Toward explaining mental health disparities

Abstract

Mental health disparities refer to the disproportionate amount of psychopathology found among persons of disadvantageous social standing, such as persons of low socioeconomic status (SES). Although social and self selection cannot entirely be ruled out as explanations for these differences, the accumulation of evidence supports a social causation interpretation for a large portion of this association for many disorders. The stress process model is applied to understand how social inequities become mental health disparities. Data from the Los Angeles Depression Study, originated by Leo Reeder are used to illustrate the key idea that explicit causal models are essential to the development of programmatic interventions to alleviate mental health disparities, as distinct from interventions to improve mental health in general. In light of recent work on neighborhood stratification and mental health, I advocate the modification of the social contexts of the stress process.