the adult population in Mongolia. Methods This study analyzed the data of 30,567 adults from the Household Socio-Economic Survey, collected in 2012 by the National Statistical Office of Mongolia. Self-reported mental health was used as a health outcome variable. Socioeconomic status was measured by household income. We employed the Wagstaff's concentration index to assess the degree of socioeconomic inequality in mental health. Results The results show that the prevalence of self-reported mental health was 1.17% among the respondents. The adults living in urban areas suffer significantly more with mental illness compared to the adults living in rural settlements. The Wagstaff's concentration index for mental health was significantly negative (-0.243), indicating that mental health problems were concentrated among the lower-income groups. The decomposition results show that education, economic activity status and marital status were the main contributors to socioeconomic inequalities in mental health after removing age-sex related contributions. Conclusions Socioeconomic inequality in mental health exists in the adult population in Mongolia, which was mainly explained by the education level, employment and marital status. Prospective policies are needed to reduce socioeconomic inequality in mental health in the country. Key messages Socioeconomic inequality in mental health exists in Mongolia. It calls for further policy actions.

Socioeconomic inequalities in mental health in Australia: Explaining life shock exposure

BackgroundRecent research suggests that there exists a strong link between life shocks and mental health. However, research on the distributional aspects of these shocks on mental health status is limited. In the health inequality literature no Australian studies have examined this relationship. ObjectiveThis study examines the distributional impact of life shocks (negative life events and financial hardships) on mental health inequality among different socioeconomic groups in a longitudinal setting in Australia. MethodsThis study analysed the data of 13,496 individuals from the Household, Income and Labour Dynamics in Australia (HILDA) survey, waves 12–17 (2012–2017). Using concentration index and Blinder-Oaxaca approaches, the study decomposed socioeconomic inequalities in mental health and changes in inequalities in mental health over the study period. The study used frailty indices to capture the severity of life shocks experienced by an individual. ResultsThe results suggest that exposure to just one life shock will result in a greater risk of mental disorder in the most disadvantaged socioeconomic groups. The results also indicate that 24.7%–40.5% of pro-rich socioeconomic mental health inequality are due to life shocks. Financial hardship shocks contributes to 21.6%–35.4% of inequality compared with 2.3%–5.4% inequality generated by negative life event shocks across waves. ConclusionsLower SES groups experience more life shocks than higher SES groups and in turn generate higher socioeconomic mental health inequality. Policies aimed at reducing socioeconomic inequality in mental health should account for these shocks when designing interventions.

Antidepressant use in over-indebted individuals compared to the general population in Germany

Abstract Background About ten percent of European households across all socioeconomic groups are considered over-indebted due to ongoing difficulties meeting financial commitments and living expenses. Studies found an association between over-indebtedness and physical and mental health such as depression independent of standard socioeconomic status measures. However, antidepressant use in the over-indebted population has been understudied. In view of the substantial economic and social burden of mental illness in Europe, the aim of this study was to examine the association between over-indebtedness and antidepressant use in Germany to advance the understanding of socioeconomic inequalities in mental health. Methods We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017 (OID), and merged data with the first wave of the German Health Interview and Examination Survey (DEGS1) representative of the general population. We used descriptive statistics and multiple logistic regression analysis to examine antidepressant use in the previous 7 days (OID: n = 699; DEGS1: n = 7115). Results Antidepressant use was more frequent in the over-indebted (12.3%) compared to the general population sample (5.0%). After adjustment for age, sex, education, employment, marital status and chronic disease, over-indebted respondents were more likely to use antidepressants than the general population sample (aOR 1.83; 95% CI 1.35-2.48). Conclusions Prevalence of antidepressant use was higher in the over-indebted compared to the general population. The association between over-indebtedness and antidepressant use cannot be fully explained by standard socioeconomic measures. Over-indebtedness reflects a relevant public health issue that needs to be addressed in health care, social policy and research. There is an urgent need to develop public health activities that specifically target those at risk of mental illness and over-indebtedness. Key messages Over-indebtedness is associated with antidepressant use. Public health interventions are needed to prevent adverse health effects of over-indebtedness and safeguard access to care according to need.

Socio-Economic Inequalities in Adolescent Summer Holiday Experiences, and Mental Wellbeing on Return to School: Analysis of the School Health Research Network/Health Behaviour in School-Aged Children Survey in Wales.

The socioeconomic inequalities found in child and adolescent mental wellbeing are increasingly acknowledged. Although interventions increasingly focus on school holidays as a critical period for intervention to reduce inequalities, no studies have modelled the role of summer holiday experiences in explaining socioeconomic inequalities in wellbeing. For this study, we analysed survey data of 103,971 adolescents from 193 secondary schools in Wales, United Kingdom, which included measures of family affluence, experiences during the summer holidays (hunger, loneliness, time with friends and physical activity) and mental wellbeing and internalising symptoms on return to school. Structural equation modelling was used to analyse the data. Although family affluence retained a direct inverse association with student mental wellbeing (r = −0.04, p < 0.001), 65.2% of its association with mental wellbeing was mediated by the experiences over the summer holidays. FAS score was not directly associated with the student’s self-reports of internalising symptoms (r = 0.00, p > 0.05). Of all summer holiday experiences, the strongest mediational pathway was observed for reports of loneliness. Although more structural solutions to poverty remain essential, school holiday interventions may have significant potential for reducing socioeconomic inequalities in mental health and wellbeing on young people’s return to school through reducing loneliness, providing nutritious food and opportunities for social interaction.

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

ObjectiveIt is known that mental health deteriorated following the 2008 global financial crisis, and that subsequent UK austerity policies post-2010 disproportionately impacted women and those in deprived areas. We aimed...

The Burden of Depression in New York City Adults: Results from the 2013-14 NYC Health and Nutrition Examination Survey.

Depression is responsible for a large burden of disability in the USA. We estimated the prevalence of depression in the New York City (NYC) adult population in 2013-14 and examined associations with demographics, health behaviors, and employment status. Data from the 2013-14 New York City Health and Nutrition Examination Survey, a population-based examination study, were analyzed, and 1459 participants met the inclusion criteria for this analysis. We defined current symptomatic depression by a Patient Health Questionnaire (PHQ-9) score ≥ 10. Overall, 8.3% of NYC adults had current symptomatic depression. New Yorkers with current symptomatic depression were significantly more likely to be female, Latino, and unemployed yet not looking for work; they were also significantly more likely to have less than a high school education and to live in a high-poverty neighborhood. Socioeconomic inequalities in mental health persist in NYC and highlight the need for better diagnosis and treatment.