What is the impact of socio-economic inequalities on the use of mental health services?

Amaddeo, Francesco; Jones, Julia

doi:10.1017/s1121189x00004565

Cited by 77 publications

(25 citation statements)

References 26 publications

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“…Finally, the results of this study indicate that DM sufferers with a low socioeconomic level suffer from a greater delay in diagnosis and are worse at controlling their condition. If this is the case, it would be consistent with the findings of the existing literature, both in terms of patients with other chronic diseases such as cancer (Woods et al 2006, Dejardin et al 2008, HIV (Giuliano & Vella 2007, Tsai et al 2009 or mental illnesses (Bonizzato & Tello 2003, Muntaner et al 2003, Amaddeo & Jones 2007, and also in terms of general health problems (Mackenbach & Bakker 2003, Knight et al 2009).…”

Section: Discussionsupporting

confidence: 87%

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Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review

Ricci‐Cabello

Ruiz-Pérez

Lima

et al. 2010

Health &Amp; Social Care in the Community

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The major increase in the prevalence of diabetes mellitus (DM) has led to the study of social inequalities in health-care. The aim of this study is to establish the possible existence of social inequalities in the prevention, diagnosis, treatment, control and monitoring of diabetes in Organisation for Economic Co-operation and Development (OECD) countries which have universal healthcare systems. We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles published up to 15 December 2007. We included observational studies carried out in OECD countries with universal healthcare systems in place that investigate social inequalities in the provision of health-care to diabetes patients. Two independent reviewers carried out the critical assessment using the STROBE tool items considered most adequate for the evaluation of the methodological quality. We selected 41 articles from which we critically assessed 25 (18 cross-sectional, 6 cohorts, 1 case-control). Consistency among the article results was found regarding the existence of ethnic inequalities in treatment, metabolic control and use of healthcare services. Socioeconomic inequalities were also found in the diagnosis and control of the disease, but no evidence of any gender inequalities was found. In general, the methodological quality of the articles was moderate with insufficient information in the majority of cases to rule out bias. This review shows that even in countries with a significant level of economic development and which have universal healthcare systems in place which endeavour to provide medical care to the entire population, socioeconomic and ethnic inequalities can be identified in the provision of health-care to DM sufferers. However, higher quality and follow-up articles are needed to confirm these results.

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Section: Discussionsupporting

confidence: 87%

“…2009) or mental illnesses (Bonizzato & Tello 2003, Muntaner et al. 2003, Amaddeo & Jones 2007), and also in terms of general health problems (Mackenbach & Bakker 2003, Marmot et al. 2008, Knight et al.…”

Section: Discussionmentioning

confidence: 99%

Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review

Ricci‐Cabello

Ruiz-Pérez

Lima

et al. 2010

Health &Amp; Social Care in the Community

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“…In their review, Fryers et al (2003) have identified several studies providing evidence of an association between markers of a less privileged social position (especially unemployment, less education and low income or poor standard of living) and higher prevalence of common mental disorders; moreover, they have also shown that a low SES has a potential to worsen mental disorders; a similar conclusion has been drawn by Amaddeo & Jones (2007); the latter authors have also stated that the precise factors linking SES and service utilization are still unclear.…”

Section: Social Inequalities and Individual Resiliencementioning

confidence: 78%

Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles

Girolamo

Dagani

Purcell

et al. 2011

Epidemiol Psychiatr Sci

425

258

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Purpose of review. In this review, we provide an update of recent studies on the age of onset (AOO) of the major mental disorders, with a special focus on the availability and use of services providing prevention and early intervention.Recent findings. The studies reviewed here confirm previous reports on the AOO of the major mental disorders. Although the behaviour disorders and specific anxiety disorders emerge during childhood, most of the high-prevalence disorders (mood, anxiety and substance use) emerge during adolescence and early adulthood, as do the psychotic disorders. Early AOO has been shown to be associated with a longer duration of untreated illness, and poorer clinical and functional outcomes.Summary. Although the onset of most mental disorders usually occurs during the first three decades of life, effective treatment is typically not initiated until a number of years later. There is increasing evidence that intervention during the early stages of disorder may help reduce the severity and/or the persistence of the initial or primary disorder, and prevent secondary disorders. However, additional research is needed on effective interventions in early-stage cases, as well as on the long-term effects of early intervention, and for an appropriate service design for those with emerging mental disorders. This will mean not only the strengthening and re-engineering of existing systems, but is also crucial the construction of new streams of care for young people in transition to adulthood.

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“…A possible explanation could be that higher educated groups and women might recognise and accept psychiatric needs more than lower educated groups and men [29]. The opposite trend for income might be a sign of minimal financial barriers, but possibly also an expression of negative influence by psychiatric disease on income (social selection) [30]. …”

Section: Discussionmentioning

confidence: 99%

Socio-economic inequalities in health care utilisation in Norway: a population based cross-sectional survey

Hansen

Halvorsen

Ringberg

et al. 2012

BMC Health Serv Res

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BackgroundNorway provides universal health care coverage to all residents, but socio-economic inequalities in health are among the largest in Europe. Evidence on inequalities in health care utilisation is sparse, and the aim of this population based study was to investigate socio-economic inequalities in the utilisation of health care services in Tromsø, Norway.MethodsWe used questionnaire data from the cross-sectional Tromsø Study, conducted in 2007–8. All together 12,982 persons aged 30–87 years participated with the response rate of 65.7%. This is slightly more than one third of the total population (33.8%) in the mentioned age group in Tromsø municipality. By logistic regression analyses we studied associations between household income, education and self-rated occupational status and the utilisation of general practitioner, somatic and psychiatric specialist outpatient services. The outcome variables were probability and frequency of use during the previous 12 months. Analyses were stratified by gender and adjusted for age, marital status, and self-rated health.ResultsSelf-rated health was the dominant predictor of health care utilisation. Women’s probability of visiting a general practitioner did not vary by socio-economic status, but high income was associated with less frequent use (odds ratio [OR] for trend 0.89, 95% confidence interval [CI] 0.81-0.98). In men, high income predicted lower probability and frequency of general practitioner utilisation (OR for trend 0.85, CI 0.76-0.94, and 0.86, 0.78-0.95, respectively). Women’s probability of visiting a somatic specialist increased with higher income (OR for trend 1.11, CI 1.01-1.21) and higher education (OR for trend 1.27, CI 1.16-1.39). We found the same trends for men, though significant only for education (OR for trend 1.14, CI 1.05-1.25). The likelihood of visiting psychiatric specialist services increased with higher education and decreased with higher income in women (OR for trend 1.57, CI 1.24-1.98, and 0.69, 0.56-0.86, respectively), but did not vary significantly by socio-economic variables in men. Higher income predicted more frequent use of psychiatric specialist services in men (OR for trend 2.02, CI 1.12-3.63).ConclusionsThis study revealed important inequalities in the utilisation of health care services in Norway, inequalities which may contribute to sustaining inequalities in health outcomes.

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What is the impact of socio-economic inequalities on the use of mental health services?

Cited by 77 publications

References 26 publications

Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review

Do social inequalities exist in terms of the prevention, diagnosis, treatment, control and monitoring of diabetes? A systematic review

Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles

Socio-economic inequalities in health care utilisation in Norway: a population based cross-sectional survey

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