Inequalities in Psychiatric Morbidity in Hong Kong and Strategies for Mitigation

Abstract

This study explores the social gradient of psychiatric morbidity. The Hong Kong Mental Morbidity Survey (HKMMS), consisting of 5719 Chinese adults aged 16 to 75 years, was used. The Chinese version of the Revised Clinical Interview Schedule (CIS-R) was employed for psychiatric assessment of common mental disorders (CMD). People with a less advantaged socioeconomic position (lower education, lower household income, unemployment, small living area and public rental housing) had a higher prevalence of depression and anxiety disorder. People with lower incomes had worse physical health (OR 2.01, 95% CI 1.05–3.82) and greater odds of having CMD in the presence of a family history of psychiatric illnesses (OR 1.67, 95% CI 1.18–2.36). Unemployment also had a greater impact for those in lower-income groups (OR 2.67; 95% CI 1.85–3.85), whereas no significant association was observed in high-income groups (OR 0.56; 95% CI 0.14–2.17). Mitigating strategies in terms of services and social support should target socially disadvantaged groups with a high risk of psychiatric morbidity. Such strategies include collaboration among government, civil society and business sectors in harnessing community resources.

Psychiatric Morbidity Among Older Hospitalized Patients

“…The majority of our subjects came from rural areas (60.6%), had completed secondary education (51.5%), and had a lower socioeconomic status–nearly half (47.4%) had monthly incomes ranging from 300-599 BAM, and almost a quarter (24.3%) had no income at all. Studies suggest increased psychiatric morbidity in individuals in unfavorable socioeconomic positions ( 14 , 15 ). More than a third of the subjects (38.3%) lived with their spouse, about a quarter (25.3%) lived alone, and close to a fifth (18.8%) lived with their spouse and their own children.…”

Adaptação transcultural e evidências de validade psicométricas da Family Health Scale para o português brasileiro

“…Sobre o acesso aos recursos de saúde e apoios externos, evidências apontam que baixos recursos familiares aumentam as chances de problemas mentais e estresse 24 , 25 . Além disso, a privação de cuidados em saúde, alimentação, vestuário, transporte, moradia e outros determinantes sociais de saúde está atrelada a uma pior saúde física e mental 26 , 27 . Crescer em circunstâncias socioeconômicas desvantajosas pode iniciar uma cadeia de risco ao predispor as pessoas a perfis de comportamento de saúde associados a uma pior qualidade de vida na velhice 28 .…”

Monitoring socioeconomic inequalities in health in Hong Kong: insights and lessons from the UK and Australia

“…A number of indicators of health and the social determinants of health deserve to be routinely collected for health inequality monitoring, including but not limited to the type and number of chronic diseases; health behaviours; healthcare access; mental health and social support; dependency in self-care; being a carer and associated caregiving stress; or even a simple question about unmet health needs. 15 , 16 , 17 , 21 , 71 , 72 , 73 Indicators at different life course stages should continue to be collected by the Department of Health, that have been described in the WHO Handbook: Maternal and child health; childhood vaccinations; provision of school health and school dental health service; and tertiary education health service. 74 Within the workplace, organizations can monitor sickness absences among different category of staff, with a view to inform health promoting management policies.…”

“… 18 Apart from physical health, deterioration in mental and social support has been observed especially over the past years following the massive anti-extradition bill social movement and the on-going COVID-19 pandemic, 19 , 20 with a greater extent of deterioration among the socioeconomically disadvantaged groups. 20 , 21 , 22 , 23 , 24 , 25 Nonetheless, despite the recent evidence in the academic field, the awareness and appreciation of this phenomenon as a matter of social injustice by the general public and policymakers remain relatively low in Hong Kong.…”