The interactive role of income (material position) and income rank (psychosocial position) in psychological distress: a 9-year longitudinal study of 30,000 UK parents

Garratt, Elisabeth; Chandola, Tarani; Purdam, Kingsley; Wood, Alex M.

doi:10.1007/s00127-016-1255-y

Cited by 11 publications

(6 citation statements)

References 55 publications

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“…Furthermore, the individuals with low education and manual occupation had a lower prevalence of depressive symptoms than individuals with high education and non-manual occupation. In the other study, by Garratt, the intersectional inequality was estimated as the excess intersectional inequality for psychological distress, which was significant [47]. The result showed an antagonistic effect, meaning that doubly disadvantaged individuals reported better mental health outcomes than expected considering their low income and low income rank separately.…”

Section: Resultsmentioning

confidence: 98%

“…Two studies reported on inequalities in mental health based the intersection of different socioeconomic indicators, one using an absolute measures of inequality [47] and one using a relative [23]. As different socioeconomic indicators, absolute income and income rank were used in one study [47] and education and occupational class were used in the other [23]. In the study by Lundberg et al the intersectional inequality was estimated as the largest difference identified between the four groups which were compared [23].…”

Section: Resultsmentioning

confidence: 99%

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Languishing in the crossroad? A scoping review of intersectional inequalities in mental health

Trygg

Gustafsson

Månsdotter

2019

Int J Equity Health

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The concept of intersectionality has gradually been introduced to health inequality research, adding depth and breadth to the way inequalities in health are approached. We conducted a scoping review with the purpose to systematically map, describe and analyze the literature about intersectional inequalities in mental health. For eligibility, the study had to analyze and report inequality defined by combinations of socioeconomic position, gender, race/ethnicity, sexual orientation or religion. The mental health outcome had to be measured as self-reported symptoms assessed through validated scales, or disorders assessed through diagnostic interviews. The search strategy was applied in two databases and the screening process yielded 20 studies. The interaction of intersectional positions showed no consistent patterns in mental health across studies, but both synergistic and antagonistic effects were observed. In most studies an absolute measure of inequality was used and few studies analyzed factors potentially explaining the intersectional inequalities. Taken together, the findings of this review highlight the value of assessing intersectional inequalities across population groups for priority setting and action on mental health inequalities. Electronic supplementary material The online version of this article (10.1186/s12939-019-1012-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Languishing in the crossroad? A scoping review of intersectional inequalities in mental health

Trygg

Gustafsson

Månsdotter

2019

Int J Equity Health

View full text Add to dashboard Cite

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“…When income inequality increases, distress levels among those at the lower end of the economic ladder tend to increase. Population based studies from Canada ( 13 ), United Kingdom ( 14 ), and the United States ( 15 ) indicate that income inequality increases the risk of mental disorders among the poor in high-income countries. Furthermore, a 9-year longitudinal study of 30,000 UK parents ( 14 ) showed that rates of psychological distress were significantly higher for the lowest levels of absolute income.…”

Section: Introductionmentioning

confidence: 99%

Lower Income Levels in Australia Are Strongly Associated With Elevated Psychological Distress: Implications for Healthcare and Other Policy Areas

et al. 2018

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Background: Australia is a high-income country with increasing income inequality. It is unclear whether Australia's well-developed mental healthcare system is making a difference to population mental health and the Federal Government has targeted outcomes accountability in service funding strategies. In high-income countries, evidence generally suggests that income inequalities increase mental disorders among the poor. This study examined psychological-distress rates—a marker of mental ill- health—as varying by income among Australians living within and outside of capital cities.Methods: Secondary data analysis was undertaken using the population-level mental health indicator of the Kessler Psychological Distress Scale (K10) as reported for 12,332 adults in the 2011/2012 National Health Survey (NHS) of Australia. K10 scores of 22 and higher indicated high/very-high distress, and 30 and higher denoted very-high distress. Very-high distress levels are strongly predictive of serious mental illness.Results: Among the poorest one-fifth of Australians, 1 in 4 people have psychological distress at a high/very-high level; this compares to about 1 in 20 people in the richest one-fifth of Australians. About 1-in-10 people making up the poorest one-fifth of Australians have current very-high distress, and this reduces to <1-in-50 people in the richest one-fifth. These disparities are consistent both within and outside of capital cities. The national prevalence of elevated distress within income quintiles varies greatly, with Poor/Rich Quintile Ratios of typically 4–5 for high/very-high levels and 7–8 for very-high levels. These effects operate more powerfully in areas marked by higher scores on the Index of Relative Socioeconomic Disadvantage.Conclusions: Altering the strong association of lower income levels in Australia with elevated psychological distress would require a multi-dimensional social policy and healthcare approach. To assess the effectiveness of adopted strategies, population level indicators need to be developed with regular data-collection. The Poor/Rich quintile ratio (P/R QR) for high/very high K10 scores is a potential candidate for a mental health inequality outcome indicator since it is easily calculated from data obtained from a regularly conducted national survey, is easily understood and resonates with a wider audience. Further research on the development of such indicators is also needed.

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“…The demographic and lifestyle characteristics that were measured based on previous studies about the risk factor for psychological distress were sex, age, education,21 BMI,22 job strain,23 occupation,24 employment contract,25 weekly working hours,26 annual family income,27 chronic medical illness,28 smoking status,29 frequency of alcohol drinking30 and physical exercise 31. Employment contract and work-unit information were obtained from the company.…”

Section: Methodsmentioning

confidence: 99%

Association of workplace social capital with psychological distress: results from a longitudinal multilevel analysis of the J-HOPE Study

et al. 2018

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ObjectivesWorkplace social capital (WSC) is increasingly recognised as a social contextual determinant of workers’ mental health, but longitudinal data are sparse. We aimed to evaluate the impact of changes in unit-level WSC on psychological distress among Japanese employees using a prospective multilevel repeated-measures design.Participants and study designWe conducted a 2-year prospective cohort study with 1,944 men and 786 women aged 18–65 years. Participants worked at two manufacturing worksites in Japan and were free from mental illness from the first to third study waves. We used a three-level multilevel regression design to evaluate the prospective association of unit-level WSC with individual-level psychological distress. WSC was measured using a validated six-item instrument and individual-level psychological distress with the Kessler Psychological Distress Scale (K6).ResultsThe null model indicated a significant degree of between-work unit variation in psychological distress (intraclass correlation=0.1%, p<0.001). In the full model, each SD increase in unit-level WSC was associated with 0.69 point improvement in K6 scores (95% CI −1.12 to −0.26).ConclusionsThis prospective study builds on existing knowledge by showing an association between unit-level WSC and modest improvements in mental health among employees in Japan. We recommend that WSC is considered alongside other contextual influences when assessing employees’ mental health risks.

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The interactive role of income (material position) and income rank (psychosocial position) in psychological distress: a 9-year longitudinal study of 30,000 UK parents

Cited by 11 publications

References 55 publications

Languishing in the crossroad? A scoping review of intersectional inequalities in mental health

Languishing in the crossroad? A scoping review of intersectional inequalities in mental health

Lower Income Levels in Australia Are Strongly Associated With Elevated Psychological Distress: Implications for Healthcare and Other Policy Areas

Association of workplace social capital with psychological distress: results from a longitudinal multilevel analysis of the J-HOPE Study

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