Mental Health, SDOH Drive Health Equity

By mid-July, 53% of adults had reported their mental health had been negatively impacted by the coronavirus—and research shows that poor and disadvantaged populations are most affected by mental health disorders.

It’s well-known that social determinants such as adequate income, a safe place to live and enough nutritious food often play an important role in a person’s health outcomes. But those social determinants (SDOH) don’t just affect physical health; they also have an impact on mental health. In fact, extensive research shows that poor and disadvantaged populations are most affected by mental health disorders.

Because social factors often directly influence mental health, both are important components of health equity. Healthcare and community organizations that work toward equitable social and environmental factors will contribute to better mental health and more equitable healthcare access for the populations they serve.

How Social Factors Drive Mental Health Outcomes

The coronavirus pandemic offers a simple case study of the impact of social determinants on mental health outcomes. Think about it: As people around the world experienced the isolation of lockdowns, along with school closures, job losses and other economic results of the pandemic, mental health challenges increased significantly. For example, 32% of U.S. adults reported in March that their mental health had been negatively impacted by worry and stress over the coronavirus, and by mid-July, that number had risen to 53%, according to research from Kaiser Family Foundation.

Social isolation and loneliness have long been linked to poor mental health, and the pandemic revealed the link in real-time. In March, 47% of people who were sheltering in place reported negative mental health effects resulting from worry or stress, compared with just 37% of those who were not sheltering in place.

Job loss also has long been linked to increased anxiety, depression and distress. And among people who lost income or employment as a result of the pandemic, more than half reported negative mental health impacts.

According to the U.S. Office of Disease Prevention and Health Promotion, a number of social conditions can influence mental health. They include interpersonal, family and community dynamics; housing quality; social support; employment opportunities; and work and school conditions.

While the coronavirus pandemic (and the isolating and economic effects that come with it) should be temporary, the situation sheds light on the fact that social and environmental factors can greatly increase the risk of mental health challenges. People who have access to positive social relationships and quality education, employment, transportation and food are more likely to avoid mental health difficulties, whether they’re living through a pandemic or not.

How Healthcare Organizations and Communities Can Help

Effective approaches to improving SDOH often can be also effective in improving mental health. For instance, “safe shared places for people to interact, such as parks and churches, can support positive mental health,” according to the Office of Disease Prevention and Health Promotion. “A better understanding of these factors, how they interact, and their impact is key to improving and maintaining the mental health of all Americans.”

Sometimes, healthcare institutions can partner with those safe community organizations to improve mental health in local populations. For example, the Hogg Foundation for Mental Health at the University of Texas at Austin provides grants to local organizations working to improve mental health in their communities, such as God’s Way Christian Baptist Church in Taylor, Texas. The church runs a number of initiatives under its Wellness and Empowerment Community Ministries (WECM), aimed at creating a culture of inclusivity and sensitivity to meet the spiritual and psychological needs of its congregation.

Those initiatives include health fairs, conferences, and community wellness and outreach events. One of those outreach initiatives is a barbershop dialogue series, in which God’s Way representatives are joined by law enforcement representatives to chat with barbershop patrons about mental health issues in the criminal justice system. With a deeper understanding of mental health issues, community leaders and members are better equipped to handle and respond to mental health emergencies. Also, the church’s youth programs, such as Vacation Bible School, include discussions of mental health issues like anxiety and depression, helping to end the stigma of mental illness, and equipping young people with the ability to recognize signs and symptoms of distress in their friends and family members.

Programs like these provide people in high-risk communities with education, support and social networks that help reduce the risk of mental health challenges. By partnering with community groups, healthcare organizations can work to lower risks and improve health outcomes for their local populations.

Helping to meet social and environmental needs can help even the playing field for both mental health and physical health. “Social determinants of health and mental health go hand in hand with health equity,” notes the Hogg Foundation for Mental Health.

The coronavirus pandemic underscored how a person’s immediate circumstances can have a significant impact on his or her mental health. Just as negative factors—like isolation, loneliness and a loss of employment—can increase risk, the addition of positive factors can decrease that risk. Through community and provider partnerships, healthcare leaders can work to build stronger support networks, improve access to necessary resources, and provide exceptional mental health education within their local populations.

 

Mental health is such an important issue, particularly during this time of uncertainty. Get more perspectives from Babette Apland, managing director of Call to Mind, an initiative started by American Public Media, in this blog post on normalizing conversations about mental health.