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Social economic inequalities and mental health. I. Concepts, theories and interpretations

Published online by Cambridge University Press:  11 October 2011

Paola Bonizzato  and
Juan Eduardo Tello
Paola Bonizzato*
Affiliation:
Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona e Azienda Ospedaliera di Verona, Verona
Juan Eduardo Tello
Affiliation:
Istituto Superiore di Sanità, Roma
*
Address for correspondence: Dr.ssa P. Bonizzato, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Policlinico G.B. Rossi, P.le L. Scuro 10, 37134 Verona. Fax: 045 585871 E-mail: paola.bonizzato@univr.it
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Abstract

Summary

Aims – Reconstructing the models used for approaching the inequalities issues in health, idenfiying the most relevant theoretical and conceptual contributions. Method – Literature electronic-search on Medline, Psyclit, Econlit, Social Science Index and SocioSearch using the key-words inequalities, deprivation, poverty, socio-economic status, social class, occupational class, mental health for the period 1965-2002; integrated with manual search. The material was classified according to the conceptual and theoretical interpretative models or to the analyses of the association 'inequalities-health' where health was expressed as mortality, morbidity or services utilisation. Results – Four different interpretative models about the genesis of inequalities were identified. Further theoretical developments overcome the distinction among conceptuals contrapositions selection versus causation, statistic artefactual versus real differences, individual behaviours versus material context. Since the 80's the concept of material deprivation has been enlarged to include social deprivation to explain health inequalities. The social exclusion is related to material deprivation and to social fragility enlarging the traditional aspects of poverty. The theories that better adapt to the psychiatric field are the social selection and social causation. Conclusions – The social exclusion and the new methodologies for measuring the inequalities seems to be an effective way for understanding of the inexplored aspects of the mental health inequalities.

Declaration of Interest: This work was partly funded by the Department of the Public Health Sciences “G. Sanarelli” of the University of Rome “La Sapienza” and the Department of Medicine and Public Health of the University of Verona.

Keywords

inequalitieshealth servicesmental health
Type
Original Papers
Information
Epidemiology and Psychiatric Sciences , Volume 12 , Issue 3 , September 2003 , pp. 205 - 218
Copyright
Copyright © Cambridge University Press 2003

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