Meta-analysis suggests income loss has greater impact on mental health than income gains

In new research published in The Lancet Public Health00058-5), researchers found that income loss at any level is associated with worsened mental health outcomes and an increase in income, especially out of poverty, is associated with better mental health outcomes.

Poor mental health has been linked with worsened physical and social outcomes. One’s income could be a major factor that impacts mental health. Research shows that low income is associated with poorer mental health outcomes, but it is unknown whether increases in one’s income improves mental health.

Low income and poor mental health share common causes, such as job loss, that may have a causal relationship with each other. Study author Rachel Thompson and her colleagues were interested in investigating how amounts of income loss and gain impact individuals’ mental health. The researchers conducted a meta-analysis and reviewed 136 studies regarding income changes and mental health outcomes, such as how income affects anxiety, depression, quality of life, and wellbeing.

A meta-analysis is a statistical technique used to combine and analyze data from multiple studies on a particular topic or research question. After identifying the relevant studies, the researcher extracts data on the study characteristics, sample size, and outcomes of interest. These data are then pooled together and analyzed using statistical methods to determine the overall effect size or magnitude of the relationship between the variables of interest.

Sixty-one percent of the studies reviewed contained reports of slight income changes and 30.1% contained reports of large income changes. Several income changes were related to taxes, healthcare, disasters, salary changes, and cash transfers.

Thompson and colleagues found that 88.9% of the studies showed that any amount of income loss was associated with poorer mental health outcomes and income increases were associated with improved mental health, regardless of the source of income loss or gain. Results also showed that mental health was affected more when income changes moved individuals across the poverty line.

Mental health outcomes from income loss were associated with two and a half times the magnitude of effect on mental health compared to income gains. In other words, individuals experienced a greater decline in mental health after income loss than individuals experiencing improved mental health after gaining income.

Thompson and colleagues argue that their findings suggest that financial loss has a greater negative impact on mental health than financial gain positively affects mental health. However, income increases is most effective in improving mental health when the increase resolves the individual from being in poverty.

“To be most supportive of population mental health and reduce inequalities, policy makers should design income and welfare policies that provide an adequate financial safety net for the most socioeconomically disadvantaged,” the researchers concluded. “There would be considerable value in future research investigating the mechanisms linking income and health, and the incorporation of these findings into intervention planning and evaluation.”

The study, “How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis00058-5/fulltext)“, was authored by Rachel M. Thomson, Erik Igelström, Amrit Kaur Purba, Michal Shimonovich, Hilary Thomson, Gerry McCartney, Aaron Reeves, Alastair Leyland, Anna Pearce, and S. Vittal Katikireddi.

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