Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 3/2012

01-03-2012 | Original Paper

Income-related inequalities in common mental disorders among ethnic minorities in England

Authors: Roshni Mangalore, Martin Knapp

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 3/2012

Login to get access

Abstract

Purpose

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.

Method

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.

Results

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.

Conclusion

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.
Literature
1.
Townsend P, Davidson N (1982) Inequalities in health (the Black Report). Penguin, Middlesex
2.
Davey Smith G, Bartley M, Blane D (1990) The Black Report on socioeconomic inequalities in health 10 years on. BMJ 301:373–377CrossRef
3.
Benzeval M, Judge K, Whitehead M (1995) Tackling inequalities in health: an agenda for action. Kings Fund Institute, London
4.
Weich S, Lewis G, Jenkins S (2001) Income inequality and the prevalence of mental disorders in Britain. Br J Psychiatry 178:222–227PubMedCrossRef
5.
Lewis G, Bebbington P, Brugha T, Farell M, Gill B, Jenkins R, Meltzer H (2003) Socio-economic status, standard of living and neurotic disorder. Int Rev Psychiatry 15:91–96PubMedCrossRef
6.
Social Exclusion Unit (2004) Mental health and social exclusion. Office of the Deputy Prime Minister, London
7.
Mangalore R, Knapp M, Jenkins R (2007) Income-related inequality in mental health in Britain: the concentration index approach. Psychol Med 37:1037–1046PubMedCrossRef
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, London
9.
Nazroo JY (2001) Ethnicity, Class and Health. Policy Studies Institute, London
10.
Brugha T, Jenkins R, Bebbington P, Meltzer H, Lewis G, Farrell M (2004) Risk factors and the prevalence of neurosis and psychosis in ethnic groups in Great Britain. Soc Psychiatry Psychiatr Epidemiol 39:939–946PubMedCrossRef
11.
Hoberman HM (1992) Ethnic minority status and adolescent mental health services utilization. J Behav Health Serv R 19:246–267
12.
Nazroo James Y (2003) The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. Am J Public Health 93:277–284PubMedCrossRef
13.
Miranda J, Siddique J, Belin TR, Kohn-Wood LP (2005) Depression prevalence in disadvantaged young black women African and Caribbean immigrants compared to US-born African Americans. Soc Psychiatry Psychiatr Epidemiol 40:253–258PubMedCrossRef
14.
Bresnahan M, Begg MD, Brown A, Schaefer C, Sohler N, Insel B, Vella L, Susser E (2007) Race and risk of schizophrenia in a US birth cohort: another example of health disparity? Int J Epidemiol 36:751–758PubMedCrossRef
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)
16.
Wang JL (2004) The difference between single and married mothers in the 12-month prevalence of major depressive syndrome, associated factors and mental health service utilization. Soc Psychiatry Psychiatr Epidemiol 39:126–132CrossRef
17.
Dekker J, Peen J, Goris A, Heijnen H, Kwakman H (1997) Social deprivation and psychiatric admission rates in Amsterdam. Soc Psychiatry Psychiatr Epidemiol 32:485–492PubMed
18.
Veling W, Selten JP, Susser E, Laan W, Mackenbach JP, Hoek HW (2007) Discrimination and the incidence of psychotic disorders among ethnic minorities in The Netherlands. Int J Epidemiol 36:761–768PubMedCrossRef
19.
Wittkampf LC, Smeets HM, Knol MJ, Geerlings MI, Braam AW et al (2010) Differences in psychotropic drug prescriptions among ethnic groups in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 45:819–826PubMedCrossRef
20.
Sagatun A, Lien L, Søgaard AJ, Bjertness E, Heyerdahl S (2008) Ethnic Norwegian and ethnic minority adolescents in Oslo, Norway: a longitudinal study comparing changes in mental health. Soc Psychiatry Psychiatr Epidemiol 43:287–295CrossRef
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, York
22.
23.
24.
Van Doorslaer E, Koolman X, Jones AM (2004) Explaining income-related inequalities in doctor utilisation in Europe. Health Econ 13:629–647PubMedCrossRef
25.
Sproston K, Nazroo J (eds) (2002) Ethnic minority psychiatric illness rates in the community (EMPIRIC). The Stationery Office, London
26.
Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule. (CIS-R), Institute of Psychiatry
27.
Bebbington P, Nayani T (1995) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–20
28.
Ware JE, Kosinski M, Keller SD (1996) A 12-item short-form health survey construction of scales and preliminary tests of reliability and validity. Med Care 34:200–223CrossRef
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, MA
30.
Wilkinson R (2000) Mind the gap: hierarchies, health and human evolution. Weidenfeld and Nicolson, London
31.
Krieger N, Rowley DL, Herman AA, Avery B, Philips MT (1993) Racism, sexism and social class: implications for studies of health, disease and wellbeing. Am J Prev Med 9(Suppl 2):82–122PubMed
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, London
33.
Nazroo JY (1998) Genetic, cultural or socioeconomic vulnerability? Expanding ethnic inequalities in health. Soc Health Illness. 20:714–734
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 41–58
35.
Department of Health (2008) Health inequalities: progress and next steps. Department of Health: London
36.
Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H (2001) Psychiatric morbidity among adults living in private households 2000. HMSO, London
37.
Boydell J, Os VJ, McKenzie K, Murray RM (2004) The association of inequality with the incidence of schizophrenia: an ecological study. Soc Psychiatry Psychiatr Epidemiol 39:597–599PubMedCrossRef
38.
Harrison J, Barrow S, Creed F (1997) Mental health in the north west region of England: associations with deprivation. Soc Psychiatry Psychiatr Epidemiol 33:124–128CrossRef
39.
Reininghaus UA, Morgan C, Simpson J, Dazzan P, Morgan K et al (2008) Unemployment, social isolation, achievement—expectation mismatch and psychosis: findings from the ÆSOP Study. Soc Psychiatry Psychiatr Epidemiol 43:743–751PubMedCrossRef
40.
Bhui K, Stansfeld S, McKenzie K, Karlsen S, Nazroo J, Weich S (2005) Racial/ethnic discrimination and common mental disorders among workers: findings from the EMPIRIC Study of ethnic minority groups in the United Kingdom. Am J Public Health 95:496–501PubMedCrossRef
41.
Maginn S, Boardman AP, Craig TKL, Haddad M, Heath G et al (2004) The detection of psychological problems by general practitioners influence of ethnicity and other demographic variables. Soc Psychiatry Psychiatr Epidemiol 39:464–471PubMedCrossRef
42.
Gater R, Tomenson B, Percival C, Chaudhry N, Waheed W et al (2009) Persistent depressive disorders and social stress in people of Pakistani origin and white Europeans in UK. Soc Psychiatry Psychiatr Epidemiol 44:198–207PubMedCrossRef
43.
Maynard MJ, Harding S, Minnis H (2007) Psychological well-being in Black Caribbean, Black African, and white adolescents in the UK Medical Research Council DASH study. Soc Psychiatry Psychiatr Epidemiol 42:759–769PubMedCrossRef
44.
Kirbride JB, Barker D, Cowden F, Stamps R, Yang M, Jones PB, Coid JW (2008) Psychoses, ethnicity and socio-economic status. Br J Psychiatry 193:18–24CrossRef
45.
Van Os J, Castle DJ, Takei N, Der G, Murray RM (1996) Psychotic illness in ethnic minorities: clarification from the 1991 census. Psychol Med 26:203–208CrossRef
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 36:1541–1550PubMedCrossRef
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, London
48.
Harrison G, Owens D, Holton A, Neilson D, Boot D (1998) A prospective study of severe mental disorder in Afro-Caribbean patients. Psychol Med 18:643–657CrossRef
49.
Cochrane R, Bal S (1989) Mental hospital admission rates of immigrants to England: a comparison of 1971 and 1981. Soc Psychiatry 24:2–11
50.
Priebe S, Want A, Saidi M, Mangalore R, Knapp M (2009) Housing services for people with mental disorders in England: patient characteristics, care provision and costs. Soc Psychiatry Psychiatr Epidemiol 44:805–814PubMedCrossRef
51.
Equalities Review (2007) Fairness and freedom: final report of the Equalities Review. Cabinet Office, London
52.
Office of National Statistics (2004) Focus on social inequalities. Palgrave Macmillan, London
53.
Thornicroft G (2006) Shunned. Oxford University Press, Oxford
54.
Shams M (1993) Social support and psychological well-being among unemployed British Asian Men. Soc Behav Personal 21:175–186CrossRef
55.
Shams M, Jackson PR (1994) The impact of unemployment on the psychological well-being of British Asians. Psychol Med 24:347–355PubMedCrossRef
Metadata
Title
Income-related inequalities in common mental disorders among ethnic minorities in England
Authors
Roshni Mangalore
Martin Knapp
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 3/2012
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-011-0345-0

Other articles of this Issue 3/2012

Social Psychiatry and Psychiatric Epidemiology 3/2012 Go to the issue

Original Paper

Mental disorder and violence: is there a relationship beyond substance use?

Original Paper

Adolescent emotional and behavioural outcomes of nonparental preschool childcare

Original Paper

The mental health system in Lombardy, Italy: access to services and patterns of care

Original Paper

Alcohol misuse among partners: a potential effect modifier in the relationship between physical intimate partner violence and postpartum depression

Original Paper

Who receives depression-specific treatment? A secondary data-based analysis of outpatient care received by over 780,000 statutory health-insured individuals diagnosed with depression

Original Paper

Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in Qatar