In this issue of JAMA Psychiatry, Suokas et al1 reinforce 2 observations emerging from the rich literature on the epidemiology of mental health problems. First, Scandinavian countries with established nationwide registries that permit the linking of diverse databases offer unparalleled opportunities to investigate the temporal associations between risk factors and mental health problems at the level of an individual’s life course and at the level of populations over time. Second, poverty, in this case defined by personal income, is a major determinant for poor mental health, in this case represented by the outcome of first psychiatric admission. In summary, this study shows that (1) the poorer you are in Finland, the higher the likelihood of experiencing a first psychiatric admission; (2) this risk gradient is seen across income strata; and (3) despite overall reductions in admission rates in adults during the 19 years of observation, which is probably a reflection of the changing orientation of psychiatric care, inequalities have persisted and even grown larger across the study period.
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Patel V. Income Inequality and Psychiatric Admission in a Rich Country: Happiness Does Not Guarantee Mental Health Equity. JAMA Psychiatry. 2020;77(3):233–234. doi:10.1001/jamapsychiatry.2019.3638
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