Associations Between Socioeconomic Position and Mental Health and Mental Health Disorders Among Adults in Canada from 2005 to 2022

Date
2025-01-16
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Abstract

Introduction: Socioeconomic position (SEP) is a fundamental determinant of mental health, often measured by income and education. Poor mental health and mental health disorders are more prevalent among adults with a lower SEP. Examining trends in associations between SEP and mental health outcomes can inform policies to reduce mental health inequities, yet these trends remain understudied. I aimed to examine (1) associations between SEP and mental health outcomes in 2022 and (2) trends in associations from 2005-2022. Methods: I used data from the Canadian Community Health Survey (2005, 2007-2022) to examine associations between SEP (annual household income, educational attainment) and mental health outcomes (fair/poor self-reported mental health (SRMH), mood disorders, anxiety disorders) among adults (≥23 years) in the ten provinces using multivariable logistic regression. I adjusted for sex, age, marital status, immigration status, race/ethnicity, and Indigenous identity and tested for modification by sex. I repeated logistic regression models for each cycle and assessed trends with random-effects meta-analysis and meta-regression. Results: In 2022, the odds of all mental health outcomes were lower with high and middle than low income and education. Associations were stronger with income than education and persisted after mutual adjustment. High income was more protective against poor/fair SRMH and mood disorders among males than females, while high education was more protective against anxiety disorders among females than males. Income and education were associated with all mental health outcomes from 2005-2022. Associations with poor/fair SRMH weakened in 2020-2022 during the COVID-19 pandemic compared to before 2020. Associations with mood disorders remained stable from 2005-2022. Trends with anxiety disorders were mixed. Conclusion: Higher income and education were associated with lower odds of adverse mental health outcomes in 2022. My study was the first to examine trends in associations and found that inequities persisted from 2005-2022. Inequities in poor/fair SRMH weakened in 2020-2022, while most inequities in mood and anxiety disorders remained stable. Policies that increase household incomes and support higher educational attainment may help reduce inequities. Future research may investigate policy responses to the COVID-19 pandemic that may have reduced certain mental health inequities in 2020-2022.

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Keywords
Socioeconomic position, Inequities, Mental health, Mental health disorders, Trends
Citation
Yin, S. (2025). Associations between socioeconomic position and mental health and mental health disorders among adults in Canada from 2005 to 2022 (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.