Social Determinants of Mental and Behavioral Health

Finally, as primary care clinicians, we must acknowledge the reciprocal impact of poor mental health and mental illness on the social determinants of mental health. Poor mental health and mental illness are associated with homelessness, school dropout, marital instability, and economic insecurity.59 Mental illness affects living and employment conditions, which limit opportunities for upward mobility on the social gradient.59 However, the slope of the social gradient is not fixed, and addressing social stratification and inequitable access to opportunities, especially in early life, may allow for improvement in the social determinants of health and ultimately lessen mental illness and improve mental health.5,60