1.1 Introduction
Socio-economic status refers to an individual’s or group’s economic and social position relative to others, based on income, education, and occupation (Krieger, 2001). The link between socio-economic status and mental health is not merely a reflection of individual circumstances but is also shaped by broader social and environmental factors. Individuals from lower socio-economic backgrounds often experience chronic stressors, such as financial instability, job insecurity, and limited access to healthcare, which contribute to mental health challenges (Marmot, 2004). Socio-economic status is a critical determinant of access to resources and opportunities, which significantly affect overall well-being and health outcomes.
This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.
1.2 Background of Study
Mental health, health status and socioeconomic status are important determinants of an individual’s wellbeing. There are thought to be important interactions between these dimensions of wellbeing, with causal links running in both directions. Poor health and poor mental health can reduce earnings ability, through their effects on education and employment, and poverty can lead to lower educational attainment, poorer physical health and depression (Ardington and Case, 2010).
Das et al. (2007) examine the correlates of mental health in five developing countries, finding that being older, female, widowed, and in poor physical health are consistently related to poorer mental health outcomes. However, their reading of their evidence on the relationship between socio-economic status (SES) and mental health is mixed. They find education to be positively associated with better mental health in a majority (but not all) of the countries that they study.
Witoelar et al (2009) analyse data from the fourth wave of the Indonesian Family Life Survey and find that education is protective against depression among Indonesians aged 45 and older but, controlling for education, they find no association between per capita expenditure and mental health for this group.
A survey of 11 smaller community based studies in six low and middle income countries finds a negative association between education and common mental disorders in all but one study (Patel and Kleinman 2003). Results for other indicators of socioeconomic status such as employment and income were more mixed. In two localized South African studies, Case and Deaton (2009) find different aspects of socioeconomic status protect in different ways: in their sites, education appears to protect health status, but has little effect on anxiety or depression, while assets protect against depression, but not against poor health.
One of the most consistent findings in the study of mental health in both developed and developing countries is that the risk of depression increases with age. Although the relationship between socioeconomic status and mental health has received considerable attention in the literature, particularly among the elderly, there is very little research that directly addresses whether the correlates of depression change as people grow older (Ardington and Case, 2010).
Considerable and growing evidence shows that mental health and many common mental disorders are shaped to a great extent by social, economic and environmental factors. A review of global evidence by Patel et al (2010) for the WHO Commission on Social Determinants of Health reported convincing evidence that low socioeconomic position is systematically associated with increased rates of depression. Gender is also important, mental disorders are more common in women, they frequently experience social, economic and environmental factors in different ways to men.
Taking action to improve the conditions of daily life from before birth, during early childhood, at school age, during family building and working ages, and at older ages provides opportunities both to improve population mental health and reduce the risk of those mental disorders that are associated with social inequalities. While comprehensive action across the life course is needed, scientific consensus is considerable that giving every child the best possible start will generate the greatest societal and mental health benefits (WHO, 2014).
The prevalence and social distribution of mental disorders has been reasonably well documented in high-income countries. While there is growing recognition of the problem in low- and middle-income countries, a significant gap still exists in research to measure and describe the problem, and in strategies, policies and programmes to prevent mental disorders. There is a considerable need to raise the political, and strategic priority given to the prevention of mental disorders and to the promotion of mental health through action on the social determinants of health (WHO, 2014).
The impact of socio-economic status (SES) on mental health is a critical issue that continues to present significant challenges globally. Despite considerable advances in understanding the relationship between SES and mental health, the mechanisms through which SES influences mental health outcomes remain complex and not fully understood. Numerous studies have documented that individuals with lower SES are at a greater risk of experiencing mental health disorders such as depression, anxiety, and substance abuse (Lorant et al., 2003).
The global economic landscape, characterized by increasing income inequality and social stratification, has further exacerbated the mental health disparities linked to SES (Wilkinson & Pickett, 2009). In many societies, economic recessions, unemployment, and austerity measures have disproportionately affected those in lower socio-economic groups, leading to a rise in mental health issues among these populations (Stuckler et al., 2009). Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the impact of socio-economic status on mental health.
1.3 Statement of Problems
Investigation revealed that the socioeconomic status is one of the most prominent environmental risk factors of mental health. People with high income, occupational status, and education tend to be happier and less likely to suffer from depression and other psychiatric disorders than people with low socioeconomic status (Clark, Frijters, & Shields, 2008; Lorant et al., 2003). In other words, income appears to be important for subjective well-being insofar as it helps people to satisfy their basic material needs but becomes less crucial beyond this point (Clark et al., 2008).
People with mental disorders, such as schizophrenia, bipolar disorder and depression are far more likely than the general population to die as a consequence of their untreated mental or physical health problems (WHO, 2008, Roshanaei and Katon, 2009). For example, people with schizophrenia and major depression have an overall increased risk of mortality 1.6 and 1.4 times, respectively, greater than for the general population, and people with schizophrenia have two- to three-fold higher mortality rates compared with the general population corresponding to 10-25-year reductions in life expectancy (Laursen et al., 2012).
One of the most striking reasons for higher mortality rates among people with mental disorders is the inequitable care and treatment that these individuals receive for both mental and physical illnesses. Between 75% and 85% of people with severe mental disorders are unable to access the treatment they need for their mental health problem in LMICs, compared with 35% and 50% of people in high-income countries (Demyttenaere, 2004; OECD, 2012).
Mental disorders have diverse and far-reaching social impacts, including homelessness, higher rates of imprisonment, poor educational opportunities and outcomes, lack of employment and limited income-generating opportunities. Moreover, the stigma, myths and misconceptions surrounding mental illness are the root cause of much of the discrimination and human rights violations experienced by people with mental disabilities on a daily basis (Baldwin and Marcus, 2011).
People with mental disorders are at much higher risk of descending into poverty than other people. They may not be able to work because of their illness. If employed, their illness may result in more sick days or reduced productivity, in turn reducing income, promotion chances, entitlements to employment-related pensions or health insurance coverage (Ssebunnya et al., 2009, Thornicroft et al., 2009). It is against the backdrop that this study seeks to address these problems by evaluating the impact of socio-economic status on mental health.
1.4 Aim and Objectives of Study
The aim of the study is to examine the impact of socio-economic status on mental health. In achieving this aim, the following specific objectives were laid out as follows:
- To investigate the correlation between income levels and the incidence of mental health disorders, including depression, anxiety, and stress-related conditions;
- To examine the relationship between occupational status and mental health, particularly in relation to job security and work conditions;
- To assess the current mental health interventions effectively addressing the needs of individuals from lower socio-economic backgrounds;
- To assess the influence of social status and perceived social standing on mental well-being, considering factors such as social inclusion, and community support;
- To determine the income level influence the prevalence and severity of mental health disorders such as depression and anxiety; and
- To propose policy recommendations that will aid socio-economic disparities reduction in mental health and improving access to mental health services for disadvantaged populations.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are current mental health interventions effectively addressing the needs of individuals from lower socio-economic backgrounds, and what gaps exist in service provision?
- How does income level influence the prevalence and severity of mental health disorders such as depression and anxiety?
- In what ways does educational attainment affect mental health outcomes, and to what extent does it serve as a protective factor?
- What is the relationship between occupational status and mental health, particularly in relation to job security and work conditions?
- How does perceived social status impact mental well-being, and what role do social inclusion and stigma play in this relationship?
- What strategies can be implemented to reduce socio-economic disparities in mental health and improve access to mental health services for disadvantaged populations?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Lower income levels are not associated with a higher prevalence of mental health disorders such as depression and anxiety.
- H1: Lower income levels are associated with a higher prevalence of mental health disorders such as depression and anxiety.
Hypothesis Two
- H0: Higher educational attainment is negatively correlated with better mental health outcomes, serving as a protective factor against mental health disorders
- H1: Higher educational attainment is positively correlated with better mental health outcomes, serving as a protective factor against mental health disorders
1.7 Significance of Study
The outcome of this research will benefit policymakers and public health professionals by identifying key socio-economic determinants that need to be addressed in mental health interventions. This will help in designing targeted programs and policies that effectively mitigate the negative impacts of low socio-economic status on mental health.
For mental health practitioners and service providers, the study will offer valuable insights into the specific needs of individuals from different socio-economic backgrounds, leading to more tailored and accessible mental health services.
Additionally, the research will contribute to the academic field by filling gaps in existing literature, providing a comprehensive analysis of how socio-economic status affects mental health, and suggesting new avenues for future research.
Lastly, the study will raise awareness among the general public and community organizations about the significant role of socio-economic factors in mental health, encouraging broader support for initiatives aimed at reducing socio-economic disparities and improving mental health outcomes.
1.8 Scope of Study
The scope of the research is focused on the impact of socio-economic status on mental health using Ikeduru Local Government Area of Imo State as a case study.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: As the research had to be completed within a limited timeframe. This constraint affected the depth of analysis and the thoroughness of the investigation into the socio-economic determinants of mental health. The need to adhere to a fixed schedule may have resulted in a less detailed exploration of some aspects of the research.
- Financial Constraint: The available budget was insufficient to cover all aspects of the research, including extended data collection and analysis. This limitation restricted the scope of the study and the ability to employ more comprehensive research methods.
- Initial Cooperation Delay from Respondents: The time required for obtaining responses from participants was longer than anticipated, which affected the overall timeline of the study. These delays contributed to a reduced sample size and potentially biased results if the final sample was not fully representative.
1.10 Definition of Terms
Socio-Economic Status (SES):
Socio-economic status refers to an individual’s or group’s economic and social position relative to others, based on income, education, and occupation (Krieger, 2001). SES is a critical determinant of access to resources and opportunities, which can significantly affect overall well-being and health outcomes.
Educational Attainment:
Educational attainment refers to the highest level of education an individual has completed. It is a significant factor in socio-economic status and influences mental health by impacting job opportunities and economic stability (Cutler & Lleras-Muney, 2006).
Mental Health:
Mental health encompasses emotional, psychological, and social well-being, affecting how individuals think, feel, and act. It is characterized by the ability to manage stress, relate to others, and make sound decisions (World Health Organization, 2013).
Income Level:
Income level is a measure of the amount of money an individual or household earns. It is often used as an indicator of economic status and has been linked to various health outcomes, including mental health (Marmot & Stansfeld, 1999).
Occupational Status:
Occupational status relates to the level of prestige or social standing associated with a person’s job. This includes factors such as job security, working conditions, and income, which can influence mental health outcomes (Warr, 2002).
