title: The association between material living standard and psychological distress: results from a New Zealand population survey.
abstract: BACKGROUND
  People with a low material living standard experience more psychological distress than those with a high living standard, but previous studies suggest the size of this difference is modest.
  
  
  OBJECTIVE
  To measure the association between living standard and psychological distress using a multidimensional measure of living standard, the Economic Living Standard Index (ELSI).
  
  
  METHODS
  Adults aged 25-64 years (n = 8,465) were selected from a New Zealand community survey. Logistic regression models were used to compare household income and ELSI scores as risk factors for high psychological distress, defined as a K10 score of 12 or over.
  
  
  RESULTS
  In the population, the prevalence of high psychological distress was 5.8%. The prevalence of high distress increased steeply with decreasing living standard. In the most deprived decile according to ELSI score, 24.3% had high distress, compared to 0.8% in the least deprived decile. For household income, high distress was present in 15.9% of people in the lowest decile and 2.2% of the highest decile. In fully adjusted models, ELSI score remained significantly associated with high distress but household income was not.
  
  
  CONCLUSIONS
  The mental health disparity between those at opposite ends of the social spectrum is very large. Comprehensive measures such as the ELSI give a more accurate estimate of this disparity than household income.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand james.foulds@otago.ac.nz.
authors.forename: James
authors.initials: J
authors.lastname: Foulds
authors.affiliation: Biostatistics and Computational Biology, University of Otago, Christchurch, New Zealand.
authors.forename: J Elisabeth
authors.initials: JE
authors.lastname: Wells
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Roger
authors.initials: R
authors.lastname: Mulder
mesh_terms: D000328:Adult; D000367:Age Factors; D003625:Data Collection; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000191:economics / Q000453:epidemiology* / Q000209:etiology
keywords: Economic Living Standard Index; K10; New Zealand; Psychological stress; income; mental disorders; socioeconomic factors