Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study
Abstract Aims The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDO...
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Cambridge University Press
2025-01-01
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| Series: | Epidemiology and Psychiatric Sciences |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796024000866/type/journal_article |
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| author | S. Tanarsuwongkul J. Liu M. Spaulding K. Perea-Schmittle M. Lohman Q. Wang |
| author_facet | S. Tanarsuwongkul J. Liu M. Spaulding K. Perea-Schmittle M. Lohman Q. Wang |
| author_sort | S. Tanarsuwongkul |
| collection | DOAJ |
| description | Abstract
Aims
The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States.
Methods
We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy People 2030: education access and quality, economic stability, healthcare access and quality, social and community context, and neighbourhood and built environment. A summary SDOH score was calculated by adding each adverse SDOH risk (any SDOH vs. no SDOH). Our primary outcomes were diagnoses of major depression (MD) (i.e., major depressive disorder, recurrent MD or MD in remission) and anxiety disorders (AD) (i.e., generalized AD and other anxiety-related disorders). Multiple logistic regression models were used to determine adjusted odd ratios (aORs) for MD and/or ADs after controlling for covariates.
Results
A total of 63,162 participants with MD were identified (22,277 [35.3%] age 50–64 years old; 41,876 [66.3%] female). A total of 77,624 participants with AD were identified (25,268 [32.6%] age 50–64 years old; 52,224 [67.3%] female). Factors associated with greater odds of MD and AD included having less than a college degree, annual household income less than 200% of federal poverty level, housing concerns, lack of transportation, food insecurity, and unsafe neighbourhoods. Having no health insurance was associated with lower odds of both MD and AD (aOR, 0.48; 95% confidence interval [CI], 0.46–0.51 and aOR, 0.44; 95% CI, 0.42–0.47, respectively). SDOH summary score was strongly associated with the likelihood of having MD and AD (aOR, 1.97; 95% CI, 1.89–2.06 and aOR, 1.69; 95% CI, 1.63–1.75, respectively).
Conclusions
This study found associations between all five domains of SDOH and the higher odds of having MD and/or AD. The strong correlations between the SDOH summary score and mental health disorders indicate a possible use of the summary score as a measure of risk of developing mental health disorders.
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| format | Article |
| id | doaj-art-fd19c9d5b74a47c4b4a3d3993265acab |
| institution | Kabale University |
| issn | 2045-7960 2045-7979 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj-art-fd19c9d5b74a47c4b4a3d3993265acab2025-01-16T21:47:45ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792025-01-013410.1017/S2045796024000866Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional studyS. Tanarsuwongkul0J. Liu1https://orcid.org/0000-0001-8685-3036M. Spaulding2K. Perea-Schmittle3M. Lohman4Q. Wang5Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USAEpidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USADepartment of Biomedical Engineering, Molinaroli College of Engineering and Computing, University of South Carolina, Columbia, SC, USADepartment of Biology, New Mexico Institute of Mining and Technology, Socorro, NM, USAEpidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USADepartment of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USAAbstract Aims The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States. Methods We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy People 2030: education access and quality, economic stability, healthcare access and quality, social and community context, and neighbourhood and built environment. A summary SDOH score was calculated by adding each adverse SDOH risk (any SDOH vs. no SDOH). Our primary outcomes were diagnoses of major depression (MD) (i.e., major depressive disorder, recurrent MD or MD in remission) and anxiety disorders (AD) (i.e., generalized AD and other anxiety-related disorders). Multiple logistic regression models were used to determine adjusted odd ratios (aORs) for MD and/or ADs after controlling for covariates. Results A total of 63,162 participants with MD were identified (22,277 [35.3%] age 50–64 years old; 41,876 [66.3%] female). A total of 77,624 participants with AD were identified (25,268 [32.6%] age 50–64 years old; 52,224 [67.3%] female). Factors associated with greater odds of MD and AD included having less than a college degree, annual household income less than 200% of federal poverty level, housing concerns, lack of transportation, food insecurity, and unsafe neighbourhoods. Having no health insurance was associated with lower odds of both MD and AD (aOR, 0.48; 95% confidence interval [CI], 0.46–0.51 and aOR, 0.44; 95% CI, 0.42–0.47, respectively). SDOH summary score was strongly associated with the likelihood of having MD and AD (aOR, 1.97; 95% CI, 1.89–2.06 and aOR, 1.69; 95% CI, 1.63–1.75, respectively). Conclusions This study found associations between all five domains of SDOH and the higher odds of having MD and/or AD. The strong correlations between the SDOH summary score and mental health disorders indicate a possible use of the summary score as a measure of risk of developing mental health disorders. https://www.cambridge.org/core/product/identifier/S2045796024000866/type/journal_articleAll of Usanxiety disordermajor depressionSDOHsocial determinants of health |
| spellingShingle | S. Tanarsuwongkul J. Liu M. Spaulding K. Perea-Schmittle M. Lohman Q. Wang Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study Epidemiology and Psychiatric Sciences All of Us anxiety disorder major depression SDOH social determinants of health |
| title | Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study |
| title_full | Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study |
| title_fullStr | Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study |
| title_full_unstemmed | Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study |
| title_short | Associations between social determinants of health and mental health disorders among U.S. population: a cross-sectional study |
| title_sort | associations between social determinants of health and mental health disorders among u s population a cross sectional study |
| topic | All of Us anxiety disorder major depression SDOH social determinants of health |
| url | https://www.cambridge.org/core/product/identifier/S2045796024000866/type/journal_article |
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