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ABSTRACT

The purpose of this study is to determine the impact of socioeconomic status on mental health. Two hypotheses were formulated to achieve the aim of this study. The study uses a survey method, were a questionnaire was used in information gathering from 200 residents of Oto-Awori Local Council Development Area of Lagos State (LCDA). Bivariate relationships between variables were calculated utilizing chi-square tests of independence. Results showed that those belonging to the low socioeconomic status group had about four times the odds of reporting poor mental health quality of life than those in the high vi socioeconomic status group. Results also showed that neighborhood violence, low neighborhood social cohesion, and experiencing unfair treatment were also independently associated with reporting poor mental health quality of life as well as being of low socioeconomic status. From results obtained, conclusions and recommendations were made by the researcher in chapter five of this work.                                               

CHAPTER ONE

INTRODUCTION

1.1              BACKGROUND OF THE STUDY

Mental health, health status and socioeconomic status are important determinants of an individual’s wellbeing. There are thought to be important interactions between these dimensions of wellbeing, with causal links running in both directions. Poor health and poor mental health can reduce earnings ability, through their effects on education and employment, and poverty can lead to lower educational attainment, poorer physical health and depression (Ardington and Case, 2010).

Das et al. (2007) examine the correlates of mental health in five developing countries, finding that being older, female, widowed, and in poor physical health are consistently related to poorer mental health outcomes. However, their reading of their evidence on the relationship between socio-economic status (SES) and mental health is mixed. They find education to be positively associated with better mental health in a majority (but not all) of the countries that they study. Witoelar et al (2009) analyse data from the fourth wave of the Indonesian Family Life Survey and find that education is protective against depression among Indonesians aged 45 and older but, controlling for education, they find no association between per capita expenditure and mental health for this group.

A survey of 11 smaller community based studies in six low and middle income countries finds a negative association between education and common mental disorders in all but one study (Patel and Kleinman 2003). Results for other indicators of socioeconomic status such as employment and income were more mixed. In two localized South African studies, Case and Deaton (2009) find different aspects of SES protect in different ways: in their sites, education appears to protect health status, but has little effect on anxiety or depression, while assets protect against depression, but not against poor health.

One of the most consistent findings in the study of mental health in both developed and developing countries is that the risk of depression increases with age. Although the relationship between socioeconomic status and mental health has received considerable attention in the literature, particularly among the elderly, there is very little research that directly addresses whether the correlates of depression change as people grow older (Ardington and Case, 2010).

Considerable and growing evidence shows that mental health and many common mental disorders are shaped to a great extent by social, economic and environmental factors. A review of global evidence by Patel et al (2010) for the WHO Commission on Social Determinants of Health reported convincing evidence that low socioeconomic position is systematically associated with increased rates of depression. Gender is also important, mental disorders are more common in women, they frequently experience social, economic and environmental factors in different ways to men.

Taking action to improve the conditions of daily life from before birth, during early childhood, at school age, during family building and working ages, and at older ages provides opportunities both to improve population mental health and reduce the risk of those mental disorders that are associated with social inequalities. While comprehensive action across the life course is needed, scientific consensus is con­siderable that giving every child the best possible start will generate the greatest societal and mental health benefits (WHO, 2014).

The prevalence and social distribution of mental disorders has been reasonably well documented in high-income countries. While there is growing recognition of the problem in low- and middle-income countries, a significant gap still exists in research to measure and describe the problem, and in strat­egies, policies and programmes to prevent mental disorders. There is a considerable need to raise the political and strategic priority given to the prevention of mental disorders and to the promotion of mental health through action on the social determinants of health (WHO, 2014).

1.2              STATEMENT OF THE PROBLEM

Socioeconomic status is one of the most prominent environmental risk factors of mental health. People with high income, occupational status, and education tend to be happier and less likely to suffer from depression and other psychiatric disorders than people with low socioeconomic status (Clark, Frijters, & Shields, 2008; Lorant et al., 2003). In other words, income appears to be important for subjective well-being insofar as it helps people to satisfy their basic material needs but becomes less crucial beyond this point (Clark et al., 2008).

People with mental disorders, such as schizophrenia, bipolar disorder and depression are far more likely than the general population to die as a consequence of their untreated mental or physical health problems (WHO, 2008, Roshanaei and Katon, 2009). For example, people with schizophrenia and major depression have an overall increased risk of mortality 1.6 and 1.4 times, respectively, greater than for the general population, and people with schizophrenia have two- to three-fold higher mortality rates compared with the general population corresponding to 10-25-year reductions in life expectancy (Laursen et al., 2012).

One of the most striking reasons for higher mortality rates among people with mental disorders is the inequitable care and treatment that these individuals receive for both mental and physical illnesses. Between 75% and 85% of people with severe mental disorders are unable to access the treatment they need for their mental health problem in LMICs, compared with 35% and 50% of people in high-income countries (Demyttenaere, 2004; OECD, 2012).

Mental disorders have diverse and far-reaching social impacts, including homelessness, higher rates of imprisonment, poor educational opportunities and outcomes, lack of employment and limited income-generating opportunities. Moreover, the stigma, myths and misconceptions surrounding mental illness are the root cause of much of the discrimination and human rights violations experienced by people with mental disabilities on a daily basis (Baldwin and Marcus, 2011).

People with mental disorders are at much higher risk of descending into poverty than other people. They may not be able to work because of their illness. If employed, their illness may result in more sick days or reduced productivity, in turn reducing income, promotion chances, entitlements to employment-related pensions or health insurance coverage (Ssebunnya et al., 2009, Thornicroft et al., 2009). It is against this backdrop that this study examines the impact of low socio-economic status on mental health with special reference to Oto-Awori Local Council Development Area of Lagos State (LCDA).

1.3              OBJECTIVE OF THE STUDY

The general objective of this study is to explore the impact of low socio-economic status on mental health. Other specific objectives of this study are to:

1.   To examine the effect of low socioeconomic status on psychiatric disorders

2.   To assess the relationship between standard of living and discrimination against the poor.

3.   To investigate the link between low socioeconomic status and homelessness in Oto-Awori LCDA.

4.   To find out the health implications of living in low socioeconomic status.

1.4              RESEARCH HYPOTHESES

HYPOTHESIS ONE:

H0: There is no significant relationship between socioeconomic status on psychiatric disorders.

H1: There is a significant relationship between of socioeconomic status on psychiatric disorders

HYPOTHESIS TWO

H0: There is no significant relationship between standard of living and discrimination against the poor

H1: There is a significant relationship between standard of living and discrimination against the poor

1.5       SIGNIFICANCE OF THE STUDY

This study on the impact of socio-economic status on mental health will be useful to providers of psychiatric and mental health services in their quest to determine the cause of a mental illness on a patient. It will be useful to the government to understand the effect of the economy on the health of the citizens and it will be beneficial to individual to intentional watch their health status.

Finally, this research work will be useful to other researchers who intend to embark on similar project.

 1.6 SCOPE AND LIMITATION OF THE STUDY

This study is primary concerned with the impact of socio-economic status on mental health. This study/project work covers Oto-Awori Local Council Development Area of Lagos State (LCDA). The researcher encountered some constraints, which limited the scope of the study. These constraints include but are not limited to the following.

a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study     

b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.

1.7 DEFINITION OF TERMS

SOCIOECONOMIC STATUS (SES) is an economic and sociological combined total measure of a person's work experience and of an individual's or family's economic and social position in relation to others, based on income, education, and occupation. When analyzing a family's SES, the household income, earners' education, and occupation are examined, as well as combined income, whereas for an individual's SES only their own attributes are assessed. However, SES is more commonly used to depict an economic difference in society as a whole.

Socioeconomic status is typically broken into three levels (high, middle, and low) to describe the three places a family or an individual may fall into. When placing a family or individual into one of these categories, any or all of the three variables (income, education, and occupation) can be assessed.

MENTAL HEALTHMental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

1.8 ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as follows

Chapter one is concerned with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study. Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding.  Chapter five gives summary, conclusion, and recommendations made of the study 


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