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. 2025 Jul 31;5(1):320.
doi: 10.1038/s43856-025-01038-8.

A cross-national analysis of demographic variation in self-rated mental health across 22 countries

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A cross-national analysis of demographic variation in self-rated mental health across 22 countries

Chukwuemeka N Okafor et al. Commun Med (Lond). .

Abstract

Background: Mental health is a critical aspect of overall well-being, encompassing not only the absence of mental disorders but also positive attributes such as stress management, and healthy relationships. Prior studies suggest that self-rated mental health varies across different cultures and sociodemographic characteristics. However, most studies on demographic variations in self-rated mental health have been conducted within specific countries or regions, leaving a gap in our understanding of how these factors influence mental health across different cultural contexts.

Methods: To address this gap, we leveraged a dataset of over 200,000 individuals from 22 countries to examine the distribution of self-rated mental health among key demographic variables such as age, gender, marital status, employment, education, and religious service attendance.

Results: Our findings reveal substantial country variations in self-rated mental health, measured as the mean score on a single-item Likert scale ranging from 0 (Poor) to 10 (Excellent). Participants in Tanzania, Kenya and Nigeria report the highest self-rated mental health scores, while those in Japan, Türkiye, and the United Kingdom report the lowest scores. Some demographic patterns - such as lower self-rated mental health among younger age groups and females, and higher self-rated mental health among those reporting regular religious service attendance - remain consistent across most countries. However, other patterns, such as the distribution of self-rated mental health by marital status, vary by country.

Conclusions: These descriptive findings highlight the need for context-specific mental health strategies and call for future research to identify social and structural factors of self-rated mental health.

Plain language summary

Mental health is important for overall well-being and includes the absence of mental disorders as well as positive attributes such as ability to manage stress and healthy relationships. People around the world rate their mental health differently depending on who they are and where they live. Here we analyze survey responses from over 200,000 adults in 22 countries to explore differences by age, gender, education, and other characteristics. We found that self-rated mental health is generally higher in some African countries and among older adults, men, married individuals, and people who frequently attend religious services. These findings suggest that mental health programs should consider cultural and demographic factors to better meet people’s needs and better understand their mental health.

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Conflict of interest statement

Competing interests: The authors declare the following competing interests: Tyler VanderWeele reports consulting fees from Gloo Inc., as well as shared revenue received by Harvard University under its licensing agreement with Gloo, in accordance with the university’s intellectual property policy. All other authors declare no competing interests.

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