Social determinants of mental health: a systematic review about current main predictors and different health contexts on the world
M. C. B. Maia, B. E. Bandeira, L. A. Brito, M. CoufalíkováIntroduction
Good mental health is an essential part of overall health and well-being. It is shaped by social, economic, and physical environments that operate at different stages of life, as shown in image 1 (Kirkbride JB et al. World Psychiatry 2024; 23:58–90). Risk factors for many common mental health conditions are closely tied to social inequalities – the greater the inequality, the greater the risk. This report reviews the main social determinants of health, defined as “the circumstances in which people are born, grow, work, live and age, and their access to power, money and resources”.
Objectives
The aim is to map the social factors most closely linked to the onset and exacerbation of mental health conditions. The project will also analyse how these factors relate to socioeconomic inequalities, gender, ethnicity, and other social markers in different contexts around the world.
Methods
This systematic literature review was conducted by searching the PubMed/MEDLINE, Scopus, Web of Science and PsycINFO databases for articles published since 2017. The keywords used were ‘social determinants of health’, ‘mental health’ and ‘predictors’.
Results
Poverty, socioeconomic inequality, lack of education, and food insecurity are consistently identified as key predictors of mental disorders, including depression and anxiety (Lund et al. Lancet Psychiatry 2018; 5 357–369). Exposure to multiple forms of social disadvantage is cumulative and exacerbates negative mental health outcomes, reflecting a pattern of “social causality” where living conditions influence health. Additionally, distinct geographic and cultural contexts modulate the manifestation and prevalence of mental disorders (Kirkbride et al. World Psychiatry 2024; 23 58–90). The application of the Social Ecological Model offers a useful lens for understanding how HSDs operate at multiple levels—individual, community, institutional, and social—to shape the mental health of adolescents and other age groups, according to table 1 (Robins et al. Journal of Human Services 2024). School environment, family relationships, and community integration play important roles as protective or risk factors for the development of psychological distress between children and teenagers (Robins et al., 2024).
Image 1: Long description.