Socioeconomic gradients and mental health: implications for public health

Background - Research on mental well-being is relatively new and studies of its determinants are rare.

Aims - To investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.

Method - Using logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.

Results - Independent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.

Conclusions - Odds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.