The social determinants of mental health (SDOMH) are societal problems that disrupt mental health, increase risk of mental illness among certain groups, and worsen outcomes for individuals with mental illnesses.[1] Much like the social determinants of health (SDOH), SDOMH include the non-medical factors that play a role in the likelihood and severity of health outcomes, such as income levels, education attainment, access to housing, and social inclusion.[2] Disparities in mental health outcomes are a result of a multitude of factors and social determinants, including fixed characteristics on an individual level – such as age, gender, race/ethnicity, and sexual orientation – and environmental factors that stem from social and economic inequalities – such as inadequate access to proper food, housing, and transportation, and exposure to pollution.[3]


Mental health describes emotional, psychological, and social well-being.

Mental health, as defined by the CDC, encompasses individuals' emotional, psychological, and social well-being, while the most common mental disorders include anxiety-disorders such as generalized anxiety disorder, social anxiety, and panic disorder; depression; and post-traumatic stress disorder (PTSD).[4][5]

The concept of social determinants stems from the life course approach. It draws from theories that explain the social, economic, environmental, and physical patterns that result in health disparities and vary across different stages of life (e.g. prenatal, early years, working age, and older ages).[6] Identifying the social and structural determinants of mental health, in addition to individual determinants, enables policy makers to promote mental health and reduce risk of illness by designing appropriate interventions and taking action beyond the health sector.[7]

Inequities in mental health

Globally, in 2019, 1 in every 8 individuals (12.5% of the population) lived with a mental disorder; however, in 2020, due to the COVID-19 pandemic, that number grew dramatically by around 27%.[citation needed] While mental illnesses and disorders have become more prevalent, studies have shown that mental health outcomes are worse for some populations and communities than others. One such inequity is that of gender: females are twice as likely to have a mental illness than males.[8][9][10]

Fixed characteristics

Fixed characteristics refers to those that are genetic and biological and/or are not subjected to be influenced by the environment or social living conditions of an individual.[11]


The second leading cause of global disability burden in 2020 was unipolar depression, and research showed that depression was twice as likely to be prevalent in women than in men.[8][9][12] Gender-based mental health disparities suggest that gender is a factor that could be leading to unequal health outcomes.[citation needed]

Research studies included in Lancet Psychiatry Women's Mental Health Series focuses on understanding why some of these gendered disparities might exist.[13] Kuehner in her article Why is depression more common among women than among men? mentions several risk factors that contributes to these inequities, including the role of a women's sex hormones and "blunted hypothalamic-pituitary-adrenal axis response to stress".[14] Other factors include a woman's increased likelihood to body shaming and rumination and stressors on an interpersonal level, as well as sexual abuse during childhood. Further, the prevalence of gender inequality and discrimination in society against women may also be a contributing factor. Li et al. finds that the monthly and lifespan fluctuations of sex hormones oestradiol and progesterone in women may also influence the gender gap, especially in the context of trauma-related, stress-related, and anxiety disorders, such as through increasing vulnerability to development of these disorders and permitting the continued persistence of symptoms for these disorders.[15]

Increased likelihood of gender-based violence for women compared to men is also another risk factor that was studied by Oram et al. Researchers found that women have a higher risk of being subjected to domestic and sexual violence, thereby increasing their prevalence to post-traumatic stress, anxiety, and depression. Also notable to consider in the context of gender-based trauma are female genital mutilation, forced and early marriage, human trafficking, and honor crimes.  

While women are reported to experience higher rates of depressive and anxiety related disorders, men are more likely to die by suicide than women: in the United Kingdom, suicide is the biggest cause of death for men 45 and younger, and in the likelihood of dying by suicide, men are four times more likely in Russia and Argentina, three and a half times more likely in the United States, and three times more likely in Australia, than women, to name a few countries.[16] Gender differences in suicide are commonly explained by pressure for gender roles and higher risk-taking behavior among men.[17]

Sexual orientation

In studies comparing mental health outcomes between members of the lesbian, gay, bisexual, transgender, queer (questioning), intersex, asexual, aromantic and agender (LGBTQIA+) community with heterosexuals, the former showed increased risks of poor mental health.[18][19] In fact, LGBTQIA+ individuals are twice as likely to have a mental disorder compared to their heterosexual counterparts, and two and a half times more likely to experience anxiety, depression, and substance misuse.[20][21]

Based on the minority stress model, these mental health disparities among LGBTQIA+ people are due to discrimination and stigma. In fact, LGBTQIA+ individuals have expressed difficulty in accessing healthcare due to experienced discrimination and stigma, which as a result, causes them to not seek healthcare at all or rather delay it.[22] Further societal isolation and feelings of rejection may also contribute to the prevalence of mental disorders among this community.[23] In addition to the perceived and experienced stigma, LGBTQIA+ have an increased likelihood of being victims of violence.[24] These factors, alongside others, contribute significantly to differences in mental health experiences for members of the LGBTQIA+ community in comparison to their heterosexual counterparts, thereby result in mental health inequities by sexual orientation.[citation needed]


Studies in the conducted in the United States have indicated that minorities have similar or smaller rates of prevalence for mental health disorders as their majority counterparts.[25] Blacks (24.6%) and Hispanics (19.6%) have lower depression rates than their White counterparts (34.7%) in the United States.[26] While racial/ethnic minority groups may have similar prevalence rates, the consequences because of mental illness are more prolonged – which may be partly explained due to the smaller access rates for mental health treatments.  In 2018, while 56.7% of the general US population who had a mental illness didn't seek treatment, 69.4% and 67.1% Black and Hispanics didn't access care.[27] Further, in the instances of some mental illnesses, such as schizophrenia, Blacks in the United States have been reported to have higher rates compared to their White counterparts, however, research suggests that this could be due to an overdiagnosis among clinicians and underdiagnosis for other illnesses, such as mood disorders, for which Blacks had lower reported prevalence rates for major depression.[28][29][30] These instances of misdiagnosis may be due to "lack of cultural understanding by health care providers,...language differences between patient and provider, stigma of mental illness among minority groups, and cultural presentation of symptoms.[citation needed]


According to Paul and Moser’s meta-analysis, countries with high income inequality and poor unemployment protections have worse mental health outcomes among the unemployed.[31]

Environmental factors

In addition to fixed characteristics, environmental factors, such as adequate access to food, housing, and health and exposure to pollution,

Social determinants of mental health include social, economic, and environmental factors

impacts an individual’s likelihood and severity of mental health outcomes. Although these factors can not directly change an individual's fixed characteristics of the social determinants of mental health, they can affect the degree to which an individual is influenced.

Inadequate access to proper food

Mental illnesses are common among those that are food insecure due to associated factors of stress and weaker community belonging.[32] Food security refers to the state of having access to sufficient and nutritious foods in order to maintain a healthy and active life, and deviations from this can lead to food insecurity.[33] While seen as an economic indicator, food insecurity can increase the risk to mental illnesses through stress, making individuals more vulnerable to worse mental health outcomes.

Another contributing factor that can explain this association between food insecurity and mental illnesses is social isolation. Research, for instance, shows that the majority of food insecure individuals in Canada do not have access to community food programs or food banks, suggesting that there is little to no access to social resources for these people.[34][35] This factor can impact an individual's ability to feel supported or a sense of belonging within their community, thereby increasing their vulnerability to mental illnesses.


Studies have found a co-occurrence between homelessness and mental illnesses. The “housing first” intervention in Canada – the At Home/Chez Soi study – which aimed to provide permanent housing to individuals reported that for the study cohort, suicidal ideation diminished over time.[36] Another study, one of the largest of its kind aimed to characterize the health of Canada's homeless youth, reported that 85% of its participants had high levels of psychological distress and 42% attempted suicide at least once.[37]

In addition to suffering from mental illnesses, homeless individuals also have trouble accessing care: for example, 50% of homeless men in a New York City shelter reported being overtly mental ill, and nearly 20–35% of mentally ill homeless individuals were in need of psychiatric services.[38][39] While homeless shelters were once viewed as transient facilities, they have been burdened to take up the role of providing care for the large number of mentally ill homeless people that occupy these shelters.[40] However, a United Kingdom survey found that only 27.1% of homeless shelters believed that their mental health services were adequate to meet the needs of the homeless youth population surveyed in the study.[41]


Despite the vast literature on the effect of air pollution on physical health outcomes, research on the mental health effects of air pollution are limited.[42] Data from the China Family Panel Studies found a positive relationship between air pollution and mental illnesses, where an 18.04 μg/m3 increase in average PM2.5 has a 6.67% increase in the probability of having a score corresponding with a severe mental illness, approximating a cost of US$22.88 billion in health expenditures associated with mental illness and treatment.

New evidence, although still non-conclusive, suggests the association between various mental health disorders and major environmental pollutants, including air pollutants, heavy metals, and environmental catastrophes, and have found that these pathogens have a direct and indirect role on the brain and in the generation of stress levels.[43] For instance, noise pollution could affect wellbeing and quality of life as a result of disturbances in circadian rhythms, noise annoyance, and noise sensitivity.[44]


In addition to the role of pathogen and pollutant exposure on mental health, adverse environmental and climate changes can lead to climate-related migration and displacement that burdens and causes a mental health toll on impacted individuals. From the disruption of social ties and support systems in their native communities to the financial and emotional stress (often due to the stigma that make it hard for climate migrants to integrate) that arises due to relocating, climate migrants experience negative mental health outcomes.[45] Forced migrants, compared to host populations, experience more common mental health disorders, including post-traumatic stress disorder, anxiety, major depression, psychosis, and suicidality due to the stressors that they experience.[46]

Changes in climate can also impact food security in regions, food prices, and household livelihoods, thereby impacting the mental health of residents.[47][48][49][50] In an Australian sample, drought was reported to affect food availability, resulting in individuals skipping meals; individuals consuming below-average food levels expressed higher levels of distress compared to those eating at above-average levels.[33]

Social factors

The social factors of the determinants of mental health looks at the role of social influences, such as discrimination and stigma, that increase the likelihood of mental health disorders among certain minority communities.


Extensive literature has pointed to the strong association of discrimination on mental health and worse psychological wellbeing of individuals – with some studies even suggesting that the role of discrimination on mental health is greater than on physical health outcomes.[51][52][53] In the scope of ‘physical health’, studies have found that discrimination in health care delivery affects standard of care for ethnic minority communities: for example, African Americans and Latinos are less likely than their white counterparts to receive sufficient pain medication for long bone fracture or kidney stones.[54]

Focusing on mental health specifically though, community and laboratory studies have found that discrimination, such as racial/ethnic discrimination, is associated with worse mental health outcomes through increased depression, anxiety, and psychological distress.[51][55] Occupational discrimination – discrimination in work organizations – also points to this same trend, in which regardless of race, those who acknowledge being discriminated against had worse poorer mental health outcomes.[56] The literature suggests that discrimination, despite the type, is harmful for mental health.  

Researchers have also studied the role of multiple types of discrimination on mental health risk and have pointed to two risk models– first, the risk model in which groups that experience discrimination have an increased risk for worse mental health and second, the resilience model, in which these groups become more resilient to various other forms of discrimination.[57] An extensive literature review on existing studies found that generally the findings aligned with the risk model, as opposed to the resilience model. Specifically, there were a higher risk for symptoms of depression among groups that experienced various forms of discrimination – including racism, heterosexism. The role of multiple forms of discrimination on other mental health problems, such as anxiety, posttraumatic stress disorder, substance use, are less, and the results are mixed.  

Discrimination also exists in mental health care delivery among marginalized communities. Provider discrimination can affect mental health treatment among racial minorities, for example: in the United States, minority groups have similar or lower prevalence rates of mental disorders when compared to their white counterparts, however Blacks were only half as likely as whites to receive treatment for diseases of similar severity.[58][59][60]


Studies have found that the stigma associated with mental health problems can impact care seeking and participation. Reasons that decrease the likelihood of care seeking include prejudice against people with mental health illnesses as well as just the expectation of prejudice and discrimination for those who seek treatment.[61] Further, lack of knowledge of mental illnesses and how to access treatment can also impact care seeking behaviors; the associated stigma surrounding mental health issues can contribute to this knowledge gap. Corrigan et al. 2014 outlines three levels of stigma – public stigma that results from label avoidance, self-stigma that results from self-shame, and structural stigma.[62] Given these varying structures of stigma and a person's varying interactions with them, the avoidance for care seeking and participation behaviors may vary vastly. A global review on the stigma of mental illnesses and discrimination found that “there is no known country, society, or culture where people with mental illness (diagnosed or recognized as such by the community) are considered to have the same value or be as acceptable as persons who do not have mental illness”.[61]

Economic factors

See also: Socioeconomic status and mental health

Economic factors can influence the frequency and severity of mental health outcomes in people of all ages.[63] Economic factors include proximal factors such as assets, debt, financial strain, food security, income, relative deprivation and unemployment, as well as distal factors such as economic inequality, economic recessions, macroeconomic policy and subjective financial strain. According to research, there is a complicated and bi-directional relationship between economic factors such as unemployment, food insecurity, poverty and increased prevalence of adult common mental disorders in low-income, middle-income, and high-income countries.[63][64][65] The relationship between economic factors and mental health is relevant throughout the lifecourse.[66]

Other factors

Biological factors

Biological factors can also affect the likelihood of certain mental illnesses among individuals. When considering major depression, for example, the HTR1A −1019C>G genotype was found to be significantly associated among patients in Utah, United States.[67] Further, the functional BDNF Val66Met polymorphism has also been found to be a potential genetic risk factor for depression because it impacts the volume of the hippocampus, and stress-induced hippocampal atrophy has been associated with the origination and development of affective disorders.[68] Extensive research and literature in the fields of neuroscience and psychology – and their intersection – aim to identify these genetic and anatomical risk factors.


Research has been conducted into examining mental health treatments and interventions that consider these social determinants of mental health and the roles they play in mental health outcomes. For example, nutritional psychiatry is an emerging area of study which aims to improve mental health of individuals through diet and food: Adan et al. 2019 highlights that intervention studies have found that diet and lifestyle could potentially influence mental health treatment and prevention.[69]


  1. ^ Shim, Ruth S.; Compton, Michael T. (January 2020). "The Social Determinants of Mental Health: Psychiatrists' Roles in Addressing Discrimination and Food Insecurity". FOCUS. 18 (1): 25–30. doi:10.1176/appi.focus.20190035. ISSN 1541-4094. PMC 7011221. PMID 32047394.
  2. ^ "Social determinants of health". Retrieved 2022-11-01.
  3. ^ General, Office of the Surgeon (2021-12-07). "U.S. Surgeon General Issues Advisory on Youth Mental Health Crisis Further Exposed by COVID-19 Pandemic". Retrieved 2022-11-01.
  4. ^ "About Mental Health". 2021-11-23. Retrieved 2022-11-10.
  5. ^ "A Look at The Three Most Common Mental Illnesses". Retrieved 2022-11-10.
  6. ^ Jones, Nancy L.; Gilman, Stephen E.; Cheng, Tina L.; Drury, Stacy S.; Hill, Carl V.; Geronimus, Arline T. (January 2019). "Life Course Approaches to the Causes of Health Disparities". American Journal of Public Health. 109 (S1): S48–S55. doi:10.2105/AJPH.2018.304738. ISSN 0090-0036. PMC 6356123. PMID 30699022.
  7. ^ World Health Organization (2022). World mental health report: transforming mental health for all. World Health Organization. pp. xviii. hdl:10665/356119. ISBN 978-92-4-004933-8.
  8. ^ a b Weissman, Myrna M.; Olfson, Mark (1995-08-11). "Depression in Women: Implications for Health Care Research". Science. 269 (5225): 799–801. Bibcode:1995Sci...269..799W. doi:10.1126/science.7638596. ISSN 0036-8075. PMID 7638596. S2CID 21510901.
  9. ^ a b Desai, Hirai D.; Jann, Michael W. (July 2000). "Women's Health Series Major Depression in Women: A Review of the Literature". Journal of the American Pharmaceutical Association (1996). 40 (4): 525–537. doi:10.1016/s1086-5802(15)30400-9. ISSN 1086-5802.
  10. ^ World Health Organization (2014). Social determinants of mental health. World Health Organization. hdl:10665/112828. ISBN 978-92-4-150680-9.
  11. ^ Alegría, Margarita; NeMoyer, Amanda; Falgàs Bagué, Irene; Wang, Ye; Alvarez, Kiara (November 2018). "Social Determinants of Mental Health: Where We Are and Where We Need to Go". Current Psychiatry Reports. 20 (11): 95. doi:10.1007/s11920-018-0969-9. ISSN 1523-3812. PMC 6181118. PMID 30221308.
  12. ^ World Health Organization (2022). World mental health report: transforming mental health for all. World Health Organization. hdl:10665/356119. ISBN 978-92-4-004933-8.
  13. ^ Riecher-Rössler, Anita (January 2017). "Sex and gender differences in mental disorders". The Lancet Psychiatry. 4 (1): 8–9. doi:10.1016/S2215-0366(16)30348-0. PMID 27856397.
  14. ^ Kuehner, Christine (February 2017). "Why is depression more common among women than among men?". The Lancet Psychiatry. 4 (2): 146–158. doi:10.1016/S2215-0366(16)30263-2. PMID 27856392.
  15. ^ Li, Sophie H; Graham, Bronwyn M (January 2017). "Why are women so vulnerable to anxiety, trauma-related and stress-related disorders? The potential role of sex hormones". The Lancet Psychiatry. 4 (1): 73–82. doi:10.1016/S2215-0366(16)30358-3. PMID 27856395.
  16. ^ Schumacher, Helene. "Why more men than women die by suicide". Retrieved 2022-11-01.
  17. ^ Murphy, George E (July 1998). "Why women are less likely than men to commit suicide". Comprehensive Psychiatry. 39 (4): 165–175. doi:10.1016/S0010-440X(98)90057-8. PMID 9675500.
  18. ^ Bränström, Richard (May 2017). "Minority stress factors as mediators of sexual orientation disparities in mental health treatment: a longitudinal population-based study". Journal of Epidemiology and Community Health. 71 (5): 446–452. doi:10.1136/jech-2016-207943. ISSN 0143-005X. PMC 5484026. PMID 28043996.
  19. ^ Robertson, Lee; Akré, Ellesse-Roselee; Gonzales, Gilbert (2021-11-01). "Mental Health Disparities at the Intersections of Gender Identity, Race, and Ethnicity". LGBT Health. 8 (8): 526–535. doi:10.1089/lgbt.2020.0429. ISSN 2325-8292. PMID 34591707. S2CID 238239420.
  20. ^ Semlyen, Joanna; King, Michael; Varney, Justin; Hagger-Johnson, Gareth (December 2016). "Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys". BMC Psychiatry. 16 (1): 67. doi:10.1186/s12888-016-0767-z. ISSN 1471-244X. PMC 4806482. PMID 27009565.
  21. ^ "Current Issues in Lesbian, Gay, Bisexual, and Transgender (LGBT) Health: Introduction", Current Issues in Lesbian, Gay, Bisexual, and Transgender Health, Routledge, pp. 17–28, 2013-04-11, doi:10.4324/9780203057582-5, ISBN 978-0-203-05758-2, retrieved 2022-11-01
  22. ^ Safer, Joshua D.; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae (April 2016). "Barriers to healthcare for transgender individuals". Current Opinion in Endocrinology, Diabetes & Obesity. 23 (2): 168–171. doi:10.1097/MED.0000000000000227. ISSN 1752-296X. PMC 4802845. PMID 26910276.
  23. ^ Hsieh, Ning (July 2014). "Explaining the Mental Health Disparity by Sexual Orientation: The Importance of Social Resources". Society and Mental Health. 4 (2): 129–146. doi:10.1177/2156869314524959. ISSN 2156-8693. S2CID 146921163.
  24. ^ "hate-crimes-and-violence-against-lesbian-gay-bisexual-and-transgender-people-may-2009-19pp". Human Rights Documents online. doi:10.1163/2210-7975_hrd-9800-0005. Retrieved 2022-11-01.
  25. ^ Williams, David R. (2005-10-01). "The Health of U.S. Racial and Ethnic Populations". The Journals of Gerontology: Series B. 60 (Special_Issue_2): S53–S62. doi:10.1093/geronb/60.Special_Issue_2.S53. ISSN 1079-5014. PMID 16251591.
  26. ^ Budhwani, Henna; Hearld, Kristine Ria; Chavez-Yenter, Daniel (2014-09-11). "Depression in Racial and Ethnic Minorities: the Impact of Nativity and Discrimination". Journal of Racial and Ethnic Health Disparities. 2 (1): 34–42. doi:10.1007/s40615-014-0045-z. ISSN 2197-3792. PMID 26863239. S2CID 207501450.
  27. ^ Rubin, Rita (2020-06-23). "Pandemic Highlights Behavioral Health Disparities". JAMA. 323 (24): 2452. doi:10.1001/jama.2020.10318. ISSN 0098-7484. PMID 32573656. S2CID 219990834.
  28. ^ Neighbors, Harold W.; Trierweiler, Steven J.; Ford, Briggett C.; Muroff, Jordana R. (September 2003). "Racial Differences in DSM Diagnosis Using a Semi-Structured Instrument: The Importance of Clinical Judgment in the Diagnosis of African Americans". Journal of Health and Social Behavior. 44 (3): 237–256. doi:10.2307/1519777. ISSN 0022-1465. JSTOR 1519777. PMID 14582306. S2CID 7188576.
  29. ^ Strakowski, S (1996-07-08). "Racial influence on diagnosis in psychotic mania". Journal of Affective Disorders. 39 (2): 157–162. doi:10.1016/0165-0327(96)00028-6. PMID 8827426.
  30. ^ McGuire, Thomas G.; Miranda, Jeanne (March 2008). "New Evidence Regarding Racial And Ethnic Disparities In Mental Health: Policy Implications". Health Affairs. 27 (2): 393–403. doi:10.1377/hlthaff.27.2.393. ISSN 0278-2715. PMC 3928067. PMID 18332495.
  31. ^ "The toll of job loss". Retrieved 2023-11-26.
  32. ^ Martin, M.S.; Maddocks, E.; Chen, Y.; Gilman, S.E.; Colman, I. (March 2016). "Food insecurity and mental illness: disproportionate impacts in the context of perceived stress and social isolation". Public Health. 132: 86–91. doi:10.1016/j.puhe.2015.11.014. PMID 26795678.
  33. ^ a b Friel, Sharon; Berry, Helen; Dinh, Huong; O’Brien, Léan; Walls, Helen L (December 2014). "The impact of drought on the association between food security and mental health in a nationally representative Australian sample". BMC Public Health. 14 (1): 1102. doi:10.1186/1471-2458-14-1102. ISSN 1471-2458. PMC 4288639. PMID 25341450.
  34. ^ Kirkpatrick, Sharon I.; Tarasuk, Valerie (March 2009). "Food Insecurity and Participation in Community Food Programs among Low-income Toronto Families". Canadian Journal of Public Health. 100 (2): 135–139. doi:10.1007/BF03405523. ISSN 0008-4263. PMC 6973985. PMID 19839291.
  35. ^ Loopstra, Rachel; Tarasuk, Valerie (December 2012). "The Relationship between Food Banks and Household Food Insecurity among Low-Income Toronto Families". Canadian Public Policy. 38 (4): 497–514. doi:10.3138/CPP.38.4.497. ISSN 0317-0861.
  36. ^ Aquin, Joshua P.; Roos, Leslie E.; Distasio, Jino; Katz, Laurence Y.; Bourque, Jimmy; Bolton, James M.; Bolton, Shay-Lee; Wong, Jacquelyne Y.; Chateau, Dan; Somers, Julian M.; Enns, Murray W.; Hwang, Stephen W.; Frankish, James C.; Sareen, Jitender (July 2017). "Effect of Housing First on Suicidal Behaviour: A Randomised Controlled Trial of Homeless Adults with Mental Disorders". The Canadian Journal of Psychiatry. 62 (7): 473–481. doi:10.1177/0706743717694836. ISSN 0706-7437. PMC 5528985. PMID 28683228.
  37. ^ Kidd, Sean A.; Gaetz, Stephen; O’Grady, Bill (July 2017). "The 2015 National Canadian Homeless Youth Survey: Mental Health and Addiction Findings". The Canadian Journal of Psychiatry. 62 (7): 493–500. doi:10.1177/0706743717702076. ISSN 0706-7437. PMC 5528986. PMID 28372467.
  38. ^ “Men’s Shelter Study Group: Report on Men Housed for One Night.” New York: Humans Resources Administration (1976).
  39. ^ Crystal, Stephen, and M. Goldstein. "New Arrivals: First Time Shelter Clients." New York: Human Resources Administration (1982).
  40. ^ Bassuk, E. L.; Rubin, L.; Lauriat, A. (December 1984). "Is homelessness a mental health problem?". American Journal of Psychiatry. 141 (12): 1546–1550. doi:10.1176/ajp.141.12.1546. ISSN 0002-953X. PMID 6209990.
  41. ^ Taylor, Helen; Stuttaford, Maria; Vostanis, Panos (2006-10-01). "A UK survey on how homeless shelters respond to the mental health needs of homeless young people". Housing, Care and Support. 9 (2): 13–18. doi:10.1108/14608790200600011. ISSN 1460-8790.
  42. ^ Chen, Shuai; Oliva, Paulina; Zhang, Peng (June 2018). "Air Pollution and Mental Health: Evidence from China" (PDF). Cambridge, MA. pp. w24686. doi:10.3386/w24686.
  43. ^ Ventriglio, Antonio; Bellomo, Antonello; di Gioia, Ilaria; Di Sabatino, Dario; Favale, Donato; De Berardis, Domenico; Cianconi, Paolo (February 2021). "Environmental pollution and mental health: a narrative review of literature". CNS Spectrums. 26 (1): 51–61. doi:10.1017/S1092852920001303. ISSN 1092-8529. PMID 32284087. S2CID 215758769.
  44. ^ Tortorella, Alfonso; Menculini, Giulia; Moretti, Patrizia; Attademo, Luigi; Balducci, Pierfrancesco Maria; Bernardini, Francesco; Cirimbilli, Federica; Chieppa, Anastasia Grazia; Ghiandai, Nicola; Erfurth, Andreas (2022-11-17). "New determinants of mental health: the role of noise pollution. A narrative review". International Review of Psychiatry. 34 (7–8): 783–796. doi:10.1080/09540261.2022.2095200. ISSN 0954-0261. PMID 36786115. S2CID 250590048.
  45. ^ Torres, Jacqueline M.; Casey, Joan A. (December 2017). "The centrality of social ties to climate migration and mental health". BMC Public Health. 17 (1): 600. doi:10.1186/s12889-017-4508-0. ISSN 1471-2458. PMC 5498922. PMID 28679398.
  46. ^ 15.  Dunsmore, Campbell. 2022. “Mitigating Mental Health Impacts of Climate-Related Migration: Incorporating Psychological Resilience Building into Disaster Risk Reduction Policy Frameworks.” U.S. Committee for Refugees and Immigrants, April.
  47. ^ Parry, M.A.J.; Lea, P.J. (December 2009). "Food security and drought". Annals of Applied Biology. 155 (3): 299–300. doi:10.1111/j.1744-7348.2009.00370.x.
  48. ^ Battisti, David. S.; Naylor, Rosamond L. (2009-01-09). "Historical Warnings of Future Food Insecurity with Unprecedented Seasonal Heat". Science. 323 (5911): 240–244. doi:10.1126/science.1164363. ISSN 0036-8075. PMID 19131626. S2CID 8658033.
  49. ^ Brown, Molly E.; Funk, Christopher C. (February 2008). "Food Security Under Climate Change". Science. 319 (5863): 580–581. doi:10.1126/science.1154102. ISSN 0036-8075. PMID 18239116. S2CID 32956699.
  50. ^ Budhwani, Henna; Hearld, Kristine Ria; Chavez-Yenter, Daniel (March 2015). "Depression in Racial and Ethnic Minorities: the Impact of Nativity and Discrimination". Journal of Racial and Ethnic Health Disparities. 2 (1): 34–42. doi:10.1007/s40615-014-0045-z. ISSN 2197-3792. PMID 26863239. S2CID 207501450.
  51. ^ a b Paradies, Yin. “A Systematic Review of Empirical Research on Self-Reported Racism and Health.” International Journal of Epidemiology, vol. 35, no. 4, August 2006, pp. 888–901. (Crossref), doi:10.1093/ije/dyl056.
  52. ^ Schmitt, Michael T., et al. “The Consequences of Perceived Discrimination for Psychological Well-Being: A Meta-Analytic Review.” Psychological Bulletin, vol. 140, no. 4, 2014, pp. 921–48. (Crossref), doi:10.1037/a0035754.
  53. ^ Williams, David R., and Selina A. Mohammed. “Discrimination and Racial Disparities in Health: Evidence and Needed Research.” Journal of Behavioral Medicine, vol. 32, no. 1, February 2009, pp. 20–47. (Crossref), doi:10.1007/s10865-008-9185-0.
  54. ^ Pletcher, Mark J., et al. “Trends in Opioid Prescribing by Race/Ethnicity for Patients Seeking Care in US Emergency Departments.” JAMA, vol. 299, no. 1, January 2008. (Crossref), doi:10.1001/jama.2007.64.
  55. ^ Williams, David R., et al. “Racial/Ethnic Discrimination and Health: Findings From Community Studies.” American Journal of Public Health, vol. 93, no. 2, February 2003, pp. 200–08. (Crossref), doi:10.2105/AJPH.93.2.200.
  56. ^ Roberts, Rashaun K., et al. “Discrimination and Occupational Mental Health.” Journal of Mental Health, vol. 13, no. 2, April 2004, pp. 129–42. (Crossref), doi:10.1080/09638230410001669264.
  57. ^ Vargas, Sylvanna M., et al. “A Critical Review of Current Evidence on Multiple Types of Discrimination and Mental Health.” American Journal of Orthopsychiatry, vol. 90, no. 3, 2020, pp. 374–90. (Crossref), doi:10.1037/ort0000441.
  58. ^ Breslau, Joshua, et al. “Lifetime Risk and Persistence of Psychiatric Disorders across Ethnic Groups in the United States.” Psychological Medicine, vol. 35, no. 3, April 2005, pp. 317–27. (Crossref), doi:10.1017/S0033291704003514.
  59. ^ Breslau, Joshua, et al. “Specifying Race-Ethnic Differences in Risk for Psychiatric Disorder in a USA National Sample.” Psychological Medicine, vol. 36, no. 1, January 2006, pp. 57–68. (Crossref), doi:10.1017/S0033291705006161.
  60. ^ Kessler, Ronald C., et al. “Prevalence and Treatment of Mental Disorders, 1990 to 2003.” New England Journal of Medicine, vol. 352, no. 24, June 2005, pp. 2515–23. (Crossref), doi:10.1056/NEJMsa043266.
  61. ^ a b Thornicroft, Graham. “Stigma and Discrimination Limit Access to Mental Health Care.” Epidemiologia e Psichiatria Sociale, vol. 17, no. 1, March 2008, pp. 14–19. (Crossref), doi:10.1017/S1121189X00002621.
  62. ^ Corrigan, Patrick W., et al. “The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care.” Psychological Science in the Public Interest, vol. 15, no. 2, October 2014, pp. 37–70. (Crossref), doi:10.1177/1529100614531398.
  63. ^ a b Lund, C.; Brooke-Sumner, C.; Baingana, F.; et al. (2018). "Social determinants of mental disorders and the Sustainable Development Goals: A systematic review of reviews". The Lancet Psychiatry. 5 (4): 357–369. doi:10.1016/S2215-0366(18)30060-9. PMID 29580610.
  64. ^ Iemmi, Valentina; Bantjes, Jason; Coast, Ernestina; Channer, Kerrie; Leone, Tiziana; McDaid, David; Palfreyman, Alexis; Stephens, Bevan; Lund, Crick (August 2016). "Suicide and poverty in low-income and middle-income countries: a systematic review". The Lancet Psychiatry. 3 (8): 774–783. doi:10.1016/s2215-0366(16)30066-9. ISSN 2215-0366. PMID 27475770.
  65. ^ Dohrenwend, Bruce P.; Levav, Itzhak; Shrout, Patrick E.; Schwartz, Sharon; Naveh, Guedalia; Link, Bruce G.; Skodol, Andrew E.; Stueve, Ann (1992-02-21). "Socioeconomic Status and Psychiatric Disorders: The Causation-Selection Issue". Science. 255 (5047): 946–952. Bibcode:1992Sci...255..946D. doi:10.1126/science.1546291. ISSN 0036-8075. PMID 1546291.
  66. ^ Lund, Crick; Brooke-Sumner, Carrie; Baingana, Florence; Baron, Emily Claire; Breuer, Erica; Chandra, Prabha; Haushofer, Johannes; Herrman, Helen; Jordans, Mark; Kieling, Christian; Medina-Mora, Maria Elena; Morgan, Ellen; Omigbodun, Olayinka; Tol, Wietse; Patel, Vikram (April 2018). "Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews". The Lancet Psychiatry. 5 (4): 357–369. doi:10.1016/S2215-0366(18)30060-9. PMID 29580610.
  67. ^ Neff, C. D., et al. “Evidence for HTR1A and LHPP as Interacting Genetic Risk Factors in Major Depression.” Molecular Psychiatry, vol. 14, no. 6, June 2009, pp. 621–30. (Crossref), doi:10.1038/mp.2008.8.
  68. ^ Montag, C., et al. “The BDNF Val66Met Polymorphism Impacts Parahippocampal and Amygdala Volume in Healthy Humans: Incremental Support for a Genetic Risk Factor for Depression.” Psychological Medicine, vol. 39, no. 11, November 2009, pp. 1831–39. (Crossref), doi:10.1017/S0033291709005509.
  69. ^ Adan, Roger A. H., et al. “Nutritional Psychiatry: Towards Improving Mental Health by What You Eat.” European Neuropsychopharmacology, vol. 29, no. 12, December 2019, pp. 1321–32. (Crossref), doi:10.1016/j.euroneuro.2019.10.011.