Does High Income Mean Worse Mental Health

Does High

Income Mean

Worse Mental

Health? Egan Cornachione

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Thank you all for being here

I hope you all enjoy the presentation!

Outline

Introduction to mental illnesses

The link between income and mental

illness

What this study attempts to find

Data and Model

What I find

Introduction

What is mental illness?

What causes it?

Affects 18.6% of adults age 18+ (NSDUH 2012)

Rate is increasing

What has been contributing to this?

Where does income fit in?

Fundamental economics: growth is good

Easterlin paradox (Easterlin 1974)

higher incomes = happier people

↑ national income ≠ ↑ national happiness

Kahneman and Deaton (2010)

Emotional well-being peak: $75,000

What do we know about the

link between income and

mental health?

Link between social inequality and mental

disorders (Fryers et al 2003)

Education, income, and unemployment

Low income →greater mental distress:

McMillan et al (2010) incomes<$17,000

Caron and Liu (2010): Living below 50% of

median income

What remains to be seen?

Causal effect not proven

Effect of high income on mental health?

High income job=high stress job

Above $75,000, well-being does not

improve

Does the nature of high income earning

lead to a higher prevalence of mental

illness?

Data

Health Reform Monitoring Survey, Second

Quarter of 2014

Survey of 7,701 American adults aged 18-64

Responses on income, mental and physical

health, and household demographics

Income is divided into 19 categories: ranging

from less than $5,000 to greater than $175,000.

Measures of Mental Illness

Two measures:

“Reported a mental or behavioral health

condition”

Number of days in the past 30 days with

bad mental health

Days w/stress, depression, emotional problems

Two levels of severity:

1) any number of days with mental issues

2) a week’s worth of days (7+) with mental issues

Descriptive Statistics Income Group % of total

Less than $5k 3.01%

$5k-$7.5k 1.43%

$7.5k-$10k 1.61%

$10k-$12.5k 2.80%

$12.5k-$15k 2.18%

$15k-$20k 3.51%

$20k-$25k 4.44%

$25k-$30k 4.54%

$30k-$35k 4.69%

$35k-$40k 5.01%

$40k-$50k 7.75%

$50k-$60k 8.66%

$60k-$75k 9.91%

$75k-$85k 7.53%

$85k-$100k 7.31%

$100k-$125k 11.21%

$125k-$150k 5.56%

$150k-$175k 3.48%

More than $175k 5.36%

Mental Health Diagnosis

% of population

sermhcondition 15.73%

mhcondition 37.87%

mentalhealth 23.89%

Variable % of population

white 71.90%

male 48.10%

married 55.41%

unemployed 32.83%

poor_phys_health 10.88%

insured 89.65%

college 39.67%

metro 85.61%

age 45.5

Household_size 2.8

Descriptive Statistics

Comparing Mental Health of Rich

(Income greater than $75,000) and Poor

(Income less than $25,000)

Variable Rich: Poor:

Obs 3115 1462

mhcondition 30.50% 49.38%

sermhcondition 9.95% 25.99%

mentalhealth 18.97% 33.17%

Model

Independent Variable: income

Dependent Variable: mental illness

Controls:

race, gender, age, education

marital status, household size, employment

status

physical health, insurance

type of city (metro area or not)

My Model

mentalhealth=β0+β1rich+β2poor+β3white+β4

male+β5married+β6unemployed+β7poor_ph

ys_health+β8insured+β9college+β10age+β11m

etro+β12household_size+u

Results mentalhealth Coef. Std. Err. t P>t [95% Conf. Interval]

rich*** -3.77% 1.10% -3.44 0.001 -5.91% -1.62%

poor*** 5.29% 1.47% 3.59 0 2.40% 8.17%

white*** 5.54% 1.08% 5.11 0 3.42% 7.67%

male*** -5.36% 0.95% -5.62 0 -7.23% -3.49%

married*** -5.29% 1.12% -4.71 0 -7.49% -3.09%

unemployed*** 7.73% 1.11% 6.98 0 5.56% 9.90%

poor_phys_health*** 19.46% 1.77% 10.98 0 15.98% 22.93%

insured*** 9.95% 1.52% 6.57 0 6.98% 12.93%

education 0.20% 0.27% 0.74 0.457 -0.33% 0.72%

metro -0.79% 1.40% -0.56 0.574 -3.53% 1.96%

age 0.05% 0.04% 1.29 0.199 -0.03% 0.13%

household _size* -0.70% 0.37% -1.89 0.059 -1.42% 0.03%

_cons 0.104696 0.040587 2.58 0.01 2.51% 18.43%

Results mhcondition Coef. Std. Err. t P>t [95% Conf. Interval]

Less than $5k** 9.65% 3.72% 2.59 0.01 2.35% 16.94%

$5k-$7.5k*** 8.77% 5.05% 1.73 0.083 -1.14% 18.68%

$7.5k-$10k 5.67% 4.70% 1.2 0.228 -3.56% 14.89%

$10k-$12.5k*** 11.78% 3.91% 3.02 0.003 4.13% 19.44%

$12.5k-$15k 1.95% 4.21% 0.46 0.643 -6.31% 10.21%

$15k-$20k*** 10.20% 3.42% 2.98 0.003 3.50% 16.90%

$20k-$25k 4.11% 3.17% 1.3 0.195 -2.10% 10.32%

$25k-$30k 2.81% 3.15% 0.89 0.372 -3.36% 8.98%

$30k-$35k** 7.44% 3.10% 2.4 0.017 1.35% 13.52%

$35k-$40k 0.40% 3.01% 0.13 0.894 -5.50% 6.30%

$40k-$50k -1.90% 2.71% -0.7 0.483 -7.20% 3.41%

$60k-$75k -2.03% 2.49% -0.82 0.413 -6.91% 2.84%

$75k-$85k -1.58% 2.67% -0.59 0.552 -6.81% 3.64%

$85k-$100k** -6.87% 2.65% -2.59 0.01 -12.06% -1.68%

$100k-$125k*** -8.82% 2.41% -3.67 0 -13.53% -4.10%

$125k-$150k*** -11.28% 2.77% -4.07 0 -16.72% -5.85%

$150k-$175k* -5.57% 3.33% -1.67 0.094 -12.10% 0.95%

More than $175k*** -11.05% 2.85% -3.88 0 -16.63% -5.46%

What I Find

Compared to median income group:

Poor: 5.3% more likely

Rich: 3.7% less likely

Below median income: ↑ mental illness

Above median income: ↓ mental illness

Logit probability of having mental illness:

$100,000-$125,000: 17.04%

$15,000-$19,999: 23.92%

What to Look Out For

Survey bias

Income is correlated with SES variables

Causality not able to be determined

Cross-sectional issues

Possible reverse causality

Takeaways

Confirmed link between low income and

mental illness

Increasing income does not increase

mental illness

Income cutoff of $175,000:

Does not include variation at very high

incomes

Median CEO salary is around $681,000

Implications

Direct policy efforts at providing mental

health resources for low income adults

Poor income group is far less likely to

receive care

Fixing this inequity is of clear importance

Has Mental Illness, Unable to Afford Mental Health Care

Rich (>$75,000/yr) 10.83%

Poor (<$25,000/yr) 22.68%

Questions