EFFECTS OF HOUSEHOLD INCOME ON MENTAL HEALTH ISSUES IN CHILDREN AND ADOLESCENTS Tanveen Dhallu, Cale Donaldson, Jeanette Eliezer Professor Thorne
ABST ABSTRACT This project examined the effects of household income on the onset of mental health issues in children and adolescents. Anxiety and depressive disorders are very common in the United States, and previous research has shown that these disorders are more common amongst residents living in poverty. However, to date, there is little research done on the prevalence of mental illnesses in children. This project wanted to explore the effects of income-level on the onset of depression and anxiety in children and adolescents. Data was examined from East Harlem and the Upper East Side. The age group was set at 5-19, and data search was focused on social anxiety and depression as the two main mental health issues. Data on poverty levels, income numbers, rates of psychological disorders and hospitalizations related to mental health was collected. Results showed that the there is a greater prevalence of mental health issues in East Harlem than the Upper East Side. Results also showed a major difference in poverty rates between the two neighborhoods. The aim of this project was to show the relationship between household income and the onset of mental health issues, as well as provide suggestions on how to reduce the number of mental health issues in East Harlem.
Bekiemp mpis , 2 2014 ADAA, 2 2014 1 in 5 Americans Anxiety and suffer from mental depressive disorders health illness every are the most year common mental illnesses in the US Sa Sareen, 2 2011 Insignificant research on Greater prevalence the relationship between Ave venevo voli, 2 2014 of depression and low-income households 11% of children in anxiety in low-income and the onset of mental US are diagnosed level households illness in children and with depression adolescents Some evidence of NCCP NC , 2 2016 higher depression 45% of children live and anxiety levels in in low-income children from low- families income families 4,6,7
QU QUESTIONS • How does income status affect mental health? • Do children from low-income families have a greater risk of developing mental health issues, i.e. social anxiety and depression, than children from high-income families? • Do infants from low-income families have higher stress levels than infants from high-income families? • Do low-income and high-income neighborhoods have the same availability of resources for mental health-issues/how does income affect the diagnosis and treatment of mental health disorders?
HYPO HYPOTHE THESES • Children and adolescents from low-income families have greater risk of developing social anxiety and depression than children and adolescents from high-income families. • Infants from low-income families have higher stress levels than infants from high-income families. • Disparity in types and number of mental health disorder resources available between low-income neighborhoods and high-income neighborhoods.
ME METH THOD ODS • Examined two neighborhoods: • East Harlem (low-income) • Upper East Side (high-income) • Data gathered from nyc.gov Community Health Profiles for East Harlem and Upper East Side
PO POVER VERTY R RATES ES • Major differences in poverty levels • Poverty level of East Harlem nearly twice as high as Manhattan and NYC • Poverty level of Upper East Side much lower than Manhattan and NYC • Poverty level of East Harlem nearly five times greater than Upper East Side • Child poverty rates much higher in East Harlem
TEENAGE REPORTS OF DEPRESSION • One in four teens reports feeling depressed (26%) in East Harlem
ME MENTAL HEALTH TH ISSUES MORE MORE PRE REVALENT T IN EAST T HARL RLEM M • More psychological distress sufferers in East Harlem than Upper East Side • 16% of children (ages 5-17) in East Harlem show signs of emotional disturbance 9 • Adolescents (ages 12-17) account for 60% of mental health sufferers though they make up only 35% of East Harlem’s population 9
ME MENTAL ILLNESSES NOT T BEING TRE TREATE TED • Barely ¼ of children in East Harlem receive mental help they need 9 • 12,500 children in need of mental health services • Only 3,150 treatment slots available • 80% of children with anxiety disorder and 60% of children with depression are not receiving treatment 12 • Need to expand resources for mental health in East Harlem
RA RACE CE AND ME MENTAL ILLNESS • African-Americans and Hispanics are more likely to develop depression than Whites 11 • African-American and Hispanic children are least likely to receive treatment for mental health 11 • East Harlem’s population is primarily African- Americans and Hispanics http://www.nyc.gov/html/doh/downloads/pdf/data/2006chp-303.pdf
HOS HOSPIT PITALIZ LIZATIONS TIONS FOR FOR M MENT NTAL ILLNE L ILLNESS • Differences in hospitalizations for mental illness • Consistent for Upper East Side • Increase yearly for East Harlem • East Harlem has four times the number of hospitalizations than Upper East Side • Decrease in hospitalizations in 2012
ME MENTAL ILLNESSES ARE RE TRE TREATABLE • Hospitalizations are avoidable • 30% of population in East Harlem has no personal doctor • Mental health issues more prevalent among uninsured 8 • Consequences of late identification of mental illness 9 • Late intervention • Conditions become more serious as child grows older • Juvenile justice system
INF INFANT ANT-ST STRESS LEVELS ESS LEVELS • Not much found on infant stress levels in neighborhoods • If mother is depressed, infant and child are more likely to develop depression 10 • Significantly higher number of teenage mothers in East Harlem • Teens are not ready to be mothers • Inadequate care of infants • Higher stress on infant because of high stress on teen mother
WHY IS THERE MORE DEPRESSION AND ANXIETY IN EAST HARLEM? • Income levels • Rent burden • Unemployment • Limited resources to help with mental illness • Minimal school intervention • Limited access to professional medical attention
ESSES SUGGEST SUGGESTIO IONS S FOR HEL ELPIN PING G MEN ENTAL AL HEAL EALTH IL ILLNESSES • East Harlem Health Outreach Partnership (EHHOP) 8 • Clinic run by Mount Sinai medical-students • Increase school based intervention • Increase access to pediatric primary care • Increase abundance of and access to child and adolescent mental health services
ON CONCL CONCLUSION • Limitations • Other factors besides income that influence mental health issues in the neighborhood • Future Research • Continue to observe data trends throughout the years • Infant-stress levels
CONCL CONCLUSION ON • Relationship between income levels and mental health issues in children and adolescents • Higher rates of mental health illnesses, especially depression and anxiety, in East Harlem than Upper East Side • Children in East Harlem are not getting proper medical attention they need for anxiety and depression
RE REFE FERE RENCE CES 1. Olson EC, Van Wye G, Kerker B, Thorpe L, Frieden TR. Take Care East Harlem. NYC Community Health Profiles, Second Edition; 2006; 21(42):1-16 2. Olson EC, Van Wye G, Kerker B, Thorpe L, Frieden TR. Take Care Upper East Side. NYC Community Health Profiles, Second Edition; 2006; 23(42):1-16. 3. P Cohen and C S Hesselbart. Demographic factors in the use of children's mental health services. American Journal of Public Health January 1993: Vol. 83, No. 1, pp. 49-52.doi: 10.2105/AJPH.83.1.49 4. Tracy, M., Zimmerman, F. J., Galea, S., McCauley, E., & Stoep, A. V. (2008). What explains the relation between family poverty and childhood depressive symptoms? Journal of Psychiatric Research , 42 (14), 1163–1175. http://doi.org/10.1016/j.jpsychires.2008.01.011 5. Sareen J, Afifi TO, McMillan KA, Asmundson GG. Relationship Between Household Income and Mental Disorders: Findings From a Population-Based Longitudinal Study. Arch Gen Psychiatry. 2011;68(4):419-427. doi:10.1001/archgenpsychiatry.2011.15.
RE REFE FERE RENCE CES 6. Buckner, JC. et al. Mental Disorders and Service Utilization Among Youths From Homeless and Low-Income Housed Families Journal of the American Academy of Child & Adolescent Psychiatry , Volume 36 , Issue 7 , 890 - 900 7. McLeod, J. D., & Shanahan, M. J.. (1996). Trajectories of Poverty and Children's Mental Health. Journal of Health and Social Behavior , 37 (3), 207–220. Retrieved from http://www.jstor.org/ stable/2137292 8. Liberman, K. M., Meah, Y. S., Chow, A., Tornheim, J., Rolon, O., & Thomas, D. C. (2011). Quality of Mental Health Care at a Student-Run Clinic: Care for the Uninsured Exceeds that of Publicly and Privately Insured Populations . Journal Of Community Health , 36 (5), 733-740. doi:10.1007/ s10900-011-9367-5 9. “Health Status of Harlem’s Children: Improving, but Lagging Far Behind the Rest of the City.” Children’s Health Fund (2006). 10. Shatkin, JP . The Diagnosis and Treatment of Pediatric Depression. NYU School of Medicine.
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