Economic Inequality and Mental Health: Causality, Mechanisms, and Interventions

Divyangana Rakesh; Koichiro Shiba; Michèle Lamont; Crick Lund; Kate E Pickett; Tyler J VanderWeele; Vikram Patel

doi:10.1146/annurev-clinpsy-081423-025710

Economic Inequality and Mental Health: Causality, Mechanisms, and Interventions

Divyangana Rakesh, Koichiro Shiba, Michèle Lamont, Crick Lund, Kate E Pickett, Tyler J VanderWeele, Vikram Patel

Health Sciences

Research output: Contribution to journal › Review article › peer-review

Abstract

Almost all countries in the world have witnessed a rapid increase in levels of economic inequality, a measure of the distribution of income and wealth across the population, since the advent of neoliberal economic policies in the 1970s. In this review, we conceptualize inequality as an ecological construct and discuss why it matters for the mental health of populations and for individual clinical outcomes. We then discuss some of the key mechanisms through which economic inequality influences mental health beyond poverty itself: social comparison and social capital. We also consider how the effect might vary across specific vulnerable groups in the population, such as young people and minoritized communities. Finally, we discuss methodological challenges in studying the relationship between inequality and mental health and conclude by outlining future research directions and possible interventions at the governmental, community, and individual levels to mitigate the negative mental health consequences of economic inequality.

Original language	English
Pages (from-to)	353-377
Number of pages	25
Journal	Annual review of clinical psychology
Volume	21
DOIs	https://doi.org/10.1146/annurev-clinpsy-081423-025710
Publication status	Published - 1 May 2025

Keywords

Humans
Socioeconomic Factors
Mental Health
Mental Disorders/economics
Social Capital

Access to Document

10.1146/annurev-clinpsy-081423-025710Licence: CC BY

annurev-clinpsy-081423-025710
© 2025 by the author(s)
Final published version, 314 KBLicence: CC BY

Cite this

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title = "Economic Inequality and Mental Health: Causality, Mechanisms, and Interventions",

abstract = "Almost all countries in the world have witnessed a rapid increase in levels of economic inequality, a measure of the distribution of income and wealth across the population, since the advent of neoliberal economic policies in the 1970s. In this review, we conceptualize inequality as an ecological construct and discuss why it matters for the mental health of populations and for individual clinical outcomes. We then discuss some of the key mechanisms through which economic inequality influences mental health beyond poverty itself: social comparison and social capital. We also consider how the effect might vary across specific vulnerable groups in the population, such as young people and minoritized communities. Finally, we discuss methodological challenges in studying the relationship between inequality and mental health and conclude by outlining future research directions and possible interventions at the governmental, community, and individual levels to mitigate the negative mental health consequences of economic inequality.",

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T2 - Causality, Mechanisms, and Interventions

AU - Rakesh, Divyangana

AU - Shiba, Koichiro

AU - Lamont, Michèle

AU - Lund, Crick

AU - Pickett, Kate E

AU - VanderWeele, Tyler J

AU - Patel, Vikram

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AB - Almost all countries in the world have witnessed a rapid increase in levels of economic inequality, a measure of the distribution of income and wealth across the population, since the advent of neoliberal economic policies in the 1970s. In this review, we conceptualize inequality as an ecological construct and discuss why it matters for the mental health of populations and for individual clinical outcomes. We then discuss some of the key mechanisms through which economic inequality influences mental health beyond poverty itself: social comparison and social capital. We also consider how the effect might vary across specific vulnerable groups in the population, such as young people and minoritized communities. Finally, we discuss methodological challenges in studying the relationship between inequality and mental health and conclude by outlining future research directions and possible interventions at the governmental, community, and individual levels to mitigate the negative mental health consequences of economic inequality.

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KW - Socioeconomic Factors

KW - Mental Health

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KW - Social Capital

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