Background Burden of mental illness is increasing worldwide, including Turkey. Social determinants are closely related with this growing public health concern. The aim of this study is to explore the prevalence of mental illness and the impact of social determinants in a population of 15 years and over in Manisa District, Turkey.
Methods This cross-sectional study was conducted between March–June 2014 in Manisa District on western Anatolia. The minimum sample size estimated for the over 15 years of age population of Manisa (n = 1,086,255) assuming 12% expected prevalence was 1,014 people. The sample size was inflated by 40% for possible nonresponse. The sample was randomly selected from the database of family physicians registration system. Dependent variable was mental illness determined by the Brief PHQ-r Questionnaire. Independent variables were age, gender, education, employment status, occupational class, income perception. Participants were interviewed by trained interviewers using a questionnaire. Logistic regression method was used to calculate age adjusted odds ratios in 95% confidence intervals of independent variables for existence of mental illness using SPSS 15.0.
Results 1,038 people were interviewed. Mean age of the study group was 43.3 ± 17.7, and 53.5% of them were women. 9.8% was illiterate, 46.0% primary, 16.1% secondary, 24.3% were high school/over graduates. Overall 37.8% of the study group was unemployed, 14.9% was agriculture workers, 14.7% was blue-collar workers and 9.4% was professionals. The prevalence of mental illness was 16.7%. The prevalence of mental illness in women was higher than men (ORadj = 8.8 95% CI: 5.4–14.3). Mental illness in illiterates and primary school graduates were higher compared to secondary school/higher graduates (respectively, ORadj = 4.0 95% CI: 2.2–7.3 and ORadj = 2.0 95% CI: 1.3–3.0). Mental illness was 2.8 fold higher in unemployed compared to employed people (ORadj = 2.8 95% CI: 2.0–4.0). Considering the occupational class, mental illness was 5.5 fold higher in unemployed/temporary workers vs professionals (ORadj = 5.5 95% CI: 2.2–13.9) but there was not a significant difference between ‘blue-collar/agriculture workers’ and ‘employers’ vs professionals (respectively, ORadj = 2.1 95% CI: 0.8–5.7 and ORadj = 2.1 95% CI: 0.6–7.0). Mental illness was higher in people with low income perception compared to middle/high income perception (ORadj = 1.8 95% CI: 1.3–2.6).
Conclusion Mental illness is found to be associated with gender, low education level, unemployment, occupational class, low income perception. Therefore, policymakers should focus on such social determinants to prevent and control mental illness in the population.
- mental illness
- social determinants