The correlation between mental health and inequality

Cases of major depressive disorder have increased by 27.6% globally as a result of the COVID-19 pandemic [1].

How does income relate to mental health? A 2008 study [2] found a positive correlation between income inequality and Major Depressive Episodes (MDEs). While some studies argue that this stems from the limited access to resources available to a large part of the population, others suggest that the reason for this would be the chronic sense of defeat that accompanies the inability to achieve one’s goals compared to others’ success. 

According to the OECD [3], Chile, a highly unequal country, had an increase in suicide rates of 54.9% between 1995 and 2009 and has shown a 9.2% prevalence of depressive disorders, one of the highest in the world. Unfortunately, the COVID-19 pandemic has contributed to the increase in depression rates: there has been a 27.6% increase in global major depressive disorder and an additional 76.2 million cases of anxiety [4]. Additionally, the IMF stated that “there are good reasons to expect that the pandemic both created new inequalities and exacerbated preexisting income gaps” [5], considering evidence of rising poverty and billionaire incomes. 

The IMF also argued that there is long-standing evidence that individuals entering the labour market during a recession tend to receive lower incomes than employees arriving before or after them, and that these differences can linger for many years [6]. “By inducing a massive global recession, COVID-19 has certainly created new inequalities among cohorts of young people” stated Francisco H. G. Ferreira, director of the International Inequalities Institute at the London School of Economics [7]. 

The possible growth in inequality for students soon entering the job market is worrying because a recent survey in Ecuador on mental health during the pandemic [8] found that students had significantly higher levels of depression, anxiety and stress than the average citizen; the results suggested that a soaring 30.7% of the participants in the study showed moderate to severe symptoms of anxiety, on top of another 17.7% with similar levels of depression. These figures were particularly high for a few groups, including women, students and single people. Interestingly, the rates were not higher for those who had COVID-19 symptoms or a positive diagnosis; however, they did increase when a relative was diagnosed with COVID-19. Ultimately, the study concluded with the confident, yet distressing statement that the COVID-19 pandemic has “definitely affected the mental health of the general population in our country.”

It could be suggested that a driver of depression and anxiety rates is the higher isolation caused by the necessary measures taken to combat the virus; this is because a lack of social integration has been linked to higher suicide rates [9]. However, what are the implications of this evidence for countries such as Chile and Ecuador? Latin America is identified as one of the most unequal regions in the world, with the top 10% of the population receiving 54% of the average national income according to the world inequality database [10]. Therefore, depression rates could increase even further as a result of the growth in inequality caused by the pandemic. Moreover, there may be higher inequality in the quality of life between social groups due to the higher rates of depression and anxiety among young people and women.  

The correlation between inequality and mental health has frightful implications for the future. To compensate for economic losses during the pandemic, do increases in inequality in terms of income, mental health and gender face the risk of being ignored? 

The COVID-19 pandemic has further pushed the sustainability train off its tracks towards the third Sustainable Development Goal of “ensur[ing] healthy lives and promot[ing] well-being for all at all ages” [11], as well as goal ten, which looks to “reduce inequality within and among countries” [12]. According to a study on social inequality and mental health in Latin American countries, “the provision of resources without a transformation of the social structure does not produce the desired effect” [13] of addressing mental health through reducing inequality. Therefore, perhaps it is time to reassess global priorities to focus on further societal integration in addition to accessibility to mental health treatment in order to build a happier and more equal society. 

Isabel Govier | 1st February 2022

References:

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext#%20 

[2] https://www.sciencedirect.com/science/article/pii/S0277953608002098 

[3] https://www.researchgate.net/publication/328079310_Social_Inequality_and_Mental_Health_in_Chile_Ecuador_and_Colombia 

[4] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-7/fulltext#%20

[5] https://www.imf.org/external/pubs/ft/fandd/2021/06/inequality-and-covid-19-ferreira.htm 

[6] https://www.imf.org/external/pubs/ft/fandd/2021/06/inequality-and-covid-19-ferreira.htm 

[7] https://www.imf.org/external/pubs/ft/fandd/2021/06/inequality-and-covid-19-ferreira.htm 

[8] https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-021-03214-1 

[9] https://www.sciencedirect.com/science/article/pii/S0277953608002098 

[10] https://wid.world/news-article/2020-regional-updates/ 

[11] https://www.un.org/sustainabledevelopment/health/ 

[12] https://www.un.org/sustainabledevelopment/inequality/ 

[13] https://www.researchgate.net/publication/328079310_Social_Inequality_and_Mental_Health_in_Chile_Ecuador_and_Colombia