Socioeconomic gradients and mental health: implications for public health

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

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

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.

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.

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.