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
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Variations in risk and protective factors for life satisfaction and mental wellbeing with deprivation: a cross-sectional study

Authors: Mark A Bellis, Helen Lowey, Karen Hughes, Lynn Deacon, Jude Stansfield, Clare Perkins

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Improving life satisfaction (LS) and mental wellbeing (MWB) is important for better public health. Like other health issues, LS and MWB are closely related to deprivation (i.e. lack of resources). Developing public health measures that reduce inequalities in wellbeing requires an understanding of how factors associated with high and low LS and MWB vary with deprivation. Here, we examine such variations and explore which public health measures are likely to improve wellbeing while reducing related inequalities.

Methods

A self-administered questionnaire measuring LS and MWB was used with a cross-sectional sample of adults from the North West of England (n = 15,228). Within deprivation tertiles, analyses examined how demographics, health status, employment, relationships and behaviours (alcohol, tobacco, physical exercise) were associated with LS and MWB.

Results

Deprivation was strongly related to low LS and MWB with, for instance, 17.1 % of the most deprived tertile having low LS compared to 8.9 % in the most affluent. After controlling for confounders, across all deprivation tertiles, better self-assessed health status and being in a relationship were protective against low LS and MWB. Unemployment increased risks of low LS across all tertiles but only risks of low MWB in the deprived tertile. For this tertile, South Asian ethnicity and higher levels of exercise were protective against low MWB. In the middle tertile retired individuals had a reduced risk of low MWB and an increased chance of high LS even in comparison to those in employment. Alcohol’s impact on LS was limited to the most deprived tertile where heavy drinkers were at most risk of poor outcomes.

Conclusions

In this study, positive outcomes for LS and MWB were strongly associated with lower deprivation and good health status. Public health measures already developed to promote these issues are likely to improve LS and MWB. Efforts to increase engagement in exercise are also likely to have positive impacts, particularly in deprived communities. The development of future initiatives that address LS and MWB must take account of variations in their risk and protective factors at different levels of deprivation.
Literature
1.
Foresight Mental Capital and Wellbeing Project: Final project report. Mental capital and wellbeing: making the most of ourselves in the 21st century. 2008, The Government Office for Science, London
2.
Pugh KL, Farrell AD: The impact of maternal depressive symptoms on adolescents' aggression: role of parenting and family mediators. J Child Family Studies. 2011, 36: 673-684.
3.
Marmot M, Atkinson T, Bell J, Black C, Broadfoot P, Cumberlege J, Diamond I, Gilmore I, Ham C, Meacher M, et al: Fair society, healthy lives. Strategic review of health inequalities in England post-2010. 2010, The Marmot Review, London
4.
Kiernan KE, Huerta MC: Economic deprivation, maternal depression, parenting and children's cognitive and emotional development in early childhood. Br J Sociol. 2008, 59: 783-806. 10.1111/j.1468-4446.2008.00219.x.CrossRefPubMed
5.
Heikkinen R-L, Kauppinen M: Mental well-being: a 16-year follow-up among older residents in Jyvaskyla. Arch Gerontol Geriat. 2010, 52: 33-39.CrossRef
6.
Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles SW: The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2005, 256: 174-186.CrossRefPubMedPubMedCentral
7.
Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH: Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences study. JAMA. 2001, 286: 3089-3096. 10.1001/jama.286.24.3089.CrossRefPubMed
8.
Radford L, Corral S, Bradley C, Fisher H, Bassett C, Howat N, Collishaw S: Child abuse and neglect in the UK today. 2011, NSPCC, London
9.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS: Am J Prev Med. 1998, 14: 245-258. 10.1016/S0749-3797(98)00017-8.CrossRefPubMed
10.
Chartier MJ, Walker JR, Naimark B: Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization. Child Abuse Negl. 2010, 34: 454-464. 10.1016/j.chiabu.2009.09.020.CrossRefPubMed
11.
Feinstein L, Lupton R, Hammond C, Mujtaba T, Salter E, Sorhaindo A: The public value of social housing: A longitudinal analysis of the relationship of housing and life chances. 2007, Centre for Research on the Wider Benefits of Learning Institute of Education, University of London
12.
Barton J, Pretty J: What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol. 2010, 44: 3947-3955. 10.1021/es903183r.CrossRefPubMed
13.
Ross CE, Mirowsky J: Neighborhood disorder, subjective alienation, and distress. J Health Soc Behav. 2009, 50: 49-64. 10.1177/002214650905000104.CrossRefPubMed
14.
Dolan P, Peasgood T, White M: Do we really know what makes us happy? A review of the economic literature on the factors associated with subjective well-being. J Econ Psychol. 2008, 29: 94-122. 10.1016/j.joep.2007.09.001.CrossRef
15.
Barger SD, Donoho CJ, Wayment HA: The relative contributions of race/ethnicity, socioeconomic status, health, and social relationships to life satisfaction in the United States. Qual Life Res. 2009, 18: 179-189. 10.1007/s11136-008-9426-2.CrossRefPubMed
16.
Voss M, Nylén L, Floderus B, Diderichsen F, Terry P: Unemployment and early cause-specific mortality: a study based on the Swedish Twin Registry. Am J Public Health. 2004, 94: 2155-2161. 10.2105/AJPH.94.12.2155.CrossRefPubMedPubMedCentral
17.
Lim C, Putnam RD: Religion, social networks, and life satisfaction. Am Sociol Rev. 2010, 75: 914-933. 10.1177/0003122410386686.CrossRef
18.
National Institute for Health and Clinical Excellence: Occupational therapy interventions and physical activity interventions to promote the mental wellbeing of older people in primary care and residential care. 2006, National Institute for Health and Clinical Excellence, London
19.
European Union: European pact for mental health and well-being. EU high-level conference together for mental health and wellbeing. 2008, European Union, Brussels, 12–13 June 2008
20.
Pickett KE, Wilkinson RG: Inequality: an underacknowledged source of mental illness and distress. Br J Psychiatry. 2010, 197: 426-428. 10.1192/bjp.bp.109.072066.CrossRefPubMed
21.
Friedli L: Mental health, resilience and inequalities. 2009, World Health Organization Regional Office for Europe, Copenhagen
22.
Commission on Social Determinants of Health: Closing the gap in a generation: health equity through action on the social determinants of health. 2008, World Health Organization, Final report of the Commission on Social Determinants of Health Geneva
23.
Dolan P, Laylard R, Metcalfe R: Measuring subjective well-being for public policy. 2011, Office for National Statistics, Newport
24.
Kobau R, Sniezek J, Zack MM, Lucas RE, Burns A: Well-being assessment: an evaluation of well-being scales for public health and population estimates of well-being among US adults. Appl Psychol: Health Well-being. 2010, 2: 272-297. 10.1111/j.1758-0854.2010.01035.x.
25.
Department of Health: Healthy lives, healthy people White Paper: Our strategy for public health in England. 2010, Department of Health, London
26.
Department of Health: No health without mental health. A cross-government mental health outcomes strategy for people of all ages. 2011, HM Government, London
27.
Office for National Statistics: Analysis of experimental subjective well-being data from the Annual Population Survey, April to September 2011. 2012, Office for National Statistics, Newport
28.
Waldron S: Measuring subjective wellbeing in the UK. 2010, Office for National Statistics, Newport
29.
Stewart-Brown S, Tennant A, Tennant R, Platt S, Parkinson J, Weich S: Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey. Health Qual Life Outcomes. 2009, 7: 15-10.1186/1477-7525-7-15.CrossRefPubMedPubMedCentral
30.
31.
Wood J, Hennell T, Jones A, Hooper J, Toxque K, Bellis MA: Where wealth means health: illustrating inequality in the North West. 2005, North West Public Health Observatory, Liverpool
32.
Bates A: Methodology used for producing ONS's small area population estimates. Population Trends. 2006, 125: 30-36.PubMed
33.
Noble M, McLennan D, Wilkinson K, Whitworth A, Barnes H, Dibben C: The English Indices of Deprivation 2007. 2008, Communities and Local Government, London
34.
Deacon L, Carlin H, Spalding J, Giles S, Stansfield J, Hughes S, Perkins C, Bellis MA: North West Mental Wellbeing Survey 2009. 2010, North West Public Health Observatory, Liverpool
35.
Pudney S: An experimental analysis of the impact of survey design on measures and models of subjective wellbeing. 2010, University of Essex, Colchester
36.
McFall SL, Garrington C: Understanding society: early findings from the first wave of the UK's Household Longitudinal Study. 2011, Institute for Social and Economic Research, University of Essex, Colchester
37.
Georgellis Y, Tsitsianis N, Yin YP: Personal values as mitigating factors in the link between income and life satisfaction: evidence from the European Social Survey. Soc Indic Res. 2009, 91: 329-344. 10.1007/s11205-008-9344-2.CrossRef
38.
Oishi S, Diener EF, Lucas RE, Suh EM: Cross-cultural variations in predictors of life satisfaction: perspectives from needs and values. Personality and Social Psychology Bulletin. 1999, 25: 980-990. 10.1177/01461672992511006.CrossRef
39.
40.
Craig R, Hirani V: Health Survey for England 2009,Volume 2: methods and documentation. 2009, The Information Centre, Leeds, 2010-
41.
Boehler CEH, Milton KE, Bull FC, Fox-Rushby JA: The cost of changing physical activity behaviour: evidence from a "physical activity pathway" in the primary care setting. BMC Public Health. 2011, 11: 370-10.1186/1471-2458-11-370.CrossRefPubMedPubMedCentral
42.
Beynon C, Jarman I, Perkins C, Lisboa P, Bellis MA: Topography of drinking behaviours in England: synthetic estimates of numbers and proportions of abstainers, lower risk, increasing risk and higher risk drinkers in local authorities in England. 2011, North West Public Health Observatory, Liverpool
43.
SPSS Inc: PASW® Regression 18. SPSS Inc, Chicago, IL
44.
Bellani L, D'Ambrosio C: Deprivation, social exclusion and subjective well-being. Soc Indic Res. 2011, 104: 67-86. 10.1007/s11205-010-9718-0.CrossRef
45.
Prince's Trust: Broke, not broken: tackling youth poverty and the aspiration gap. 2011, Prince's Trust, London
46.
Bellis MA, Hughes K, Wood S, Wyke S, Perkins C: National five-year examination of inequalities and trends in emergency hospital admission for violence across England. Inj Prev. 2011, 17: 319-325. 10.1136/ip.2010.030486.CrossRefPubMed
47.
Riots Communities and Victims Panel: After the riots. 2012, Riots Communities and Victims Panel, London
48.
Knabe A, Ratzel S: Quantifying the psychological costs of unemployment: the role of permanent income. Appl Econ. 2011, 43: 2751-2763. 10.1080/00036840903373295.CrossRef
49.
Artazcoz L, Benach J, Borrell C, Cortès I: Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am J Public Health. 2004, 94: 82-88. 10.2105/AJPH.94.1.82.CrossRefPubMedPubMedCentral
50.
Howell RT, Kern ML, Lyubomirsky S: Health benefits: meta-analytically determining the impact of well-being on objective health outcomes. Health Psychol Rev. 2007, 1: 83-136. 10.1080/17437190701492486.CrossRef
51.
Kotakorpi K, Laamanen J-P: Welfare state and life satisfaction: evidence from public health care. Economica. 2010, 77: 565-583.
52.
Maynard MJ, Harding S: Ethnic differences in psychological well-being in adolescence in the context of time spent in family activities Soc Psychiatry Psychiatr Epidemiol. 2010, 45: 115-123.PubMed
53.
Berthoud R: Family formation in multi-cultural Britain: diversity and change. Ethnicity, social mobility and public policy: comparing the USA and UK. Edited by: Loury GC, Modood T, Teles SM. 2005, Cambridge University Press, Cambridge
54.
Laurence J, Health A: Predictors of community cohesion: multi-level modelling of the 2005 Citizenship Survey. 2008, Department for Communities and Local Government, London
55.
Masood N, Okazaki S, Takeuchi DT: Gender, family, and community correlates of mental health in South Asian Americans. Cultur Divers Ethnic Minor Psychol. 2009, 15: 265-274.CrossRefPubMedPubMedCentral
56.
57.
Piper ME, Kenford S, Fiore MC, Baker TB: Smoking cessation and quality of life: changes in life satisfaction over 3 years following a quit attempt. Annals of Behav Med. 2012, 43: 262-270. 10.1007/s12160-011-9329-2.CrossRef
58.
Koivumaa-Honkanen H, Kaprio J, Korhonen T, Honkanen RJ, Heikkila K, Koskenvuo M: Self-reported life satisfaction and alcohol use: a 15-year follow-up of healthy adult twins. Alcohol Alcohol. 2012, 47: 160-168.CrossRefPubMed
59.
Paul LA, Grubaugh AL, Frueh BC, Ellis C, Egede LE: Associations between binge and heavy drinking and health behaviors in a nationally representative sample. Addict Behav. 2011, 36: 1240-1245. 10.1016/j.addbeh.2011.07.034.CrossRefPubMedPubMedCentral
60.
61.
Bellis MA, Hughes K, Tocque K, Hennell T, Humphrey G, Wyke S: Assessing and communicating the health and judicial impact of alcohol use. Public Health. 2005, 119: 253-261. 10.1016/j.puhe.2005.01.005.CrossRefPubMed
62.
Franco OH, Wong YL, Kandala N-B, Ferrie JE, Dorn JM, Kivimaki M, Clarke A, Donahue RP, Manoux AS, Frueudenheim JL, et al: Cross-cultural comparison of correlates of quality of life and health status: the Whitehall II Study (UK) and the Western New York Health Study (US). Eur J Epidemiol. 2012
63.
Valentine G, Holloway SL, Jayne M: Contemporary cultures of abstinence and the nighttime economy: Muslim attitudes towards alcohol and the implications for social cohesion. Environ Planning. 2010, 42: 8-22. 10.1068/a41303.CrossRef
64.
Department of Health: Physical activity health improvement and protection: start active, stay active. A report on physical activity for health from the four home countries' Chief Medical Officers. 2011, Department of Health, London
65.
National Institute for Health and Clinical Excellence: Management of depression in primary and secondary care. 2004, National Institute for Health and Clinical Excellence, London
66.
Packard CJ, Cavanagh J, McLean JS, McConnachie A, Messow C-M, Batty GD, Burns H, Deans KA, Sattar N, Shiels PG, et al: Journal of Public Health. 2012
Metadata
Title
Variations in risk and protective factors for life satisfaction and mental wellbeing with deprivation: a cross-sectional study
Authors
Mark A Bellis
Helen Lowey
Karen Hughes
Lynn Deacon
Jude Stansfield
Clare Perkins
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-492

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue

Research article

The effect of participatory community communication on HIV preventive behaviors among ethnic minority youth in central Vietnam

Research article

A comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding

Research article

A multilevel examination of gender differences in the association between features of the school environment and physical activity among a sample of grades 9 to 12 students in Ontario, Canada

Research article

Ethnic discrimination prevalence and associations with health outcomes: data from a nationally representative cross-sectional survey of secondary school students in New Zealand

Research article

Risk indicators of coronal and root caries in Greek middle aged adults and senior citizens

Research article

Socio-demographic factors influencing knowledge, attitude and practice (KAP) regarding malaria in Bangladesh