Prevalence of Mental Disorders by Socioeconomic Status in Australia: A Cross-Sectional Epidemiological Study

Abstract

Purpose:

To present the prevalence of 3 broad categories of mental disorder (anxiety-related, affective and other disorders) by socioeconomic status and examine the associated socioeconomic risk factors of mental disorders in Australia.

Design:

A population-based, cross-sectional national health survey on mental health and its risk factors across Australia.

Setting:

National Health Survey (NHS), 2017-2018 conducted by the Australian Bureau of Statistics (ABS)

Participants:

Under aged: 4,945 persons, Adult: 16,370 persons and total: 21,315 persons

Measures:

Patient-reported mental disorder outcomes

Analysis:

Weighted prevalence rates by socioeconomic status (equivalised household income, education qualifications, Socio-Economic Index for Areas (SEIFA) scores, labor force status and industry sector where the adult respondent had their main job) were estimated using cross-tabulation. Logistic regression utilizing subsamples of underage and adult age groups were analyzed to test the association between socioeconomic status and mental disorders.

Results:

Anxiety-related disorders were the most common type of disorders with a weighted prevalence rate of 20.04% (95% CI: 18.49-21.69) for the poorest, 13.85% (95% CI: 12.48-15.35) for the richest and 16.34% (95% CI: 15.7-17) overall. The weighted prevalence rate for mood/affective disorders were 20.19% (95% CI: 18.63-21.84) for the poorest, 9.96% (95% CI: 8.79-11.27) for the richest, and 13.57% (95% CI: 12.99-14.17) overall. Other mental disorders prevalence were for the poorest: 9.07% (95% CI: 7.91-10.39), the richest: 3.83% (95% CI: 3.14-4.66), and overall: 5.93% (95% CI: 5.53-6.36). These patterns are also reflected if all mental disorders were aggregated with the poorest: 30.97% (95% CI: 29.15-32.86), the richest: 19.59% (95% CI: 18.02-21.26), and overall: 23.93% (95% CI: 23.19-24.69). The underage logistic regression model showed significant lower odds for the middle (AOR: 0.75, 95% CI: 0.53 -1.04, p < 0.1), rich (AOR: 0.71, 95% CI: 0.5-0.99, p < 0.05) and richest (AOR: 0.6, 95% CI: 0.41-0.89, p < 0.01) income groups. Similarly, in the adult logistic model, there were significant lower odds for middle (AOR: 0.84, 95% CI: 0.72-0.98, p < 0.05), rich (AOR: 0.73, 95% CI: 0.62-0.86, p < 0.01) and richest (AOR: 0.76, 95% CI: 0.63-0.91, p < 0.01) income groups.

Conclusion:

The prevalence of mental disorders in Australia varied significantly across socioeconomic groups. Knowledge of different mental health needs in different socioeconomic groups can assist in framing evidence-based health promotion and improve the targeting of health resource allocation strategies.

Keywords

Mental Disorders Public Mental health Community Health Health Disparities Social Class Health Care Policy Health Promotion

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