Inequalities in mental health and well-being in a time of austerity: Baseline findings from the Stockton-on-Tees cohort study

Abstract

Since 2010, the UK has pursued a policy of austerity characterised by public spending cuts and welfare changes. There has been speculation – but little actual research – about the effects of this policy on health inequalities. This paper reports on a case study of local health inequalities in the local authority of Stockton-on-Tees in the North East of England, an area characterised by high spatial and socio-economic inequalities. The paper presents baseline findings from a prospective cohort study of inequalities in mental health and mental wellbeing between the most and least deprived areas of Stockton-on-Tees. This is the first quantitative study to explore local mental health inequalities during the current period of austerity and the first UK study to empirically examine the relative contributions of material, psychosocial and behavioural determinants in explaining the gap. Using a stratified random sampling technique, the data was analysed using multi-level models that explore the gap in mental health and wellbeing between people from the most and least deprived areas of the local authority, and the relative contributions of material, psychosocial and behavioural factors to this gap. The main findings indicate that there is a significant gap in mental health between the two areas, and that material and psychosocial factors appear to underpin this gap. The findings are discussed in relation to the context of the continuing programme of welfare changes and public spending cuts in the UK.

Geographical inequalities in health in a time of austerity: Baseline findings from the Stockton-on-Tees cohort study

“…Contribution of behavioural factors towards health inequality gap was relatively lower for all three health outcomes compared to material and contextual factors. In our linked study, Mattheys et al (2016) found a similar relationship for inequalities in mental health outcomes.…”

“…Using eight questions that focus on the health status of the participants during the last four weeks, SF8 produces two health scores: physical health score (SF8-PCS) and mental health score (SF8-MCS) (Warren et al, 2014). However, in this paper, the analysis is limited to SF8-PCS only and our linked study has used the SF8-MCS (see Mattheys et al (2016)). The scores for this measure ranges between 0 and 100: the higher the score, better is the physical health state.…”

Inequalities in mental health and well-being in a time of austerity: Follow-up findings from the Stockton-on-Tees cohort study

“…There are similarly stark inequalities in mental health with, for example, suicide and self-harm rates considerably higher in the most deprived neighbourhoods ( Cairns, Graham, & Bambra, 2017 ). Baseline analysis of the Stockton-on-Tess cohort also found a significant gap in mental health and wellbeing between the most and least deprived areas ( Bambra, 2011 , Beckfield and Bambra, 2016 , Mattheys et al, 2016 , Farrants et al, 2016 ).…”

“…Consumption of high amounts of alcohol appears to be a particular risk factor for mental ill health – whilst other behavioural factors such as smoking have a more nuanced relationship ( WHO and Calouste Foundation 2014 ). The baseline analysis of the Stockton-on-Tess cohort found material and psychosocial factors to be the most important determinants of inequalities in mental health ( Bambra, 2011 , Bambra et al, 2015 , Beckfield and Bambra, 2016 , Mattheys et al, 2016 ).…”

Social determinants of emotional well-being in new refugees in the UK

“…Importantly, the dynamic social and political climate of a country of asylum, can impact on refugee well-being. The roll out of austerity measures in the UK since 2010, has resulted in several public funding and welfare cuts 37 . State weekly support to asylum seekers has been reduced to £36.95 per single adult or child 38 , refugee services such as the Refugee Council have suffered funding cuts of 61.7% 39 and cuts have impacted several other refugee community organisations 40 .…”