Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis

Ribeiro, Wagner Silva; Bauer, Annette; Andrade, Mário César Rezende; York‐Smith, Marianna; Pan, Pedro Mário; Pingani, Luca; Knapp, Martín; Coutinho, Evandro Silva Freire; Evans‐Lacko, Sara

doi:10.1016/s2215-0366(17)30159-1

Cited by 159 publications

(116 citation statements)

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“…A review of studies on the association of income inequality and a range of mental health related outcomes reported heterogeneous findings, with about one third of studies observing a positive association between income inequality and the prevalence or incidence of mental health problems, one third observing mixed results for different subgroups, and one third observing no association 5 . Depression was one of the mental health outcomes considered in studies showing a positive association with income inequality.…”

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confidence: 99%

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

et al. 2018

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Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high-income countries. Nearly two-thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta-analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07-1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low-income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo-material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality.

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confidence: 99%

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

et al. 2018

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“…There are even studies finding no linkage between income inequality and environmental quality [45,46]. Some studies found that income anticipations could affect mental health and that income inequality generally damaged subjective well-being and led to psychological problems [18,[47][48][49][50][51]. Further, Velek and Steg (2007) proposed that psychological factors were important in promoting sustainable consumption of natural resources [52].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Income Inequality on Carbon Emissions in China: A Household-Level Analysis

2020

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This study investigates the impact of income inequality on household carbon emissions in China using nationwide micro panel data. The effect is positive—households in counties with greater income inequality emit more—and remarkably robust to a battery of robustness checks. We also explore the roles that consumption patterns, time preference, and mental health play in the relationship between income inequality and household carbon emissions. The findings suggest that the change in consumption patterns caused by income inequality may be an important reason for the positive effect of inequality on household carbon emissions and that a lower time preference for consumption and improved mental health can mitigate the positive effect of income inequality on household carbon emissions. Furthermore, substantial differences are found among households at different income levels and households with heads of different ages. The findings of this study provide important insights for policy makers to reduce both inequality and emissions.

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“…no. reviews contributing termsReviews contributing terms‘Place’Place of residence5No-5No-5[10–14]‘Race’Race / ethnicity / culture / language3Yes →69No-9[11, 15–22]Occupation6No-6No-6[11], [13], [16], [23], [24], [25]‘Gender’Gender / sex1Yes →67No-7[16], [17], [18], [19], [26], [27], [28]Religion0Yes →11Yes →23[17, 29, 30]Education7No-7No-7[11, 13, 16, 24, 25, 31, 32]‘SES’Socio-economic status12No-12No-12[11], [13], [15], [23], [24], [25], [31], [32], [33], [34], [35], [36]Social capital0Yes →11Yes →45[17, 37–40]Other category not encompassed by PROGRESS-Plus6No-...…”

Section: Resultsmentioning

confidence: 99%

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

Prady

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et al. 2018

BMC Med Res Methodol

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BackgroundHealth inequalities, worse health associated with social and economic disadvantage, are reported by a minority of research articles. Locating these studies when conducting an equity-focused systematic review is challenging due to a deficit in standardised terminology, indexing, and lack of validated search filters. Current reporting guidelines recommend not applying filters, meaning that increased resources are needed at the screening stage.MethodsWe aimed to design and test search filters to locate studies that reported outcomes by a social determinant of health. We developed and expanded a ‘specific terms strategy’ using keywords and subject headings compiled from recent systematic reviews that applied an equity filter. A ‘non-specific strategy’ was compiled from phrases used to describe equity analyses that were reported in titles and abstracts, and related subject headings. Gold standard evaluation and validation sets were compiled. The filters were developed in MEDLINE, adapted for Embase and tested in both. We set a target of 0.90 sensitivity (95% CI; 0.84, 0.94) in retrieving 150 gold standard validation papers. We noted the reduction in the number needed to screen in a proposed equity-focused systematic review and the proportion of equity-focused reviews we assessed in the project that applied an equity filter to their search strategy.ResultsThe specific terms strategy filtered out 93-95% of all records, and retrieved a validation set of articles with a sensitivity of 0.84 in MEDLINE (0.77, 0.89), and 0.87 (0.81, 0.92) in Embase. When combined (Boolean ‘OR’) with the non-specific strategy sensitivity was 0.92 (0.86, 0.96) in MEDLINE (Embase 0.94; 0.89, 0.97). The number needed to screen was reduced by 77% by applying the specific terms strategy, and by 59.7% (MEDLINE) and 63.5% (Embase) by applying the combined strategy. Eighty-one per cent of systematic reviews filtered studies by equity.ConclusionsA combined approach of using specific and non-specific terms is recommended if systematic reviewers wish to filter studies for reporting outcomes by social determinants. Future research should concentrate on the indexing standardisation for equity studies and further development and testing of both specific and non-specific terms for accurate study retrieval.Electronic supplementary materialThe online version of this article (10.1186/s12874-018-0567-x) contains supplementary material, which is available to authorized users.

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Income inequality and mental illness-related morbidity and resilience: a systematic review and meta-analysis

Cited by 159 publications

References 45 publications

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

The Impact of Income Inequality on Carbon Emissions in China: A Household-Level Analysis

Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen

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