Mental health disparities across regions: Exploring the roles of inequality, socioeconomic factors and regional public health service

The main objective of this study is to analyze whether inequality in income distribution together with other determinants influences Risk of poor mental health and non-specific psychological distress, Prevalence of registered mental disorders, and Mortality in mental disorders, and how the public health system mitigates these effects. The study also aims to contribute to the existing empirical evidence focusing on a regional basis considering that mental disorders are not only seen as an individual problem, but also as a social issue, emerging the need for regional strategies. To this end, the case of seventeen Spanish regions is used, indexes by principal component analysis are obtained and panel data models are estimated. The results obtained allow us to conclude that regions with a higher level of income inequality generate a higher Risk of poor mental health and a higher rate of Registered mental disorders, but do not increase Mortality, highlighting the importance of the Spanish regions public Health Service, which does not distinguish by income level. Similarly, factors such as access to healthcare services, the perceived quality of medical institutions and patient’s satisfaction, unemployment and socioeconomic deprivation, as well as population density, play a critical role in the prevention, early detection, and effective treatment of mental illness. These results show that mental health status is no exception to the social pattern, as disparities in regional income and deprivation translate into unequal mental health outcomes. This relationship underscores the importance of addressing socioeconomic determinants as a central component of mental health policies, emphasizing prevention and equity as fundamental strategies to reduce the burden of mental illness in vulnerable populations. Effective policies should combine: (i) the reduction of regional inequalities and the strengthening of local capacities and health systems, (ii) strategic planning of medical services, particularly those aimed at addressing deficiencies in mental health care, and (iii) investment in health and reduction of direct costs for individuals.