The Social Determinants of Mental Health

Compton, Michael T.; Shim, Ruth S.

doi:10.1176/appi.focus.20150017

Cited by 564Health disparities and outcomesPublic Health and Social InequalitiesMental Health Treatment and Access

The Social Determinants of Mental Health

Compton, Michael T., Shim, Ruth S.·2015·Focus

DOI 10.1176/appi.focus.20150017

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Abstract

It is well known that social factors affect risk for mental illnesses and substance use disorders, as well as health outcomes of persons with these disorders. Social and environmental factors, in addition to their independent and combined effects, can influence genetic determinants of health and illness through gene-by-environment interactions and epigenetic mechanisms. Such social and environmental factors clearly have an effect at the individual level and should encounter intervention in the clinical setting. However, the social determinants of health and the social determinants of mental health exert their effects more broadly at the societal level and thus can be most effectively addressed through changes in public policies and social norms. Specifically, the social determinants of mental health—exemplified here by income inequality and poor education—are understood as being underpinned by unequal distribution of opportunity and, more deeply, by public policies (e.g., legislation that may not specifically pertain to health but ultimately has far-reaching effects on health) and social norms (e.g., cultural opinions and biases that set the stage for poorer health among disadvantaged groups). The greatest population-based impact for improving mental health and reducing risk of mental illnesses and substance use disorders will be achieved by optimizing public policies to make them more health promoting, and by altering social norms so that the health of all members of society is a priority.

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“While research indicates healthcare is a social determinant for all people (Abbott & Elliott, 2017; Compton & Shim, 2015; Frier et al., 2018; Kim et al., 2012; Raphael, 2006; United States Office of Disease Prevention and Health Promotion, , n.d.; World Health Organization, 2010b), Medicaid in…”
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“Significant research has demonstrated that social factors at the macro, mezzo and micro-level of society are key factors in the development, severity and chronicity of mental health problems across the life course, frequently starting during childhood (Compton and Shim 2015).”
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“Therefore, interventions aiming to address such inequalities and social determinants of mental health might differ from families residing in urban or rural settings in the same country (34).”
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“For example, income inequality, economic vulnerability, discrimination, sexism, ableism and various forms of prejudice can also contribute to health inequity and can be seen as SDoH (Compton & Shim, 2015).”
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“Compton and colleagues [22] argue that these social determinants for mental health, exemplified in their work by income inequality and poor education, need to be addressed by public policies and social norms.”
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“…being actively involved in changing policies at the organizational level, speaking up against everyday racism and gendered oppression, and advocating for the recruitment and retention of racial/ethnic minorities in the field (Compton & Shim, 2015; Corneau & Stergiopoulos, 2012; Ratts et al., 2016).”
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“…the nine core SDMH: (1) poor access to care, (2) un/underemployment, (3) food insecurity, (4) poorly built environment, (5) housing insecurity, (6) adverse early life experiences, (7) discrimination/social exclusion, (8) poor education, and (9) poverty/income inequality (Compton & Shim, 2015).”
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Disparities in Documented Drug Use Disorders Between Transgender and Cisgender U.S. Veterans Health Administration Patients
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“For example, discrimination may lead to economic insecurity among transgender people,(7) which may contribute to likelihood of drug use disorders through stress-related pathways.(20,35) Experiencing gender minority stress may also lead to the development of chronic health conditions,(6,36) which may impact likelihood…”
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“This literature calls for more attention to be paid to socio-political determinants of mental health and well-being (Compton & Shim, 2015; Ehsan & De Silva, 2015; Silva et al., 2016) and suggests more work is needed to understand and counteract negative impacts of attitudes and stigma.”
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Authors: Compton, M. T., & Shim, R. S.
Affiliations: Hofstra University (US)
ORCID: Compton, Michael T.
Shim, Ruth S.
Venue: Focus
Publisher: American Psychiatric Association Publishing
Published: 2015-10
Volume: 13
Issue: 4
Pages: 419-425
ISSN: 1541-4094 (ISSN-L)
1541-4108
DOI: 10.1176/appi.focus.20150017
OpenAlex: W2099594539
Cited by: 564
References: 46
Citations by year: 2026: 50 · 2025: 76 · 2024: 86 · 2023: 90 · 2022: 65 · 2021: 88 · 2020: 38 · 2019: 28 · 2018: 18 · 2017: 9 · 2016: 9 · 2015: 4 · 2014: 3
FWCI: 16.63
Type: journal article
Language: en
Open access: closed
Locations: FOCUS The Journal of Lifelong Learning in Psychiatry (publishedVersion)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Health › Public Health and Social Inequalities
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: social determinants of mental health, mental illness, substance use disorders, income inequality, gene-environment interaction, epigenetics, public policy, social norms, health promotion, health disparities

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