Social determinants of mental health
[2] Disparities in mental health outcomes are a result of a multitude of factors and social determinants, including fixed characteristics on an individual level – such as age, gender, race/ethnicity, and sexual orientation – and environmental factors that stem from social and economic inequalities – such as inadequate access to proper food, housing, and transportation, and exposure to pollution.
[9][10][11] Fixed characteristics refers to those that are genetic and biological and/or are not subjected to be influenced by the environment or social living conditions of an individual.
[14] Research studies included in Lancet Psychiatry Women's Mental Health Series focuses on understanding why some of these gendered disparities might exist.
mentions several risk factors that contributes to these inequities, including the role of a women's sex hormones and "blunted hypothalamic-pituitary-adrenal axis response to stress".
[16] Other factors include a woman's increased likelihood to body shaming and rumination and stressors on an interpersonal level, as well as sexual abuse during childhood.
Researchers found that women have a higher risk of being subjected to domestic and sexual violence, thereby increasing their prevalence to post-traumatic stress, anxiety, and depression.
Also notable to consider in the context of gender-based trauma are female genital mutilation, forced and early marriage, human trafficking, and honor crimes.
[20][21] In fact, LGBTQIA+ individuals are twice as likely to have a mental disorder compared to their heterosexual counterparts, and two and a half times more likely to experience anxiety, depression, and substance misuse.
[27] Studies in the conducted in the United States have indicated that minorities have similar or smaller rates of prevalence for mental health disorders as their majority counterparts.
[30] Further, in the instances of some mental illnesses, such as schizophrenia, Blacks in the United States have been reported to have higher rates compared to their White counterparts, however, research suggests that this could be due to an overdiagnosis among clinicians and underdiagnosis for other illnesses, such as mood disorders, for which Blacks had lower reported prevalence rates for major depression.
Mental illnesses are common among those that are food insecure due to associated factors of stress and weaker community belonging.
[38][39] This factor can impact an individual's ability to feel supported or a sense of belonging within their community, thereby increasing their vulnerability to mental illnesses.
[41] Another study, one of the largest of its kind aimed to characterize the health of Canada's homeless youth, reported that 85% of its participants had high levels of psychological distress and 42% attempted suicide at least once.
Specifically, there were a higher risk for symptoms of depression among groups that experienced various forms of discrimination – including racism, heterosexism.
The role of multiple forms of discrimination on other mental health problems, such as anxiety, posttraumatic stress disorder, substance use, are less, and the results are mixed.
Provider discrimination can affect mental health treatment among racial minorities, for example: in the United States, minority groups have similar or lower prevalence rates of mental disorders when compared to their white counterparts, however Blacks were only half as likely as whites to receive treatment for diseases of similar severity.
According to research, there is a complicated and bi-directional relationship between economic factors such as unemployment, food insecurity, poverty and increased prevalence of adult common mental disorders in low-income, middle-income, and high-income countries.
[72] Further, the functional BDNF Val66Met polymorphism has also been found to be a potential genetic risk factor for depression because it impacts the volume of the hippocampus, and stress-induced hippocampal atrophy has been associated with the origination and development of affective disorders.
[73] Extensive research and literature in the fields of neuroscience and psychology – and their intersection – aim to identify these genetic and anatomical risk factors.
