Social inequalities in health and mental health in France. The results of a 2010 population-based survey in Paris Metropolitan Area

Abstract

The present study aimed to assess socioeconomic inequalities in general and mental health, depression and substance use disorders (daily tobacco use, hazardous alcohol use). Data from the 2010 SIRS (French acronym for Health, Inequalities, and Social Ruptures) study, which is deemed to be representative of the French-speaking adult population living in the Paris Metropolitan Area, were analysed. Different socioeconomic position indicators were selected: education, income and perceived financial status. Absolute measures (the slope index of inequality (SII)) and relative measures (the odds ratio (OR) and relative index of inequality (RII)) of health inequalities were used. The OR, RII and SII were adjusted for age, household type and migration characteristics and all analyses were performed separately for men and women. The study included 3,006 adults. The results showed significant relative and absolute socioeconomic inequalities in general, mental health and depression for all socioeconomic position indicators considered (education, income, and perceived financial status). The absolute inequalities were greater for women than for men. Strongest inequalities were observed by perceived financial status for men and women. Education seemed to play a stronger role in inequalities for women, whereas, for men, income seemed to play a stronger role. Only few socioeconomic inequalities were found in daily tobacco use, while a reversed gradient was observed for hazardous alcohol use. We hope that these results will be regularly re-evaluated and compared across time in order to monitor socioeconomic inequalities in health.

Socio-economic inequalities in the association between alcohol-use disorder and depressive disorder among Thai adults: a population-based study

“…The higher prevalence of both MDE and AUD among those in the lowest SES group could lend support to this nding. This is consistent with other studies which showed that people who have a low SES and are experiencing a greater social disadvantage generally suffer poor health outcomes, including depressive and substance use disorders, have more disabilities, and poorer access to health care [9,10,17,19,38,41,42]. Whether the strong association between depressive episode and harmful-dependent drinking in the high and low SES groups is driven by a high accessibility to alcohol in the high SES group or an enhanced susceptibility to negative health outcomes when exposed to chronic di culties among the low SES group is plausible and deserves further research to elucidate mechanisms explaining this social disparity.…”

“…We also found a signi cant association of MDE with either hazardous or harmful-dependent drinking in those with a secondary school or higher level of education but not in those with a primary school level of education, and a higher AOR among those living in urban areas compared to those living in rural areas. Inequalities in the prevalence of MDE and AUD between levels of wealth index, education, employment, and area of residence were also found, which supports studies investigating social inequalities in mental health conditions within a country [11,13,19,38].…”

Socio-economic inequalities in the association between alcohol-use disorder and depressive disorder among Thai adults: a population-based study

“…The higher prevalence of both MDE and AUD among those in the lowest SES group could lend support to this nding. This is consistent with other studies which showed that people who have a low SES and experiencing greater social disadvantage generally suffer poor health outcomes, including depressive and substance use disorders, have more disabilities, and poorer access to health care [8,10,11,15,34,38,39]. On the other hand, people in the highest SES group may have more means to access alcohol or other drugs for selfmedication when they get depressed.…”

“…We also found a signi cant association of MDE with harmful-dependent drinking in those with a secondary school or higher level of education but not in those with a primary school level of education, and a higher AOR among those living in urban areas compared to those living in rural areas. Inequalities in the prevalence of MDE and AUD between levels of wealth index, education, employment, and area of residence were also found, which supports studies investigating social inequalities in mental health conditions within a country [8,19,34,35].…”

Socio-economic inequalities in the association between alcohol-use disorder and depressive disorder among Thai adults: a population-based study

“…Inequalities in the prevalence of AUD and MDE between levels of wealth index, education, employment and urban vs. rural populations were also found, which supports studies investigating social inequalities in mental health conditions within a country [28,7,15,29].…”