Mental ill-health in Sweden. Causes and consequences from an inequality perspective.

The purpose of this thesis is to improve the understanding of factors related to mental ill-health, and itsdistribution, in the Swedish population. The thesis consists of four studies. In study I, we find thatbetween the years 1994 and 2011, the probability of receiving a psychiatric inpatient diagnosisincreased by 12.6 percent, while the relative and absolute income-related inequalities in diagnosisincreased by 48.2 and 66.7 percent, respectively. In fact, in 2011, more than half of psychiatricinpatients were found among the poorest fifth of the population. Although the population changedsubstantially during this period, for example in terms of education level and migration background,these changes did not drive the increase in inequality. In study II, we show that the labor marketconsequences following common mental disorders differ between groups in the population. High-educated individuals and men have higher odds of non-employment and sick leave compared to lower-educated individuals and women. Furthermore, individuals with migration backgrounds have higherodds of non-employment and lower odds of sick leave, compared to individuals born in Sweden. Youngage is moreover associated with higher odds of non-employment and disability pension, and lowerodds of sick leave, following common mental disorders. This heterogeneity suggests that it may bemotivated to consider not only inequalities in the prevalence of mental disorders in the population butalso to regard heterogeneity in the associated adverse labor outcomes in order to curb the burden ofmental ill-health. In study III, we find that over-grading in upper secondary school, that is receiving agrade that does not reflect one’s actual skills or performance, had a protective impact on mental healthamong young women. Further, in study IV, we find that introducing grades in school at an earlier age,in grade 6 instead of grade 8, increased the probability of mental ill-health among girls. Similar effectsof over-grading and earlier grades were not found among boys ...