This resource is available in English only.
This systematic review conceptualizes access to healthcare services as a downstream measure in the treatment of mental health, which the authors present as including positive and negative mental health, as well as the diagnosis of mental illness. The authors propose that examining welfare structures — a structural determinant of health — will provide insight into the values and norms that guide the development of public policy.
The structural determinants of health are a set of factors that include “all social and political mechanisms that generate … stratification and social class divisions in society and that define individual socioeconomic position within hierarchies of power, prestige and access to resources.” (1, p. 5)
Due to an increased appreciation for the impact of structural determinants on population health outcomes, public health at all levels is also being called to attend to mental health promotion from a policy level.
In this review, structural determinants are framed as influencing the distribution of social, economic and physical resources, which leads to inequities in population mental health outcomes. Results of this review show some causal effect of structural determinants on mental health inequities, and the authors note a particular impact of policy on gender inequalities in mental health outcomes.
The review also describes findings and implications related to welfare, family, employment, income-support, education, and area-based policy domains.
Use this resource to:
- facilitate discussion about the role of public health policy to promote mental health through equitable socioeconomic policies;
- integrate language around mental health promotion and structural determinants into workplans and organizational strategic directions; and
- develop a tool for examining public policies and their impact on mental health inequities.
Works cited
[1.] Solar, O. & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva; World Health Organization.
Reference
McAllister, A., Fritzell, S., Almroth, M., Harber-Aschan, L., Larsson, S. & Burström, B. (2018). How do macro-level structural determinants affect inequalities in mental health? – A systematic review of the literature. International Journal for Equity in Health 17, 180. https://doi.org/10.1186/s12939-018-0879-9
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