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SES-Mental Health Essay
JHSPH09
25
Other
Graduate
12/21/2009

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Term
National Comorbidity Survey
Definition
The National Comorbidity Study demonstrated that people in the lowest income levels compared with those in the highest were most at risk for affective disorders and that socioeconomic status was more strongly linked to anxiety disorders than to affective disorders. (Kessler et al. (1994).
Term
Epidemiological Catchment Area and low SES
Definition
The ECA study found that socioeconomic status was not associated with depression but had an inverse association with lifetime rates of alcohol abuse. (Williams et al. (1992).
Term
The Jarvis Commission
Definition
(1854) - Showed that lunatics and idiots were much more common in the paupers as opposed to the independents
Term
Faris and Dunham
Definition
(1939) - Using IL state mental hospital records, they showed that, unlike patients with other diagnoses, individuals with schizophrenia were most likely to come from inner-city, socially disintegrated urban areas and least likely to have lived in suburban areas with better socioeconomic conditions. This study provided strong evidence that rates of schizophrenia were inversely related to social class, although whether this association was attributable to social selection, environmental stress
Term
The New Haven Study
Definition
(Hollingshead and Redlich (1958) - Neurosis was more common in the wealthy, but psychosis was much more common in the poor (social class distributions provided). They also discovered that psychopathology was more prevalent in children from lower socio-economic status (SES) families when compared to upper-SES families)
Term
Midtown Manhattan Study
Definition
(Langner and Michael, 1963) - Stress scores were much higher for low income when compared to high income
Term
Depression Meta-Analysis
Definition
Lorant and colleagues (2003) - Huge meta-analysis found that MDD prevalence comparing lowest to highest, was significant across prevalence (OR=1.68), Incidence (OR=1.21) and Persistence (OR=1.91)
Term
Important note about dx discrepancies and low SES
Definition
Most studies published before 1980 found a higher prevalence in the upper socioeconomic classes. This finding may be attributed to a bias assessment of researchers and clinicians in diagnosing subjects with lower socioeconomic status as schizophrenic and psychotic subjects from upper socioeconomic status as bipolar. In contrast, more recent epidemiologic studies have not found a significant difference of bipolar disorder related to social class. (Tohen, 2002 - book)
Term
Treatment needs in low SES
Definition
There could also be a relationship between access to care and mental disorders, considering the significant unmet needs seen in lower income families. The inability to receive treatment could then account for an increase in the prevalence of mental disorders. Self-reported barriers as well as accessibility were noted in lower income groups (Steele and colleagues, 2007)
Term
Adverse events more prominent in low SES
Definition
Traumatic and other stressful events tend to be more frequent in low SES and racial/ethnic minorities groups (Hatch, 2007)
Term
Latah study
Definition
Saint-Martin, 1999
Term
Racial diagnosis bias towards schizophrenia
Definition
Strakowski and colleagues, 1996
Term
Social selection theory evidence?
Definition
Dohrenwend, 1992 and schizophrenia
Term
Poverty in a stress-diathesis model?
Definition
The stress!
Term
Importance of social supports and confidants
Definition
(Brown, 1975) In the presence of recent life stress, the onset of depression was found only in 4% of individuals with a confidant, vs. 38% for those without
Term
Moving to Opportunity
Definition
Gave housing vouchers to low-income families, moving them to low-poverty neighborhoods with better resources than the usual high-poverty neighborhoods that Section 8 voucher holders usually move to. Results showed that lower rates of obesity and depression, and their female children were more likely to graduate from high school, and less likely to engage in delinquent or risky behavior (Kling, 2006)
Term
A child study showing the same thing in terms of low SES and child health problems
Definition
Costello and colleagues (1996) in a representative sample of 9, 11 and 13-year olds, found that children below the poverty line were more likely to meet criteria for any DSM-III-R psychiatric disorder, relative to children above the cutoff
Term
Example of Social Causation
Definition
Conditions in life associated with low SES increase the risk of mental disorders (Eaton 1980, 1985)
Term
Define Social Selection Theory using Eaton's definition
Definition
Within a generation, mental disorders may cause downward mobility among adults and lead them to "drift" into the lower socioeconomic strata
Term
What study investigated whether social causation or social selection was at work? What sample?
Definition
Miech, 1999 - Dunedin cohort
Term
Main results of (Miech, 1999)
Definition
Social selection = Externalizing Disorders
Social causation = Internalizing Disorders
Term
What is the third option, besides social causation and social selection?
Definition
Labeling explanation
Term
Ways to operationalize SES?
Definition
1) Family background
2) Education,
3) Occupational prestige
4) Income
Term
What study showed that more serious disorders are likely to socially drift?
Definition
Ortega and Rush (1983)
Term
Gender differences in substance use, particularly alcohol use
Definition
(Koposov, 2002)
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