Socioeconomic gradients and mental health: implications for public health

BACKGROUND: Research on mental well-being is relatively new and studies of its determinants are rare. AIMS: To investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness. METHOD: Using logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England. RESULTS: Independent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01-2.10) and those aged 35-54 years (OR = 1.58, 95% CI 1.35-1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62-0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23-1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09-1.69); education where there was no association; and equivalised income for which the association was non-linear. CONCLUSIONS: Odds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.