BackgroundAnxiety and depression are common among women during pregnancy and the year after birth. The consequences, both for the women themselves and for their children, can be considerable and last for many years. This study focuses on the economic consequences, aiming to estimate the total costs and health-related quality of life losses over the lifetime of mothers and their children. MethodA pathway or decision modelling approach was employed, based on data from previous studies. Systematic and pragmatic literature reviews were conducted to identify evidence of impacts of perinatal anxiety and depression on mothers and their children. ResultsThe present value of total lifetime costs of perinatal depression (anxiety) was £75,728 (£34,811) per woman with condition. If prevalence estimates were applied the respective cost of perinatal anxiety and depression combined was about £8,500 per woman giving birth; for the United Kingdom, the aggregated costs were £6.6 billion. The majority of the costs related to adverse impacts on children and almost a fifth were borne by the public sector. LimitationsThe method was exploratory in nature, based on a diverse range of literature and encountered important data gaps. ConclusionsFindings suggest the need to allocate more resources to support women with perinatal mental illness. More research is required to understand the type of interventions that can reduce long-term negative effects for both mothers and offspring. Highlights Using modelling techniques, we estimated the lifetime costs of perinatal depression and anxiety reflecting the impact on mothers and children 1 ALSPAC = Avon Longitudinal Study of Parents and Children, ED = Education, HRQoL = Health-related quality of life, HSC = Health and social care, OOP = Out-of-pocket expenditure, NHS = National Health Service, p = probability, PL = Productivity loss, pp. = percentage points, PTB = Pre-term birth, RD = Risk difference, UC = Unpaid care, UK = United Kingdom, wks. = weeks, yrs. = years 2  We found that costs were substantial and that the majority related to the impact on children  There is a need to understand the role of interventions in alleviating symptoms and reducing long-term negative effects for both mothers and offspring.  New costing methods are required for conditions with transgenerational origins and impact.

Background: Studies on the association between income inequality and mental have shown mixed results, probably due to methodological heterogeneity. By dealing with such heterogeneity through a systematic review and meta-analysis, we examine the relationship between income inequality, mental health problems, use of mental health services, and resilience.

The compact city has become a leading concept in the planning of peri-urban areas. The compact city concept is often advocated as 'sustainable', because of claims that include lower emissions and conservation of the countryside. The literature shows, however, that there are certain trade-offs in striving for compaction, especially between environmental and social aspects of sustainability. In this paper, we describe expressions of the compact city concept in the planning practice of several European urban sample regions, as well as policies and developments that contradict the compact city. We look at examples of positive and negative impacts of the compact city that were observed in the sample regions. Further, we discuss attempts by planners to deal with sustainability trade-offs. Being aware that developments in the peri-urban areas are closely connected to those in the inner city, we compare the sample regions in order to learn how the compact city concept has been used in planning peri-urban areas across different contexts in Europe: in Western, Central and Mediterranean Europe, and with growing, stable or declining populations. We conclude with recommendations with respect to balance in applying the compact city concept.

Background Depression in mothers during pregnancy and in the postnatal period has been recognised to have wide-ranging adverse impacts on offspring. Our study examines some of the outcomes and long-term economic implications experienced by offspring who have been exposed to perinatal depression. Method We analysed the effects of perinatal depression on child development outcomes of children at ages 11 and 16 years from a community-based South London Child Development Study. Economic consequences were attached to those outcomes through simple decision-analytic techniques, building on evidence from studies of epidemiology, health-related quality of life, public sector costs and employment. The economic analysis takes a life-course perspective from the viewpoints of public sector, individual and society. Results Additional risks that children exposed to perinatal depression develop emotional, behavioural or cognitive problems ranged from 5% to 21%. In addition, there was a high risk (24%) that children would have special educational needs. We present results in the form of cost consequences attached to adverse child outcomes. For each child exposed to perinatal depression, public sector costs exceeded £3,030, costs due to reduced earnings were £1,400 and health-related quality of life loss was valued at £3,760. Conclusion Action to prevent or treat mothers’ depression during pregnancy and after birth is likely to reduce public sector costs, increase earnings and improve quality of life for children who were exposed to the condition.

Background Perinatal mental health problems, defined as mental health problems occurring from the start of pregnancy to one year after birth, substantially affect women's and children's quality of life in low- and middle-income countries. In South Africa, despite high prevalence and documented negative impacts, most women do not receive any care. Methods A modelling study examined the costs of perinatal mental health problems, namely depression and anxiety, for a hypothetical cohort of women and their children in South Africa over part of their life course (10 years for women, 40 years for children). In sensitivity analysis, additional impacts of post-traumatic stress disorder (PTSD) and completed suicide were included. Data sources were published findings from cohort studies, as well as epidemiological and economic data from South Africa. Data from international studies were considered where no data from South Africa were available. Results Lifetime costs of perinatal depression and anxiety in South Africa amount to USD 2.8 billion per annual cohort of births. If the impacts of PTSD and suicide are included, costs increase to USD 2.9 billion. This includes costs linked to losses in quality of life (USD 1.8 billion), losses in income (USD 1.1 billion) and public sector costs (USD 3.5 million). Conclusions Whilst important progress has been made in South Africa with regards to mental health policies and interventions that include assessment and management of perinatal mental health problems, substantial underinvestment prevents progress. Findings from this study strengthen the economic case for investing in perinatal mental health care.

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IntroductionAlthough cash transfer programmes are not explicitly designed to improve mental health, by reducing poverty and improving the life chances of children and young people, they may also improve their mental health. This systematic review and meta-analysis assessed the evidence on the effectiveness of cash transfers to improve the mental health of children and young people in low-income and middle-income countries.MethodsWe searched Pubmed, EBSCOhost, Scientific Electronic Library Online, ISI Web of Science and Social Sciences Citation Index and grey literature (from January 2000 to July 2020) for studies which quantitatively assessed the impact of cash transfers on mental health in young people (aged 0–24 years), using a design that incorporated a control group. We extracted Cohen’s d effects size and used a random-effects model for the meta-analysis on studies that measured depressive symptoms, I2 statistic and assessment of study quality.ResultsWe identified 12 116 articles for screening, of which 12 were included in the systematic review (covering 13 interventions) and seven in the meta-analysis assessing impact on depressive symptoms specifically. There was high heterogeneity (I2=95.2) and a high risk of bias (0.38, 95% CIs: −5.08 to 5.85; p=0.86) across studies. Eleven interventions (85%) showed a significant positive impact of cash transfers on at least one mental health outcome in children and young people. However, no study found a positive effect on all mental health outcomes examined, and the meta-analysis showed no impact of cash transfers on depressive symptoms (0.02, 95% CIs: −0.19 to 0.23; p=0.85).ConclusionCash transfers may have positive effects on some mental health outcomes for young people, with no negative effects identified. However, there is high heterogeneity across studies, with some interventions showing no effects. Our review highlights how the effect of cash transfers may vary by social and economic context, culture, design, conditionality and mental health outcome.

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