Socioeconomic vulnerabilities of individuals living with a mental disorder

Jean-Baptiste HAZO¹, Coralie GANDRÉ²

¹Drees, Paris, France
²Irdes, Paris, France

Introduction

Social inequalities in mental health are wide and scientific discussion on causal pathways between socioeconomic status (SES) and mental disorders is ongoing. A recent linkage of the main longitudinal population sample representative of the population living in France with the national health data system offers new research opportunities on the topic. Our objective was to increase the evidence base on socio-economic disparities of incidence and prevalence of mental disorders.

Methods

Individuals with mental disorders were identified in the 2016-2017 period using data on causes of hospitalizations, conditions leading to entry in the long-term illness scheme and drug deliveries over the past five years. Considered SES indicators included the standard of living, household composition, socio-professional category, level of education, marital and migratory status, and residency in a deprived priority neighborhood or in social housing. Sub-analyses were carried out by gender, age, and type of mental disorders.

Results

Findings underscored a marked socio-economic gradient for both prevalence and incidence of psychotic, bipolar and other mood disorders. Prevalence were two to seven times higher for individuals in the quintile of the lowest standard of living compared to those in the highest quintile. These differences grew with age, revealing an increasing impoverishment of individuals with mental disorders over time. Furthermore, in comparison to the general population, they had increased odds of not completing their secondary education, of living alone, in a priority neighborhood and in social housing.

Discussion

A better understanding of the socio-economic vulnerabilities faced by people with mental disorders offers avenues for future research, including on inequities in their care pathways after adjustment on these vulnerabilities and the implementation of longitudinal studies focused on causal links between mental illnesses and SES.