Income-related inequalities in common mental disorders among ethnic minorities in England
The relative prevalence of common mental health problems among different ethnic groups in Britain is one of the least researched topics in health variations research. We calculate and compare income-related inequalities in common mental disorders among ethnic groups in Britain.
Data from a nationally representative survey of ethnic minorities (the EMPIRIC survey) were used to calculate concentration index values to indicate the extent of income-related inequalities within and across ethnic groups.
Looking at income-related inequalities in common mental disorders within each of the ethnic groups, it was found that the burden of these disorders were greater for the lower income groups among the Irish, White and African Caribbean communities. Within-group inequality was less clearly defined for each of the three Asian communities: Indian, Bangladeshi and Pakistani. However, when the data were pooled and individuals were assigned income ranks in the pooled set (not within their own ethnic group), the relative position of those in lower income groups among the different groups was striking. The poor among the Bangladeshi, Pakistani and the African Caribbean groups clearly suffered both from low income and a greater burden of mental health morbidity than the other three groups. The effect of lower income is thus worse for the mental health of populations if they are African Caribbean, Pakistani or Bangladeshi than if they are White, Irish or Indian.
Inequality in mental health morbidity between and within ethnic groups is at least partly linked to income, and thus to employment and education. Tackling disadvantage and discrimination in these areas could help to tackle the challenge of mental ill-health.
KeywordsInequality Equity Ethnicity Income Neurosis Common mental disorders
Conflict of interest
- 1.Townsend P, Davidson N (1982) Inequalities in health (the Black Report). Penguin, MiddlesexGoogle Scholar
- 3.Benzeval M, Judge K, Whitehead M (1995) Tackling inequalities in health: an agenda for action. Kings Fund Institute, LondonGoogle Scholar
- 6.Social Exclusion Unit (2004) Mental health and social exclusion. Office of the Deputy Prime Minister, LondonGoogle Scholar
- 8.Nazroo JY (1999) The racialisation of ethnic inequalities in health. In: Dorling D, Simpson S (eds) Statistics in society: the arithmetic of politics. Arnold, LondonGoogle Scholar
- 9.Nazroo JY (2001) Ethnicity, Class and Health. Policy Studies Institute, LondonGoogle Scholar
- 11.Hoberman HM (1992) Ethnic minority status and adolescent mental health services utilization. J Behav Health Serv R 19:246–267Google Scholar
- 15.Simning A, Wijngaarden EV and Conwell Y (2010) Anxiety, mood, and substance use disorders in United States African-American public housing residents. Soc Psychiatry Psychiatr Epidemiol (online first, 9 July)Google Scholar
- 21.Cochrane R and Sashidharan SP (1996) Mental health and ethnic minorities: a review of the literature and implications for services. In: Ethnicity and health, CRD Report 5. NHS Centre for reviews and Dissemination, Social Policy Research Unit: University of York, YorkGoogle Scholar
- 23.World Bank (2003) Quantitative techniques for health equity analysis—technical notes. (http://siteresources.worldbank.org/INTPAH/Resources/Publications/Quantitative-Techniques/health.eqtn07.pdf). Accessed 15 February 2006
- 25.Sproston K, Nazroo J (eds) (2002) Ethnic minority psychiatric illness rates in the community (EMPIRIC). The Stationery Office, LondonGoogle Scholar
- 26.Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule. (CIS-R), Institute of PsychiatryGoogle Scholar
- 27.Bebbington P, Nayani T (1995) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–20Google Scholar
- 29.Ware JE, Kosinski M, Keller SD (1998) How to score the SF-12 physical and mental summary scales, 3rd edn. The Health Institute, New England Medical Center, Boston, MAGoogle Scholar
- 30.Wilkinson R (2000) Mind the gap: hierarchies, health and human evolution. Weidenfeld and Nicolson, LondonGoogle Scholar
- 32.Madood T, Berthoud R, Lakey J, Nazroo JY, Smith P, Virdee S, Beishon S (1997) Ethnic minorities in Britain: diversity and disadvantage. Policy Studies Institute, LondonGoogle Scholar
- 33.Nazroo JY (1998) Genetic, cultural or socioeconomic vulnerability? Expanding ethnic inequalities in health. Soc Health Illness. 20:714–734Google Scholar
- 34.Nazroo J, Davey Smith G (2000) The contribution of socioeconomic position to health differentials between ethnic groups: evidence from the United States and Britain. In: Macbeth H, Shetty P (eds) Health and ethnicity: society for the study of human biology series: 41. Taylor and Francis, London, England, pp 41–58Google Scholar
- 35.Department of Health (2008) Health inequalities: progress and next steps. Department of Health: LondonGoogle Scholar
- 36.Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H (2001) Psychiatric morbidity among adults living in private households 2000. HMSO, LondonGoogle Scholar
- 46.Fearon P, Kirkbride J, Morgan C, Dazzan P, Morgan K, Lloyd T, Hutchinson G, Tarrant J, Fung A, Holloway J, Mallet R, Harrison G, Leff J, Jones P, Murray R (2006) Incidence of schizophrenia and other psychoses in ethnic minority groups: results from the MRC AESOP Study. Psychol Med 36:1541–1550PubMedCrossRefGoogle Scholar
- 47.Health Care Commission (2005) Count me in: results of a National Census of Inpatients in Mental Health Hospitals and Facilities in England and Wales. Health Care Commission, LondonGoogle Scholar
- 49.Cochrane R, Bal S (1989) Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Soc Psychiatry 24:2–11Google Scholar
- 51.Equalities Review (2007) Fairness and freedom: final report of the Equalities Review. Cabinet Office, LondonGoogle Scholar
- 52.Office of National Statistics (2004) Focus on social inequalities. Palgrave Macmillan, LondonGoogle Scholar
- 53.Thornicroft G (2006) Shunned. Oxford University Press, OxfordGoogle Scholar