ArticleSocial psychiatry and psychiatric epidemiology2017
Income inequality among American states and the conditional risk of post-traumatic stress disorder.
Article in Social psychiatry and psychiatric epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The association between income inequality and adult mental health at the subnational level-a systematic review.Social psychiatry and psychiatric epidemiology · 2022Pooled it
- Effect of Evidence-Based Supported Employment vs Transitional Work on Achieving Steady Work Among Veterans With Posttraumatic Stress Disorder: A Randomized Clinical Trial.JAMA psychiatry · 2018Trial
- Economic hardship and mental health following a national trauma and amid ongoing conflict: a longitudinal cohort study.Social psychiatry and psychiatric epidemiology · 2026Article
- Relative Poverty and Mental Illness in Adults, Children, and Adolescents in Industrialized Countries.Deutsches Arzteblatt international · 2025Review
- Hospitalizations with post-traumatic stress disorder in France between 2013 and 2022: a nationwide retrospective study.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Neighborhood-level economic characteristics and depression and PTSD symptoms among Houstonians who have experienced Hurricane Harvey and COVID-19.Psychiatry research · 2024Article
- Structural inequities contribute to racial/ethnic differences in neurophysiological tone, but not threat reactivity, after trauma exposure.Molecular psychiatry · 2023Article
- The buffering effect of social capital for daily mental stress in an unequal society: a lesson from Seoul.International journal for equity in health · 2023Article
- Associations between relative deprivation with opioid use among working-age adults during the great recession.Journal of psychiatric research · 2023Article
- How Income and Income Inequality Drive Depressive Symptoms in U.S. Adults, Does Sex Matter: 2005-2016.International journal of environmental research and public health · 2022Article
- Correlates of Obtaining Employment among Veterans Receiving Treatment for Severe PTSD in Specialized Intensive Programs.The Psychiatric quarterly · 2021Article
- The Impact of Income Inequality on Subjective Environmental Pollution: Individual Evidence from China.International journal of environmental research and public health · 2021Article
- Incidence and Direct Medical Cost of Acute Stress Disorder and Post-traumatic Stress Disorder in Korea: Based on National Health Insurance Service Claims Data from 2011 to 2017.Journal of Korean medical science · 2021Article
- Youth, poverty, and interpersonal violence: a recipe for PTSD.Trauma surgery & acute care open · 2021Article
- Neighborhood disadvantage is associated with stable deficits in neurocognitive functioning in traumatically-injured adults.Health & place · 2021Article
- Occupational stress and psychological health impact on hypertension of miners in noisy environment in Wulumuqi, China: a case-control study.BMC public health · 2020Article
- Prospective prediction of PTSD diagnosis in a nationally representative sample using machine learning.BMC psychiatry · 2020Article
- Chromosomes to Social Contexts: Sex and Gender Differences in PTSD.Current psychiatry reports · 2018Review
Corrections and comments
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5 authors.
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Abstract
purposeVulnerability to post-traumatic disorder (PTSD) following a traumatic event can be influenced by individual-level as well as contextual factors. Characteristics of the social and economic environment might increase the odds for PTSD after traumatic events occur. One example that has been identified as a potential environmental determinant is income inequality. The purpose of this study is to investigate the association between State-level income inequality and PTSD among adults who have been exposed to trauma.
methodsWe used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,653). Structured diagnostic interviews were administered at baseline (2001-2002) and follow-up (2004-2005). Weighted multi-level logistic regression was used to determine if US State-level income inequality, as measured by the Gini coefficient, was associated with incident episodes of PTSD during the study's 3-year follow-up period adjusting for individual and state-level covariates.
resultsThe mean Gini coefficient across states in the NESARC was 0.44 (SD = 0.02) and ranged from 0.39 to 0.53. Of the respondents, 27,638 reported exposure to a traumatic event. Of this sample, 6.9 and 2.3% experienced persistent or recurrent and incident PTSD, respectively. State-level inequality was not associated with increased odds for persistent or recurrent PTSD (OR = 1.02; 95% CI 0.85, 1.22), but was associated with incident PTSD (OR = 1.30, 95% CI 1.04, 1.63).
conclusionThe degree of income inequality in one's state of residence is associated with vulnerability to PTSD among individuals exposed to traumatic events. Additional work is needed to determine if this association is causal (or alternatively, is explained by other socio-contextual factors associated with income inequality), and if so, what anxiogenic mechanisms explain it.
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