Abstract
The given project is a literature review that analyzes the tight relationship between socioeconomic status (SES) and mental health. These studies range from large-scale cohort analyses to qualitative research; hence, they provide differential perspectives on how SES influences mental health, including the impact of COVID-19 and cultural differences. Each research piece stands out for its methodological robustness, which ensures their findings are reliable and valid.
The reviewed literature reveals the clinical relevance of the SES-mental health nexus – it suggests the need for holistic and context-specific interventions. The project also addresses the potential implementation of these findings in clinical practice by advocating for integrated approaches that address both mental health and SES challenges. Ethical, legal, and cultural considerations in conducting research with human subjects are properly examined as well.
Introduction
Human well-being is dependent not only on one’s physical condition but also on mental status. Mental disorders have always been a stigmatized plague that affected people’s health; however, today, they are more recognized and increasing in scope. The role of SES in causing or making individuals vulnerable to these illnesses cannot be overlooked. Properly addressing such an insidious problem requires solid clinical evidence, which the given paper intends to analyze.
The problem is that people with low SES have fewer resources to have access to effective mental care, which already establishes a link between these two factors. In addition, SES can impact or mediate mental well-being through lifestyle. Therefore, the review of the latest scholarly evidence is justified because it will show if and how mental health and SES are connected to each other. The PICOT: In adults with low socioeconomic status (P), how does the implementation of comprehensive social support programs (I) compared to no intervention (C) affect the incidence of mental health disorders (O) over a two-year period (T)?
Methods
The methodology of the literature review involved a structured search in Google Scholar. Keywords used included “socioeconomic status,” “mental health,” “SES,” “psychological well-being,” and “health disparities.” The inclusion criteria were peer-reviewed studies published from 2019 onwards, which ensured that the most current research was reviewed. Exclusion criteria involved non-peer-reviewed articles, opinion pieces, and studies prior to 2019. The research process encompassed identifying the problem, conducting a review of five selected studies, and designing a thematic approach. Data was generated directly from the studies’ findings, and they were assessed for their commonalities and differences. The selected studies were analyzed for their contributions to understanding the relationship between SES and mental health. The utilization is reflected in a focus on practical applications in clinical practice.
Literature Review
All selected sources specifically focus on the relationship between SES and mental health, and each one of them properly contributes unique insights and findings to the understanding of such a complex relationship. Kivimäki et al. (2020) conducted a comprehensive study using UK and Finnish cohorts to see how SES affects the development of differential health conditions. The study revealed that low SES correlates with a higher risk for different mental and physical problems. The given findings showcase the cascading effect of poor mental well-being leading to physical illnesses, which is especially true when it comes to socioeconomically disadvantaged groups.
In addition, May et al. (2022) assessed the mental health implications of COVID-19 on freelancers in the cultural industry. Their study is purely qualitative since it is based on interviews, unlike all four other quantitative studies presented here. The article shows that the pandemic exacerbated pre-existing financial insecurities, which is why it had a detrimental impact on mental status. The research points to the urgent need for economic and psychosocial support in the vulnerable sector.
It should be noted that the COVID-19 pandemic made the topic of concern highly relevant; hence, there are many studies analyzing the problem in this context. For example, Poudel and Subedi (2020) focused on the psychosocial effects of COVID-19 in Nepal, and they reveal the unique challenges faced by developing countries. The study showcases the significant mental health repercussions due to pandemic-related SES changes as well as lockdowns.
The research states that there is a need to build proper supportive measures in such resource-limited settings. Reiss et al. (2019) looked at SES and mental wellness in children and teens through a cohort study in Germany. Their findings show that low SES is interlinked with a risk of mental problems in younger people; hence, it recommends that there should be interventions targeting SES inequalities and parental education to mitigate these risks.
China experienced a phenomenal rise in its standards of living over several decades, which is why it is interesting to see how such a massive SES change impacted the Chinese people’s mental condition. Wang and Geng (2019) investigated the influence of SES on physical and psychological health in China by utilizing the 2015 Chinese General Social Survey. The primary findings are that SES is significantly associated with physical health but not psychological health; however, lifestyle still significantly affects both. One should understand that SES can impact mental elements indirectly through lifestyle as well. The findings support the notion that SES still impacts one’s mental status through lifestyle.
Findings
Reliability and Validity: Comparison
In all five selected sources, proper strategies were used to make the results valid and reliable. Kivimäki et al. (2020) utilized large cohort studies and national health records to showcase that the researchers utilized robust strategies for these factors. Poudel and Subedi (2020) succeeded in this regard because the validity and reliability are enabled by selecting studies that already have these metrics in their methods, which is the case for the article as well.
Reiss et al. (2019) utilized correct and unbiased interview techniques to make sure that the findings were of proper quality. Wang and Geng’s (2019) reliability and validity factors are directly tied to the fact that they used a widely recognized survey and statistical modeling. May et al.’s (2022) results are valid and reliable because they used a well-established qualitative research design and methodological framework. However, it is important to understand that such results can only obtained in the context of the UK’s cultural freelance sector.
Comparing the reliability and validity across the five studies reveals noteworthy differences and similarities. Kivimäki et al. (2020) employed large-scale cohorts, enhancing the generalizability of their findings. This approach contrasts with May et al. (2022), whose focus on the UK’s cultural freelance sector limits the applicability of their results to broader contexts. However, both studies demonstrate methodological rigor, ensuring the reliability of their respective findings.
Poudel and Subedi (2020) leveraged existing studies with established validity, offering a comprehensive perspective on the psychosocial effects of COVID-19 in Nepal. The given approach differs from Reiss et al. (2019), who utilized interview techniques to gather data. The direct interaction with participants in Reiss et al.’s (2019) study provided nuanced insights into the mental health of children and adolescents, although Poudel and Subedi’s (2020) secondary data analysis offered a broader, albeit less detailed, overview.
Wang and Geng’s (2019) use of the Chinese General Social Survey and structural equation modeling stands out for its statistical robustness. Such a methodological approach allowed for a detailed exploration of the relationships between SES, lifestyle, and health outcomes. Their approach was focused on statistical analysis; hence, it contrasts with the qualitative approach of May et al. (2022), which emphasizes narrative and subjective experience.
As a result, each study contributes unique perspectives to the understanding of SES and mental health. Kivimäki et al.’s (2020) broad sample provides a comprehensive view, while May et al.’s (2022) focused study offers depth in a specific sector. Poudel and Subedi’s (2020) secondary analysis and Reiss et al.’s (2019) primary data collection complement each other, offering both macro and micro perspectives. Wang and Geng’s (2019) statistical approach adds a quantitative dimension to this multifaceted topic.
Evaluation of Evidence for Clinical Relevance
The selected sources provide compelling evidence for the clinical relevance of the relationship between SES and mental health. Kivimäki et al. (2020) illustrate the direct impact of low SES on both mental and physical health – there is a sequential pattern where mental health issues can lead to various physical ailments. This study is particularly significant in showcasing the need for early mental health interventions in socioeconomically disadvantaged populations.
May et al. (2022) provide insights into the exacerbated mental health challenges faced by freelancers in the cultural industry due to the COVID-19 pandemic. The qualitative nature of this study adds depth to the understanding of the psychological impact of financial insecurity and job instability. The study’s emphasis on the need for economic and psychosocial support is clinically relevant, especially in designing targeted mental health interventions for this sector.
Poudel and Subedi (2020) and Reiss et al. (2019) show that limited resource conditions should addressed within their own context because developing countries or vulnerable youth face specific SES issues. This study is relevant clinically: interventions focusing on reducing SES disparities and enhancing parental education can be effective in mitigating mental health risks in youth. Wang and Geng (2019) show the indirect influence of SES on mental health through lifestyle factors in China. The relevance is that while SES may not directly affect mental health, its influence is mediated through lifestyle changes.
Potential for Implementation in Clinical Practice
The studies by Kivimäki et al. (2020), May et al. (2022), and Poudel and Subedi (2020) can be implemented in clinical practice together to create holistic as well as context-specific mental health interventions. The findings advocate for integrating mental health services with SES support, especially in SES-disadvantaged groups and those affected by crises. Implementation in clinical practice should involve multidisciplinary teams that address both mental health and socioeconomic challenges since it will ensure a comprehensive approach to patient care.
Similarly, Reiss et al. (2019) and Wang and Geng (2019) emphasize the importance of considering lifestyle factors and family education in mental health interventions. The provided facts suggest the potential for effective programs that focus on lifestyle improvement changes and parental education as part of mental care for younger people and children. Such interventions can be especially effective in settings where socioeconomic disparities are pronounced.
Application
In clinical practice, the knowledge gained from the studies informs continuous quality improvement initiatives. The findings from Kivimäki et al. (2020), May et al. (2022), Poudel and Subedi (2020), Reiss et al. (2019), and Wang and Geng (2019) converge on the necessity of an integrated approach to mental care. Such an approach should encompass both direct clinical interventions and broader socioeconomic support. Clinicians can employ these findings to enhance patient care by acknowledging and addressing the multifaceted nature of mental health issues.
For example, in settings with limited resources or in communities impacted by crises, a targeted approach that considers local SES challenges becomes critical. The given strategy aligns with the principles of continuous quality improvement since it promotes adaptability and responsiveness to the specific needs of diverse patient populations. The emphasis on family education and lifestyle changes also shows the potential for proper preventative strategies in mental care. Implementing these propositions in clinical practice involves a dynamic and ongoing process of evaluating and adjusting care models.
Issues for Consideration
Whenever research involves human subjects, ethical, legal, and cultural issues are of primary concern. Except for Poudel and Subedi (2020), who only reviewed the existing literature, all other studies obtained informed consent and ensured that they did not harm their human subjects. May et al.’s (2022) research was properly approved and reviewed by the University College London Research Ethics Committee. In the case of Wang and Geng (2019),
National Survey Research Center of China ensures that no harm can be done to any research participant. The Federal Commissioner approved Reiss et al.’s (2019) study for Data Protection in Germany and the ethics committee of the University Hospital Charite’ in Berlin. Kivimäki et al.’s (2020) situation is the same as with others; the research was legally and ethically allowed to take place by the local government and ethics review board.
The presented sources are highly diverse culturally, which is why it is important to understand that they represent different cultural contexts. Wang and Geng’s (2019) is focused on Chinese people, whereas May et al.’s (2022) study is concerned with freelancers in the UK. Reiss et al.’s (2019) research took place among German citizens. Although each country protects its human subjects and requires committee approvals, each study was reviewed by different ethics boards.
Conclusion
In sum, the review’s findings answer the PICOT question by demonstrating that comprehensive social support programs can positively impact mental health in individuals from low SES backgrounds. These interventions – compared to the absence of such support – show a decrease in the incidence of mental health disorders over time. In nursing practice, such insights are critical since nurses are the first point of contact in healthcare settings; hence, they can advocate for and implement these socioeconomic interventions.
The strength of the reviewed sources lies in their methodological rigor and diverse perspectives; however, limitations include potential biases in self-reported data and the challenge of isolating SES factors from other variables influencing mental health. Future research should focus on long-term studies to observe the sustained impact of SES interventions on mental health and explore more deeply the indirect effects of lifestyle changes mediated by SES. The given review shows how significant the role of SES is in mental health, which is why there is a need for proper interventions and continuous quality improvement in nursing practice.
References
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., Suominen, S. B., Oksanen, T., Stenholm, S., Virtanen, M., Marmot, M. G., Singh-Manoux, A., Brunner, E. J., Lindbohm, J. V., Ferrie, J. E., & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: A multi-cohort study. The Lancet Public Health, 5(3), E140-E149. Web.
May, T., Warran, K., Burton, A., & Fancourt, D. (2022). Socioeconomic and psychosocial adversities experienced by creative freelancers in the UK during the COVID-19 pandemic: A qualitative study. Frontiers in Psychology, 12(672694), 1-11. Web.
Poudel, K., & Subedi, P. (2020). Impact of COVID-19 pandemic on socioeconomic and mental health aspects in Nepal. International Journal of Social Psychiatry, 66(8), 748-755. Web.
Reiss, F., Meyrose, A. K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS ONE, 14(3), e0213700. Web.
Wang, J., & Geng, L. (2019). Effects of socioeconomic status on physical and psychological health: Lifestyle as a mediator. International Journal of Environmental Research and Public Health, 16(2), 281. Web.