Socioeconomic circumstances are known to be associated with mental health since the seminal work conducted by Edward Jarvis in the State of Massachusetts in the United States in 1855, showing that persons belonging to socioeconomically deprived groups were disproportionately represented among those hospitalized in then-called ‘asylums’[1]. Like many physicians and pioneer epidemiologists of his time, Jarvis primarily attributed the relationship between mental ill health and poverty to individuals’ innate flaws, which were thought to be amenable to change via “moral treatment”, but which were largely unavoidable. It followed that social inequalities in mental health were thought to be equally unavoidable.

160 years later, what is the state of understanding of the relationship between mental health and socioeconomic position? Research conducted in recent years, including the article published by Hu et al. in this month’s issue of ECAP [2] shows that in the twenty-first century, socioeconomic position—as measured by neighborhood characteristics—still predicts psychopathology in children and adolescents (in this case the experience of clinically relevant self-harm). Other studies report that parental educational level, income and employment status as well as family food insecurity and children’s perception of their social standing predict internalizing [3, 4, 5] as well as externalizing symptoms and substance use [4, 5, 6]. An important issue is that the extent of social inequalities observed varies both with measures of socioeconomic position and psychopathology. Measures tapping into poverty, such as food insecurity, or those that take into account young people’s perceptions appear most strongly associated with mental health. Similarly, socioeconomic inequalities appear most consistent with regard to externalizing rather than internalizing symptoms.