title: Socioeconomic Inequalities in Mental Health of Adult Population: Serbian National Health Survey.
abstract: BACKGROUND
  The global burden of mental disorders is rising. In Serbia, anxiety is the leading cause of disability-adjusted life years. Serbia has no mental health survey at the population level. The information on prevalence of mental disorders and related socioeconomic inequalities are valuable for mental care improvement.
  
  
  OBJECTIVE
  To explore the prevalence of mental health disorders and socioeconomic inequalities in mental health of adult Serbian population, and to explore whether age years and employment status interact with mental health in urban and rural settlements.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  This study is an additional analysis of Serbian Health Survey 2006 that was carried out with standardized household questionnaires at the representative sample of 7673 randomly selected households - 15563 adults. The response rate was 93%. A multivariate logistic regression modeling highlighted the predictors of the 5 item Mental Health Inventory (MHI-5), and of chronic anxiety or depression within eight independent variables (age, gender, type of settlement, marital status and self-perceived health, education, employment status and Wealth Index). The significance level in descriptive statistics, chi square analysis and bivariate and multivariate logistic regressions was set at p<0.05.
  
  
  RESULTS
  Chronic anxiety or depression was seen in 4.9% of the respondents, and poor MHI-5 in 47% of respondents. Low education (Odds Ratios 1.32; 95% confidence intervals=1.16-1.51), unemployment (1.36; 1.18-1.56), single status (1.34; 1.23-1.45), and Wealth Index middle class (1.20; 1.08-1.32) or poor (1.33; 1.21-1.47) were significantly related with poor MHI-5. Unemployed persons in urban settlements had higher odds for poormMHI-5 than unemployed in rural areas (0.73; 0.59-0.89). Single (1.50; 1.26-1.78), unemployed (1.39; 1.07-1.80) and inactive respondents (1.42; 1.10-1.83) had a higher odds of chronic anxiety or depression than married individuals, or those with partner, and employed persons. Those with perceived good health status had lower odds for poor MHI-5, chronic anxiety or depression than those whose general health was average and poor.
  
  
  CONCLUSIONS
  Almost half of the population assessed their mental health as poor and 5% had diagnosed chronic anxiety or depression. Multi-sectoral socioeconomic and female-sensitive policies should be wisely tailored to reduce mental health inequalities contributed by differences in age, education, employment, marriage and the wealth status of the adult population.
authors.affiliation: Institute of Social Medicine, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors.forename: Milena
authors.initials: M
authors.lastname: Santric-Milicevic
authors.affiliation: Institute of Social Medicine, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors.forename: Janko
authors.initials: J
authors.lastname: Jankovic
authors.affiliation: Institute of Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors.forename: Goran
authors.initials: G
authors.lastname: Trajkovic
authors.affiliation: Institute of Social Medicine, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Terzic-Supic
authors.affiliation: Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Uros
authors.initials: U
authors.lastname: Babic
authors.affiliation: Institute of Social Medicine, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors.forename: Marija
authors.initials: M
authors.lastname: Petrovic
keywords: Anxiety; depression; socioeconomic factors; subjective health