Literature review final draft

20FL-KG601-146

Isleidy Ramos

Monroe College

Prof. Rosenstein

20FL-KG601-146

Abstract

Socio-economic status (SES) is a major determinant of health globally. SES is measured through various variables such as income level, unemployment, and educational attainment. Differences in SES lead to unequal distribution of resources, exposing low SES individuals to stressful life situations, reduced social participation, and economic burdens. Limited resources hinder their ability to cope with socioeconomic challenges, leading to psychological distress and poor mental health outcomes. Additionally, low SES families have reduced social ties and are less likely to draw social support than high SES families. They are also less likely to participate in social activities, which continuously affect their self-worth and emotional well-being. The goal of this paper is to review a large body of empirical literature to determine how socioeconomic status affects mental health. The findings from the articles indicate a positive correlation between SES and mental health. Low SES families have poor mental health outcomes. Policy and therapeutic interventions are needed to address socioeconomic inequalities and reduce mental health problems.

Literature Review

How Socioeconomic Status Affects Mental Health

Widening economic inequalities in America continues to impact millions of Americans per year. Most people live in impoverished conditions, which continuously affect their physical and mental health. Socio-economic status (SES) is a major determinant of health outcomes globally. Research shows that low SES is associated with poor mental health and high rates of depression. Research about the effects of socioeconomic status and mental health is well documented, with a huge emphasis on the unequal distribution of resources, which creates health disparities between upper and lower class persons. Social participation has a positive effect on mental health such as reduced depression and enhanced well-being. Areas with inadequate resources are vulnerable to poverty and resultant reduced access to health services.

Reiss et al. (2019) conducted a study to examine the effect of low socioeconomic status on adolescent’s mental health and concluded that children in low SES are exposed to more stressful economic, social, and political situations and are at a higher risk of developing mental problems than children from high SES. The authors highlighted that low SES families face various problems such as low income, high unemployment rates, worse social participation, and reduced access to health services. These factors act as stressors, rendering low SES children to mental health problems. Reiss et al. (2019) used a sample of German children and adolescents from the BELLA cohort-study and found that low SES increases stressful situations, which increases the likelihood of developing mental illnesses. Particularly, children from families with uneducated or low-educated parents had a higher risk of developing mental health problems than children with highly-educated parents. Low SES families are also exposed to financial stressors which increase the risk of poverty and the development of mental disorders.

Similarly, research by Rivenbark et al. (2020) shows that adolescents’ perceptions of their families' SES correlate positively with their mental health and well-being. The study consisted of participants from the Environmental Risk Longitudinal Twin study who were brought up in the same family background. Although they were raised in the same family backgrounds, participants revealed different social status perceptions. Congruent to findings by Reiss et al. (2019), the study found that adolescents that hold negative attitudes towards their families’ social status have a higher likelihood of developing mental illnesses compared to adolescents with positive attitudes. Adolescents who perceived their family as having high subjective family social status (SFSS) had low chances of developing mental health problems. Rivenbark et al. (2020) associate these disparities with anxiety, behavioral problems, and optimism towards the future linked with a family’s socioeconomic status. Children from low SES develop anxiety, engage in maladaptive behaviors such as substance abuse, and are pessimistic about the future. These behaviors, in turn, hinder social mobility in impoverished which coupled with low expectations pose increasing risks to population health. Inequalities weaken socioeconomic opportunity, which discourages people from engaging in behaviors that promote well-being.

Evidence by Potts and Henderson (2020) highlights that low SES families hold therapeutic pessimism, which hinders them from seeking mental health treatment. Unlike other studies by Reiss et al. (2019) and Rivenbark et al. (2020) which focuses on the direct socioeconomic effects on mental health, Potts and Henderson (2020) conducted a secondary analysis of data from the Attitudes to Mental illness survey to explore the effects of socioeconomic status on familiarity with mental health treatments and stigmatization for mental health patients. Inequalities against mental health patients expose them to reduced access to mental healthcare, high unemployment rate, poverty, and homelessness. Patients from low SES mainly face stigmatization, which increases the experience of mental problems. Equally, the research highlighted that patients from middle and high SES were more likely to respond to mental health treatments and patients from low SES. These families have high incomes, more education opportunities, and higher employment rates, which foster their familiarity with mental health treatments.

Evidence in the study indicated that socioeconomic deprivation leads to poor health outcomes and people in low SES tend to interact with people experiencing severe symptoms of mental illnesses, which leads to increased therapeutic pessimism (Potts and Henderson, 2020). People from low SES families have reduced access to knowledge and educational resources about mental health. As such, the lack of knowledge about the disease process, possible treatments, and lifestyle changes for improved quality of life. Such people live in impoverished regions that compound the problem due to inadequate resources and low-quality healthcare services. A study by Kim and Cho (2020) explained that low SES families respond to stressors caused by limited resources, which consequently exposes them to risks of developing mental health. They lack the resources to cope with socioeconomic challenges. Disadvantaged environments for low SES families render them vulnerable to economic precarity, conflicts, and threats and they often have inadequate resources to manage the threats effectively. These factors create chronic stress, which continuously affects low SES families’ mental health.

Agberotimi et al. (2019) affirmed that there was a relationship between socioeconomic status and mental health. The study used recent effects of socioeconomic status and mental health during the novel Covid-19 pandemic to show that 36% of low SES Nigerians had developed depression and deteriorated emotional wellbeing since the beginning of the pandemic. Middle and low-class economic families comprise the highest population of the Nigerian population. Faced with Covid-19 effects such as lockdown and reduction of business hours, most suffered psychological distress. The increased rate of depression recorded by Agberotimi et al. (2020) confirms arguments by Reiss et al. (2019) that uneven distribution of resources leads to unequal distribution of mental problems between high-class and low-class individuals. In the comparative study, the researchers showed that the socioeconomic status of citizens during a pandemic leads to the development of depressive symptoms.

The economic hardships caused by the Covid-19 pandemic reduced people's ability to afford basic needs while purchasing safety materials such as nose masks, and sanitizers (Agberotimi et al., 2020). Low SES families’ resources have been strained, added economic burdens, and enhanced prevalence of mental problems among low-income families. Additionally, the problem was compounded by isolation and exclusion of affected persons. People from low SES who had been isolated were more likely to develop psychological distress due to continued worrying about their affected families and inadequate financial resources to manage the effects of the pandemic. Social-distancing and self-isolation reduced social participation which is vital in ensuring emotional wellbeing and mental health. As a result, the researchers concluded that low SES is associated with poor mental health as indicated by increased rates of depression, anxiety, and psychological distress. These findings imply that economic instabilities and social exclusion deprive individuals of the economic opportunities needed for social mobility and social participation, thereby rendering them vulnerable to mental health problems.

A similar study by Poudel and Subedi (2020) confirmed these findings and highlighted that Covid-19 containment measures such as social distancing affected people’s overall mental, social, physical, and spiritual health. The authors reviewed published articles about the psychosocial effects of Covid-19 and other outbreaks to explain the effects of social participation on psychological well being. These measures have led to an increase in neuropsychiatric problems such as anxiety, depression, and deteriorated wellbeing. Even people infected with Covid-19 experience mental health problems caused by stigmatization and discrimination from family members and society. Social discrimination prevents people from seeking medication and adopting healthy lifestyles, which has increased suffering people and increased the prevalence of mental problems. A pandemic such as Coronavirus leads to economic uncertainties such as unemployment, economic instabilities, health inequalities, and social disparities. Poudel and Subedi (2020) also postulated that the most vulnerable populations are those from low SES with limited sources of income. These groups experience socioeconomic disadvantage caused by unemployment, housing unaffordability, discrimination, and poverty, which exposes them to mental problems.

Both studies by Agberotimi et al. (2020) and Poudel and Subedi (2020) highlight the need for effective measures to reduce the mental health burden faced by people with low SES. The researchers underline the importance of social participation and economic disability as predictors of mental well-being during global pandemics for both the infected and affected persons. Social participation is a form of social capital through which individuals create social relationships for social well-being.

The articles reviewed in this section emphasize that social structural conditions such as a persons’ SES and income level determine their networks, which in turn provide them with social opportunities, social engagement, and enhanced access to resources such as medical information. It is apparent that families from low SES have weak social networks and reduced social participation. Low SES individuals struggle to meet financial and basic needs and are also less likely to participate in social participation activities than high SES individuals. As a result, low SES are less likely to receive social support, have limited access to mental health information, and have a lower sense of well-being when compared to high SES individuals. Low SES individuals are economically disadvantaged in terms of the distribution of mental health services, and therefore become pessimistic towards mental health therapies. These individuals also have limited resources and access to mental health services and are likely to delay or avid treatment. Such individuals are less likely to draw on social ties for support and more likely to be excluded from social participation.

Low SES is a stressor that exposes individuals to stressful situations and consequent mental health problems. Low SES creates financial burdens, poverty, reduced access to health services, and unequal distribution of health services, which in turn, exacerbates mental health problems. Individuals have limited resources at their disposal to cope up with socioeconomic challenges, and often end –up worrying or growing anxious about the future. As a result, they develop psychological problems, which are exacerbated by stigma and discrimination by families and society. Socioeconomic inequalities widen the gap between low and high SES, leading to uneven distribution of mental health problems. The findings from this review reflect the need for policy and therapeutic interventions to reduce mental health problems, especially among low SES populations.

References

Agberotimi, S. F., Akinsola, O. S., Oguntayo, R., & Olaseni, A. O. (2020). INTERACTIONS BETWEEN SOCIOECONOMIC STATUS AND MENTAL HEALTH OUTCOMES IN THE NIGERIAN CONTEXT AMID COVID-19 PANDEMIC: A COMPARATIVE STUDY.

Kim, Y. M., & Cho, S. I. (2020). Socioeconomic status, work‐life conflict, and mental health. American Journal of Industrial Medicine.

Potts, L. C., & Henderson, C. (2020). Moderation by socioeconomic status of the relationship between familiarity with mental illness and stigma outcomes. SSM-Population Health, 100611.

Poudel, K., & Subedi, P. (2020). Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal. International Journal of Social Psychiatry, 66(8), 748-755.

Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS one, 14(3), e0213700.

Rivenbark, J., Arseneault, L., Caspi, A., Danese, A., Fisher, H. L., Moffitt, T. E., ... & Odgers, C. L. (2020). Adolescents’ perceptions of family social status correlate with health and life chances: A twin difference longitudinal cohort study. Proceedings of the National Academy of Sciences.