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Cited by 1,375Mental Health Treatment and AccessEmployment and Welfare StudiesHealth disparities and outcomes

Poverty and common mental disorders in low and middle income countries: A systematic review

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Lund, Crick, Breen, Alison, Flisher, Alan J., Kakuma, Ritsuko, Corrigall, Joanne, Joska, John A., Swartz, Leslie, Patel, Vikram·2010·Social Science & Medicine
DOI 10.1016/j.socscimed.2010.04.027PMC PMC4991761
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Abstract

In spite of high levels of poverty in low and middle income countries (LMIC), and the high burden posed by common mental disorders (CMD), it is only in the last two decades that research has emerged that empirically addresses the relationship between poverty and CMD in these countries. We conducted a systematic review of the epidemiological literature in LMIC, with the aim of examining this relationship. Of 115 studies that were reviewed, most reported positive associations between a range of poverty indicators and CMD. In community-based studies, 73% and 79% of studies reported positive associations between a variety of poverty measures and CMD, 19% and 15% reported null associations and 8% and 6% reported negative associations, using bivariate and multivariate analyses respectively. However, closer examination of specific poverty dimensions revealed a complex picture, in which there was substantial variation between these dimensions. While variables such as education, food insecurity, housing, social class, socio-economic status and financial stress exhibit a relatively consistent and strong association with CMD, others such as income, employment and particularly consumption are more equivocal. There are several measurement and population factors that may explain variation in the strength of the relationship between poverty and CMD. By presenting a systematic review of the literature, this paper attempts to shift the debate from questions about whether poverty is associated with CMD in LMIC, to questions about which particular dimensions of poverty carry the strongest (or weakest) association. The relatively consistent association between CMD and a variety of poverty dimensions in LMIC serves to strengthen the case for the inclusion of mental health on the agenda of development agencies and in international targets such as the millenium development goals.

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  • Low- and middle-income countries suffer dual challenges of reduced service coverage and limited financial protection for mental, neurological, and substance use disorders, in addition to adverse economic consequences for households.

    “Thus, LMICs suffer from the dual challenges of reduced service coverage as well as limited financial protection for mental, neurological, and substance use (MNS) disorders; in addition to pronounced adverse economic consequences for households [5].”

    From Sustainable financing mechanisms for strengthening mental health systems in Nigeria (2019) · cites this paper as [5]

    The Discussion (Population factors; page unavailable) says inadequate access to health care is likely to affect mental health, and the Introduction (page unavailable) describes increased health expenditure and lost income as possible consequences of mental illness. But the paper does not establish reduced service coverage or limited financial protection for mental, neurological, and substance use disorders in LMICs, nor pronounced economic consequences for their households. Its review focuses on common mental disorders. (LLM, conf=0.82)

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6 of the 114 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Barnes H Wright G Noble M Dawes A The South African index of multiple deprivation for children: Census 2001 2007 Cape Town HSRC Press
  2. Townsend P Deprivation Journal of Social Policy 1987 16 125 146
  3. Toye M Infanti J Social inclusion and community economic development: Literature review Victoria, BC The Canadian CED Network 2004

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Authors
Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., Swartz, L., & Patel, V.
Affiliations
  • University of Cape Town (ZA)
  • Centre for Addiction and Mental Health (CA)
  • Stellenbosch University (ZA)
  • London School of Hygiene & Tropical Medicine (GB)
Corresponding author
Lund, Crick
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2010-08
Volume
71
Issue
3
Pages
517-528
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2010.04.027
PMC
PMC4991761
OpenAlex
W2068380169
Cited by
1,375
References
114
Citations by year
2026: 93 · 2025: 138 · 2024: 108 · 2023: 89 · 2022: 119 · 2021: 122 · 2020: 174 · 2019: 95 · 2018: 86 · 2017: 72 · 2016: 52 · 2015: 63 · 2014: 50 · 2013: 41 · 2012: 38
FWCI
4.44
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • UK Department for International Development (DfID)
  • Western Cape Department of Health
  • International Development Research Council
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
  • Social Sciences › Health › Health disparities and outcomes
Keywords
poverty, common mental disorders, low- and middle-income countries, poverty dimensions, food insecurity, housing, social class, socioeconomic status, financial stress, Millennium Development Goals
MeSH terms
Mental Disorders, Developing Countries, Humans, Poverty, Multivariate Analysis, Health Status Disparities

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