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Outline
Introduction to mental illnesses
The link between income and mental
illness
What this study attempts to find
Data and Model
What I find
Introduction
What is mental illness?
What causes it?
Affects 18.6% of adults age 18+ (NSDUH 2012)
Rate is increasing
What has been contributing to this?
Where does income fit in?
Fundamental economics: growth is good
Easterlin paradox (Easterlin 1974)
higher incomes = happier people
↑ national income ≠ ↑ national happiness
Kahneman and Deaton (2010)
Emotional well-being peak: $75,000
What do we know about the
link between income and
mental health?
Link between social inequality and mental
disorders (Fryers et al 2003)
Education, income, and unemployment
Low income →greater mental distress:
McMillan et al (2010) incomes<$17,000
Caron and Liu (2010): Living below 50% of
median income
What remains to be seen?
Causal effect not proven
Effect of high income on mental health?
High income job=high stress job
Above $75,000, well-being does not
improve
Does the nature of high income earning
lead to a higher prevalence of mental
illness?
Data
Health Reform Monitoring Survey, Second
Quarter of 2014
Survey of 7,701 American adults aged 18-64
Responses on income, mental and physical
health, and household demographics
Income is divided into 19 categories: ranging
from less than $5,000 to greater than $175,000.
Measures of Mental Illness
Two measures:
“Reported a mental or behavioral health
condition”
Number of days in the past 30 days with
bad mental health
Days w/stress, depression, emotional problems
Two levels of severity:
1) any number of days with mental issues
2) a week’s worth of days (7+) with mental issues
Descriptive Statistics Income Group % of total
Less than $5k 3.01%
$5k-$7.5k 1.43%
$7.5k-$10k 1.61%
$10k-$12.5k 2.80%
$12.5k-$15k 2.18%
$15k-$20k 3.51%
$20k-$25k 4.44%
$25k-$30k 4.54%
$30k-$35k 4.69%
$35k-$40k 5.01%
$40k-$50k 7.75%
$50k-$60k 8.66%
$60k-$75k 9.91%
$75k-$85k 7.53%
$85k-$100k 7.31%
$100k-$125k 11.21%
$125k-$150k 5.56%
$150k-$175k 3.48%
More than $175k 5.36%
Mental Health Diagnosis
% of population
sermhcondition 15.73%
mhcondition 37.87%
mentalhealth 23.89%
Variable % of population
white 71.90%
male 48.10%
married 55.41%
unemployed 32.83%
poor_phys_health 10.88%
insured 89.65%
college 39.67%
metro 85.61%
age 45.5
Household_size 2.8
Descriptive Statistics
Comparing Mental Health of Rich
(Income greater than $75,000) and Poor
(Income less than $25,000)
Variable Rich: Poor:
Obs 3115 1462
mhcondition 30.50% 49.38%
sermhcondition 9.95% 25.99%
mentalhealth 18.97% 33.17%
Model
Independent Variable: income
Dependent Variable: mental illness
Controls:
race, gender, age, education
marital status, household size, employment
status
physical health, insurance
type of city (metro area or not)
My Model
mentalhealth=β0+β1rich+β2poor+β3white+β4
male+β5married+β6unemployed+β7poor_ph
ys_health+β8insured+β9college+β10age+β11m
etro+β12household_size+u
Results mentalhealth Coef. Std. Err. t P>t [95% Conf. Interval]
rich*** -3.77% 1.10% -3.44 0.001 -5.91% -1.62%
poor*** 5.29% 1.47% 3.59 0 2.40% 8.17%
white*** 5.54% 1.08% 5.11 0 3.42% 7.67%
male*** -5.36% 0.95% -5.62 0 -7.23% -3.49%
married*** -5.29% 1.12% -4.71 0 -7.49% -3.09%
unemployed*** 7.73% 1.11% 6.98 0 5.56% 9.90%
poor_phys_health*** 19.46% 1.77% 10.98 0 15.98% 22.93%
insured*** 9.95% 1.52% 6.57 0 6.98% 12.93%
education 0.20% 0.27% 0.74 0.457 -0.33% 0.72%
metro -0.79% 1.40% -0.56 0.574 -3.53% 1.96%
age 0.05% 0.04% 1.29 0.199 -0.03% 0.13%
household _size* -0.70% 0.37% -1.89 0.059 -1.42% 0.03%
_cons 0.104696 0.040587 2.58 0.01 2.51% 18.43%
Results mhcondition Coef. Std. Err. t P>t [95% Conf. Interval]
Less than $5k** 9.65% 3.72% 2.59 0.01 2.35% 16.94%
$5k-$7.5k*** 8.77% 5.05% 1.73 0.083 -1.14% 18.68%
$7.5k-$10k 5.67% 4.70% 1.2 0.228 -3.56% 14.89%
$10k-$12.5k*** 11.78% 3.91% 3.02 0.003 4.13% 19.44%
$12.5k-$15k 1.95% 4.21% 0.46 0.643 -6.31% 10.21%
$15k-$20k*** 10.20% 3.42% 2.98 0.003 3.50% 16.90%
$20k-$25k 4.11% 3.17% 1.3 0.195 -2.10% 10.32%
$25k-$30k 2.81% 3.15% 0.89 0.372 -3.36% 8.98%
$30k-$35k** 7.44% 3.10% 2.4 0.017 1.35% 13.52%
$35k-$40k 0.40% 3.01% 0.13 0.894 -5.50% 6.30%
$40k-$50k -1.90% 2.71% -0.7 0.483 -7.20% 3.41%
$60k-$75k -2.03% 2.49% -0.82 0.413 -6.91% 2.84%
$75k-$85k -1.58% 2.67% -0.59 0.552 -6.81% 3.64%
$85k-$100k** -6.87% 2.65% -2.59 0.01 -12.06% -1.68%
$100k-$125k*** -8.82% 2.41% -3.67 0 -13.53% -4.10%
$125k-$150k*** -11.28% 2.77% -4.07 0 -16.72% -5.85%
$150k-$175k* -5.57% 3.33% -1.67 0.094 -12.10% 0.95%
More than $175k*** -11.05% 2.85% -3.88 0 -16.63% -5.46%
What I Find
Compared to median income group:
Poor: 5.3% more likely
Rich: 3.7% less likely
Below median income: ↑ mental illness
Above median income: ↓ mental illness
Logit probability of having mental illness:
$100,000-$125,000: 17.04%
$15,000-$19,999: 23.92%
What to Look Out For
Survey bias
Income is correlated with SES variables
Causality not able to be determined
Cross-sectional issues
Possible reverse causality
Takeaways
Confirmed link between low income and
mental illness
Increasing income does not increase
mental illness
Income cutoff of $175,000:
Does not include variation at very high
incomes
Median CEO salary is around $681,000
Implications
Direct policy efforts at providing mental
health resources for low income adults
Poor income group is far less likely to
receive care
Fixing this inequity is of clear importance
Has Mental Illness, Unable to Afford Mental Health Care
Rich (>$75,000/yr) 10.83%
Poor (<$25,000/yr) 22.68%