title: Income and psychological distress: the role of the social environment.
abstract: BACKGROUND
  This article examines the relationship between lower income and the risk of experiencing high psychological distress over twelve years.
  
  
  METHODS
  Data from the first 12 years of the longitudinal National Population Health Survey (1994/1995 through 2006/2007) were analysed. Proportional hazards modelling was conducted to determine whether lower household income was associated with a greater risk of experiencing high distress, when adjusting for sociodemographic characteristics and baseline health status. It was also used to examine the relationship between reporting a stressor and experiencing a subsequent episode of distress.
  
  
  RESULTS
  Overall, 11% of the initial sample experienced at least one episode of high distress during the 12 years of the study. Low-income respondents were at a significantly higher risk of becoming psychologically distressed, and many of the stressors were associated with a significantly higher risk of becoming distressed. Stressors accounted for 22% of the relationship between low income and distress for men, and more than a third of this relationship for women.
  
  
  CONCLUSIONS
  Low income is an important risk factor for becoming psychologically distressed, and stressors account for part of this increased risk.
authors.affiliation: Health Information and Research Division, Statistics Canada, Ottawa, Ontario. Heather.Orpana@statcan.gc.ca
authors.forename: Heather M
authors.initials: HM
authors.lastname: Orpana
authors.forename: Louise
authors.initials: L
authors.lastname: Lemyre
authors.forename: Ronald
authors.initials: R
authors.lastname: Gravel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D007182:Income / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D055815:Young Adult