Income inequality and mental health : a cross-country analysis

(2026)

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Abstract
This paper examines the relationship between income inequality and mental health outcomes using cross-sectional data from 75 countries for the year 2021. Employing OLS regression with multiple specifications, the analysis uses the Gini coefficient as the primary measure of income inequality alongside two alternative measures - the top 10% and top 1% income shares - and two measures of mental health outcomes. The results reveal a negative and statistically significant association between the Gini coefficient and depressive disorder prevalence, a finding that contrasts with the predominant hypothesis in the literature. This result is interpreted in light of systematic underreporting of mental health conditions in lower-income, higher-inequality countries and regional heterogeneity in mental health surveillance capacity. The robustness checks using alternative inequality measures yield insignificant coefficients, suggesting that the association is sensitive to the choice of inequality measure. The findings highlight the importance of measurement choices in cross-country analyses and underscore the need for investment in mental health data infrastructure.