The association between labour force participation and being in income poverty amongst those with mental health problems

Internet use and mental health problems among older people in Shanghai, China: the moderating roles of chronic diseases and household income

Objectives: This study investigates whether the impact of Internet use on old adults' mental health problems differs across health conditions and income groups in Shanghai, China.Methods: This study uses data from a large-scale sample of 2117 respondents aged 60-80 years in Shanghai, China. This study measures mental health problems with the 10-item version of the Hopkins Symptom Checklist, assesses Internet use with a 4-item scale and chronic diseases with a 12-item scale. This study applies ordinary least square regression models to assess associations between Internet use and mental health problems across income groups and health conditions.Results: Elderly people using the Internet more frequently have substantially lower odds of having mental health problems. Further analyses find the moderating roles of chronic diseases and household income on mental health problems. Chronic diseases significantly increase the correlation of Internet use with mental health problems. Meanwhile, Internet use reduces more elders' mental health problems in the low-income group than in the high-income group.Conclusion: This study sheds evidence on the negative correlation of Internet use with mental health problems. It also indicates that Internet use may reduce more mental health problems in the low-income group and the unhealthy group. Therefore, increasing Internet use in the low-income group and the unhealthy group is suggested as a promising strategy to promote elders' mental health.

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

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.

Examining protective and buffering associations between sociocultural factors and adverse childhood experiences among American Indian adults with type 2 diabetes: a quantitative, community-based participatory research approach

OBJECTIVES

The purpose of this study was to determine the frequency of select adverse childhood experiences (ACEs) among a sample of American Indian (AI) adults living with type 2 diabetes (T2D) and the associations between ACEs and self-rated physical and mental health. We also examined associations between sociocultural factors and health, including possible buffering processes.

DESIGN

Survey data for this observational study were collected using computer-assisted survey interviewing techniques between 2013 and 2015.

SETTING

Participants were randomly selected from AI tribal clinic facilities on five reservations in the upper Midwestern USA.

PARTICIPANTS

Inclusion criteria were a diagnosis of T2D, age 18 years or older and self-identified as AI. The sample includes n=192 adults (55.7% female; mean age=46.3 years).

PRIMARY MEASURES

We assessed nine ACEs related to household dysfunction and child maltreatment. Independent variables included social support, diabetes support and two cultural factors: spiritual activities and connectedness. Primary outcomes were self-rated physical and mental health.

RESULTS

An average of 3.05 ACEs were reported by participants and 81.9% (n=149) said they had experienced at least one ACE. Controlling for gender, age and income, ACEs were negatively associated with self-rated physical and mental health (p<0.05). Connectedness and social support were positively and significantly associated with physical and mental health. Involvement in spiritual activities was positively associated with mental health and diabetes-specific support was positively associated with physical health. Social support and diabetes-specific social support moderated associations between ACEs and physical health.

CONCLUSIONS

This research demonstrates inverse associations between ACEs and well-being of adult AI patients with diabetes. The findings further demonstrate the promise of social and cultural integration as a critical component of wellness, a point of relevance for all cultures. Health professionals can use findings from this study to augment their assessment of patients and guide them to health-promoting social support services and resources for cultural involvement.

Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults

PURPOSE

To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards.

METHODS

Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The sample was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale.

RESULTS

After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001); having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty.

CONCLUSION

To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.

Retirement, age, gender and mental health: findings from the 45 and Up Study

OBJECTIVES

To examine the relationships of retirement and reasons for retirement with psychological distress in men and women at the age of 45-79 years.

METHOD

Data from 202,584 Australians participating in the large-scale 45 and Up Study was used. Psychological distress was measured by the Kessler psychological distress scale. Associations between different work status and reasons for retirement with psychological distress were assessed for men and women at different ages using logistic regression.

RESULTS

Being fully retired or unemployed was associated with the high levels of psychological distress compared to being in paid work for men and women aged 45-64 (p < 0.0001), and for men aged 65-74 years (p ≤ 0.0014). At the age of 75-79 years, there was no difference in psychological distress between different work statuses. Among retirees, retirement due to ill health, being made redundant or caring duty was associated with the high level of psychological distress.

CONCLUSION

The association between work and mental health underscores the importance of policies and strategies to encourage and enable people to continue in the workforce after age 55, particularly for men. Important reasons for retirement with worse mental health outcomes include redundancy, ill health and needing to care for family or a friend. These circumstances will affect whether a person can continue working and their risk of poor mental health, and both considerations should be addressed in developing approaches for maintaining older workers or assisting them with their retirement transition.