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Social inequalities in mental health: results from the EU contribution to the World Mental Health Surveys Initiative

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Abstract

Purpose

The objective of the present study was to provide updated data from nine European countries about the impact of social inequalities in the prevalence of common mental disorders.

Methods

Cross-sectional household survey of a representative sample of the adult general population of Belgium, Bulgaria, Germany, Italy, The Netherlands, Northern Ireland, Portugal, Romania and Spain. In total, 34,395 individuals were included. Social inequalities in 12-month mood, anxiety and alcohol-related disorders were evaluated.

Results

In Europe, income seems not to be related to the prevalence of mental disorders. Unemployment and disablement are associated with mental disorders. Lower educational level augments the risk for mood disorders. Living in small (rural) areas decreases the risk for mood disorders and living in urban settings increases it. Northern Ireland, Portugal and Belgium are the countries with the highest risks for mental disorders.

Conclusions

Despite some contradictions with previous literature, in Europe there are social inequalities in the prevalence of mental disorders. However, income showed not to be associated with inequalities in mental health. Being younger, unemployed or disabled, with no education or incomplete primary studies, living in urban settings, and in Northern Ireland, Portugal or Belgium were associated to an augmented prevalence of mental disorders. Policy makers could focus on mental health promotion and mental disorders prevention programmes for risk groups such as unemployed/disabled individuals. Support to vulnerable groups (unemployed or those with less education) and mental health literacy can improve European citizens’ mental health.

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Acknowledgments

The World Health Organisation World Mental Health (WMH) Survey Initiative is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Centre (FIRCA R03-TW006481), the Pan American Health Organisation, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. The ESEMeD project was funded by the European Commission (Contracts QLG5-1999-01042, SANCO 2004123 and EAHC 20081308), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICSRD06/0011 REM-TAP). The analysis for this paper was carried out in conjunction with the World Health Organization WMH Survey Initiative. We thank the WMH staff for assistance with instrumentation, fieldwork and data analysis. This project was co-funded by the Executive Agency for Health and Consumers and the European Commission (2008/1308 EU WMH). Information about the funding of WMH can be found here: http://www.hcp.med.harvard.edu/wmh/.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Parc Sanitari Sant Joan de Déu, C/Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain

    Alejandra Pinto-Meza, Maria Victoria Moneta & Josep Maria Haro

  2. Health Services Research Unit, IMIM - Hospital del Mar Medical Research Institute, C/Dr. Aiguader, 88, PRBB Building, 08003, Barcelona, Spain

    Jordi Alonso

  3. Center for Public Mental Health, Untere Zeile 13, 3482, Gösing am Wagram, Austria

    Matthias C. Angermeyer

  4. Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven (UPC-KUL), Herestraat 49, 3000, Leuven, Belgium

    Ronny Bruffaerts

  5. Faculty of Medical Sciences, NOVA University of Lisbon, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal

    José Miguel Caldas de Almeida

  6. IRCCS Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy

    Giovanni de Girolamo

  7. Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands

    Ron de Graaf

  8. National School of Public Health, Management and Professional Development, 31 Vaselor street, Bucharest, Romania

    Silvia Florescu

  9. EHESP Ecole des hautes études en santé publique, Hotel Dieu 1 place du paris de notre dame, 75181, Paris Cedex 04, France

    Viviane Kovess Masfety

  10. Psychology Research Institute, University of Ulster, Northland Road, Londonderry, BT487JL, UK

    Siobhan O’Neill

  11. New Bulgarian University, Bulgaria Sofia 1504 “Chataldja” 17-19 St. “Analytica”, Sofia, Bulgaria

    Svetlozar Vassilev

  12. CIBER de Salud Mental (CIBERSAM), Barcelona, Spain

    Josep Maria Haro

  13. Program of Epidemiology, CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    Jordi Alonso

  14. Program of Public Health, Pompeu Fabra University (UPF), Barcelona, Spain

    Jordi Alonso

Authors
  1. Alejandra Pinto-Meza
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  2. Maria Victoria Moneta
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  3. Jordi Alonso
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  4. Matthias C. Angermeyer
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  5. Ronny Bruffaerts
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  6. José Miguel Caldas de Almeida
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  7. Giovanni de Girolamo
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  8. Ron de Graaf
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  9. Silvia Florescu
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  10. Viviane Kovess Masfety
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  11. Siobhan O’Neill
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  12. Svetlozar Vassilev
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  13. Josep Maria Haro
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Corresponding author

Correspondence to Alejandra Pinto-Meza.

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Pinto-Meza, A., Moneta, M.V., Alonso, J. et al. Social inequalities in mental health: results from the EU contribution to the World Mental Health Surveys Initiative. Soc Psychiatry Psychiatr Epidemiol 48, 173–181 (2013). https://doi.org/10.1007/s00127-012-0536-3

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  • DOI: https://doi.org/10.1007/s00127-012-0536-3

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