Psychosocial intermediaries

Psychosocial consequences arise from structural and social inequities. Almost without exception, studies
find that higher levels of discrimination are associated with poorer mental health status. Many studies
have shown associations between poverty measures and mental health. For example, in European
countries, higher rates of depression and anxiety are associated with lower education levels,
unemployment, and social isolation with aging. A cycle then develops whereby mental illness leads to
reduced income and employment, making it more difficult to get out of poverty, leading to worsening
mental illness.

Mental health is strongly linked with socioeconomic status. For example, it has been shown that
mothers experiencing food insecurity have higher rates of depression and anxiety disorders, even when
controlling for physical health, substance use, and domestic violence. Income inequality, in and of itself,
is linked with mental health outcomes. Societies with greater inequality have a higher prevalence of
depression, even factoring in per capita income, education, and age. Individual and systemic racism and
discrimination are associated with poor mental health.

Source:

Health Systems Science

Second Edition
Skochelak, Susan E., MD, MPH; Hammoud, Maya M., MD, MBA; Lomis, Kimberly D., MD; Borkan,
Jeffrey M., MD, PhD; Gonzalo, Jed D., MD, MSc; Lawson, Luan E., MD, MAEd; Starr, Stephanie R.,
MD
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