SynthesisInternational journal for equity in health2018
How do macro-level structural determinants affect inequalities in mental health? - a systematic review of the literature.
Synthesis in International journal for equity in health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Discrimination and Gender: An Umbrella Review of Psychological Evidence.International journal of environmental research and public health · 2026Pooled it
- Pooled it
- National or population level interventions addressing the social determinants of mental health - an umbrella review.BMC public health · 2021Pooled it
- What works to address inequalities in primary care: Development of Living Evidence Maps using machine learning.Public health in practice (Oxford, England) · 2026Article
- An Integrated Analysis of Informal Caregiving and Psychosocial Work Stressors on Mental Health Trajectories in Later Life.Research square · 2026Article
- Sociodemographic and mental health predictors of mental health service use across provider types.PloS one · 2026Article
- Rural-urban disparities in socio-health determinants of anxiety among women of reproductive age in Bangladesh.Global mental health (Cambridge, England) · 2026Article
- Examining the profile of couples attending a violence prevention intervention: A dyadic latent profile analysis.International health trends and perspectives · 2025Article
- Mental health prevention: moving forward with the evidence.Discover mental health · 2025Article
- A cross-lagged network analysis of multisystemic factors influencing adolescent depressive symptoms: considering gender differences.Child and adolescent psychiatry and mental health · 2025Article
- Mental health and structural injustice: a qualitative investigation of interlocking patterns of disadvantage among displaced populations in Nairobi, Kenya.Conflict and health · 2025Article
- Socioeconomic differences in adolescent health behaviors and their effect on inequalities in adult depressed mood: findings from a 27-year longitudinal study.BMC psychiatry · 2025Article
- Towards democratised psychiatry: building metacommunities for inclusive and equitable global mental health.BJPsych international · 2025Review
- A qualitative evaluation of a partnership between a local authority and community organisations to improve mental health and wellbeing.Discover public health · 2025Article
- Multiple material need insecurities and severity of psychological distress during the COVID-19 pandemic among women who use drugs.BMC public health · 2024Article
- The social determinants of mental health and disorder: evidence, prevention and recommendations.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- The youth mental health crisis: analysis and solutions.Frontiers in psychiatry · 2024Review
- Tracking of depressed mood from adolescence into adulthood and the role of peer and parental support: A partial test of the Adolescent Pathway Model.SSM - population health · 2023Article
- The Effect of Welfare State Policy Spending on the Equalization of Socioeconomic Status Disparities in Mental Health.Journal of health and social behavior · 2023Article
- A multi-country survey of the socio-demographic factors associated with adherence to COVID-19 preventive measures during the first wave of the COVID-19 pandemic.BMC public health · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Europe and elsewhere there is rising concern about inequality in health and increased prevalence of mental ill-health. Structural determinants such as welfare state arrangements may impact on levels of mental health and social inequalities. This systematic review aims to assess the current evidence on whether structural determinants are associated with inequalities in mental health outcomes.
methodsWe conducted a systematic review of quantitative studies published between 1996 and 2017 based on search results from the following databases Medline, Embase, PsychInfo, Web of Science, Sociological Abstracts and Eric. Studies were included if they focused on inequalities (measured by socio-economic position and gender), structural determinants (i.e. public policies affecting the whole population) and showed a change or comparison in mental health status in one (or more) of the Organisation for Economic Cooperation and Development (OECD) countries. All studies were assessed for inclusion and study quality by two independent reviewers. Data were extracted and synthesised using narrative analysis.
resultsTwenty-one articles (17 studies) met the inclusion criteria. Studies were heterogeneous with regards to methodology, mental health outcomes and policy settings. More comprehensive and gender inclusive welfare states (e.g. Nordic welfare states) had better mental health outcomes, especially for women, and less gender-related inequality. Nordic welfare regimes may also decrease inequalities between lone and couple mothers. A strong welfare state does not buffer against socio-economic inequalities in mental health outcomes. Austerity measures tended to worsen mental health and increase inequalities. Area-based initiatives and educational policy are understudied.
conclusionAlthough the literature on structural determinants and inequalities in mental health is limited, our review shows some evidence supporting the causal effects of structural determinants on mental health inequalities. The lack of evidence should not be interpreted as lack of effect. Future studies should apply innovative methods to overcome the inherent methodological challenges in this area, as structural determinants potentially affect both levels of mental health and social inequalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.