Why are people who live in poverty disproportionately affected by mental illness? Can policies that aim to improve well-being reduce poverty? In a Review, Matthew Ridley and colleagues examine the accumulating interdisciplinary evidence demonstrating a bidirectional causal relationship between poverty and the most common mental illnesses, depression and anxiety, an especially urgent consideration during the COVID-19 pandemic, they note. According to Ridley et al., understanding the mechanisms underlying these causal effects is crucial for developing effective policies and interventions that aim to improve psychological well-being and reduce poverty. Research leveraging natural and controlled economic experiments involving populations worldwide suggests that people who live in poverty are often disproportionately affected by mental illness. Similarly, those afflicted with depression and anxiety are more likely to face greater economic challenges due to a loss of employment and income, leading to poverty. Many of these studies also show that interventions or programs designed to improve mental health or economic condition often positively affect those suffering poverty or mental illness, respectively. A study offering largely free health insurance to low-income recipients in Oregon reduced depression by about a quarter in a few months, as one example. The authors propose and discuss several plausible mechanisms that may underlie the bidirectional causal relationship - including the worries and uncertainty that come with living in poverty, and the effects of poverty on childhood development. They argue that there is a strong economic case for investing in those suffering from mental illness and poverty, noting that such efforts can have intergenerational effects. Public-health crises such as the ongoing COVID-19 pandemic tend to uniquely affect those living in poverty, the authors say. "The pandemic has disproportionally affected the poor and may have lasting adverse impacts on their economic and mental well-being," write Ridley et al. "A massive investment in mental health was long overdue even before the pandemic and has become critically urgent now."
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Journal
Science