title: Socio-economic position and mental disorders in a working-age Finnish population: the health 2000 study.
abstract: BACKGROUND
  Mental disorders are more common in people with lower socio-economic position (SEP) but it is not known which specific SEP component is most strongly linked to poor mental health. We compared the strength of associations of three SEP components-occupation, income and education-with common mental disorders in a Finnish population.
  
  
  METHODS
  Cross-sectional analysis of a nationally representative sample of 4561 men and women aged 30-65 years. Mental disorders were assessed using the Composite International Diagnostic Interview resulting in 12-month DSM-IV diagnoses of depressive, anxiety and alcohol use disorders. Participants were classified as having low SEP if they worked in a manual occupation, lacked secondary-level education or had income below the Organisation for Economic Co-operation and Development (OECD) definition of relative poverty.
  
  
  RESULTS
  In models comparing the simultaneous association of all three socio-economic indicators with mental disorders, low income was associated with increased risk for depressive disorder [odds ratio (OR)=1.73, 95% confidence interval (CI) =1.31-2.29] and anxiety disorder (OR=1.56, 95% CI 1.14-2.12). Manual occupational class was modestly associated with risk for alcohol use disorder (OR=1.44, 95% CI 1.06-1.95). Low income was the only socio-economic component associated with psychiatric comorbidity, that is, a combination of various disorders within the same individual (OR 2.26, 95% CI 1.52-3.37 for any combination).
  
  
  CONCLUSIONS
  Low income seems to be a more important correlate of mental disorders than education or occupation in a high-income country such as Finland.
authors.affiliation: Finnish Institute of Occupational Health, Work and Organizations Centre of Expertise, Work and Mental Health, Topeliuksenkatu, Finland. laura.pulkki-raback@helsinki.fi
authors.forename: Laura
authors.initials: L
authors.lastname: Pulkki-Råback
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Mirka
authors.initials: M
authors.lastname: Hintsanen
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
authors.forename: Jouko
authors.initials: J
authors.lastname: Lönnqvist
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012737:Sex Factors; D012959:Socioeconomic Factors