Thread by @awgaffney

One of the most under-emphasized findings of the Oregon Medicaid Experiment was that it found a causal link between lack of health insurance and depression that cannot be explained by lack of access to mental healthcare alone ...

ncbi.nlm.nih.gov/pmc/articles/P…

... Gaining health insurance reduced the rate of depression by about 30% (or 9 percentage points).

The increase in mental health treatment experienced by those newly covered can't fully explain this increase. So what can?

...Well, it should be unsurprising that the uncertainty and profound strain produced by precarity & deprivation would worsen mental health! Alleviating some of that uncertainty might, conversely, help improve mental health.

A recent paper examining studies on the *causal* linkage between poverty and depression / anxiety finds that it does: "positive economic shocks to individuals are shown to improve mental health, whereas negative economic shocks undermine mental health."

science.sciencemag.org/content/370/65…

Needless to say, deprivation isn't the sole cause of these common mental illnesses — they afflict all socioeconomic groups — but they are one important cause.

Which also should be uncontroversial: if deprivation is associated with lower lung function, higher blood pressure, and worse kidney function — should we be surprised that there are economic determinants of mental health?

The big question, however, is the extent to which these & other health gradients are produced by absolute versus relative disadvantage. Insofar as relative disadvantage matters, iaddressing inequality itself — not merely the mediators between status and disease — is necessary.