Is social inequality associated with more mental morbidity? Social psych and epi: Feb.2013


Social class and standard of living are strongly associated with the prevalence of mental disorders.Lower  social class/socio economic status is shown to be independently associated with higher mental morbidity. Among the usual class indicators, (i.e.  income , occupation and education), some research suggest income as a fundamental determinant of this inverse association.Individuals living in disadvantaged areas show more mental health related morbidity and mortality.  Those with less education generally tend to have more morbidity.Comparing different countries in terms of mental health and social inequalities provide another  opportunity to revisit these associations.

Alejandra Pinto-Meza and colleagues examine the relationship between social inequalities and mental health using the general population survey data from 10 European Countries (World Mental Health Survey: Belgium, France, Germany, Italy, The Netherlands, and Spain,Bulgaria, Northern Ireland, Portugal and Romania from Europe, 2001-2009). Individuals were interviewed using CIDI by trained lay interviewers.The overall weighted response rate was 63.4 %.


( prevalence of 12 month mental disorders)

1. Women showed higher prevalences of 12-month mood, anxiety and any 12-month mental disorders.  Mental disorders were more prevalent among those separated/widowed/divorced .

2. Those with higher education showed higher prevalences of  mental disorders except for mood disorders.Mood disorders were more prevalent among those with lower education.

3. Unemployed/disabled showed the highest prevalences of mental disorders.

4.  Mood disorders were more prevalent among those receiving a low and a low-average income. However, after adjusting for all the other factors, no significant association between income and mental disorders was seen.

5. Compared with those living in large urban areas, those living in small (\10,000 inhabitants) and medium (10,000–99,999 inhabitants) areas had a lower risk of mood disorders.

Income is an expression of several variables (education, gender, age, employment etc) and this study did not find an association between income and the presence of mental disorders when these factors  were considered. However, the data in general support previous findings regarding social inequalities in the prevalence of mental disorders.

Summary of the article:

Social inequalities in mental healthresults from the EU contribution to the World Mental Health Surveys Initiative.

Pinto-Meza A, Moneta MV, Alonso J, Angermeyer MC, Bruffaerts R, Caldas de Almeida JM, de Girolamo G, de Graaf R, Florescu S, Kovess Masfety V, O’Neill S, Vassilev S, Haro JM. Soc Psychiatry Psychiatr Epidemiol. 2013 Feb;48(2):173-81

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