Social Inequalities in Mental Health and Illness – the Significance of an Interconnecting, Multi-Factorial and Dynamic Approach

Social inequalities in mental health and illness grow out of a dynamic interplay between individual, organizational and societal factors and conditions. Individual´s health and well-being are shaped by an interactive process where the social context and social position play a vital role. This paper discusses how welfare institutions could affect social inequalities in mental health through direct and indirect mechanisms. Beyond medical reasons, health disparities also arise from a multitude of differences in living and working conditions influencing access to resources such as material, emotional and informational support. Hence, a successful way of reducing social inequalities in mental health requires a multilevel approach as well as a theoretical approach framing actors and structures in interaction. Despite this knowledge, health care and welfare service institutions in contemporary societies have developed towards specialized work organizations with a more unidirectional perspective and stricter regulations. Moreover, research has reported that individuals with multifaceted social and mental health problems through this institutional development face an increased risk of falling between different support systems resulting in unmet needs. Dynamic models which emphasize an enhanced understanding of the complex pathways and mechanisms in institutional structures that may affect social inequalities in mental health and illness are therefore warranted.