Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar;60(2):185-96.
doi: 10.1177/0020764013481426. Epub 2013 Apr 16.

Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality

Jonathan K Burns  1 , Andrew Tomita, Amy S Kapadia
Affiliations

Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality

Jonathan K Burns et al. Int J Soc Psychiatry. 2014 Mar.

Abstract

Background: Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia.

Aims: The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level.

Method: We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates.

Results: One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03).

Conclusions: Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

Keywords: Gini coefficient; Schizophrenia; income inequality; systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Scatter plot showing the relationship between Gini coefficient per country and mean schizophrenia incidence.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Antai D. Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of individual and contextual determinants. BMC Infectious Diseases. 2009;9:181. - PMC - PubMed
    1. Babones SJ. Income inequality and population health: correlation and causality. Social Science and Medicine. 2008;66:1614–1626. - PubMed
    1. Boydell J, Van Os J, McKenzie K, Murray RM. The association of inequality with the incidence of schizophrenia: an ecological study. Social Psychiatry and Psychiatric Epidemiology. 2004;39:597–99. - PubMed
    1. Burns JK, Esterhuizen T. Poverty, inequality and the treated incidence of first-episode psychosis – an ecological study from South Africa. Social Psychiatry and Psychiatric Epidemiology. 2008;43:331–335. - PubMed
    1. Byrne M, Agerbo E, Eaton WW, Mortensen PB. Parental socio-economic status and risk of first admission with schizophrenia – a Danish national register based study. Social Psychiatry and Psychiatric Epidemiology. 2004;39:87–96. - PubMed

Publication types