This section examines the relationship between current income and mental health at the micro level, by looking at how the level of income and material deprivation are related to mental well-being at the individual level. Figure 13 shows the average WHO-5 score by income quartile across the different countries and country groups. Two main features stand out. Firstly, as expected, across all countries a higher income is associated with a higher score on the WHO-5 scale. Secondly, moving from the less prosperous countries to the wealthiest, the gap between those at the bottom of the income distribution scale and those at the top becomes narrower. This last point can be illustrated by the fact that the ratio of the average value of the top to the bottom income quartiles is 1.1 for the EU15, 1.2 for the NMS12 and 1.4 for the CC3. Across the country groups, it also emerges that respondents in the bottom income quartile in the EU15 countries still enjoy a higher WHO-5 score than those in the middle income quartile in the NMS12 and than respondents in the top income quartile in the CC3.
At the bottom end of the income distribution scale, six countries – namely, Turkey and five of the NSM12 countries – have an average WHO-5 score of lower than 50. Among the EU15 countries, Portugal and Austria have the lowest average WHO-5 score for their bottom income groups, with a value of about 51. Most of the EU15 countries have values of between 56 (Greece) and 67 (Norway), with 11 of the EU15 Member States showing values of above 60. Hungary is the only NMS12 country whose bottom income quartile score is in the same range as that of the EU15 countries, with a value of 58. The pattern for the middle income quartiles is similar to that for the bottom income quartiles across the countries under consideration, the main exception being Austria, which enjoys a higher ranking. Finally, looking at the top income quartile, Turkey has the lowest score at 53, while Norway has the highest score at 72.
Impact of living conditions and perceived social exclusion on mental well-being
Figure 13: Average WHO-5 mental well-being score, by income quartile
0 10 20 30 40 50 60 70 80
Highest quartile Lowest quartile Middle quartiles
TR RO LV MK BG MT HR PT IT LT PL CY EE HU SI SK UK EL CZ AT FR LU ES FI BE IE DE SE NL DK NO CC3 NMS 12 EU 15 EU 27
Note: MK refers to the former Yugoslav Republic of Macedonia. Source: EQLS (2007), authors’ calculations
Figure 14 shows the association between lifestyle deprivation and mental well-being. The deprivation measure is constructed to allow for a comparison between the impact of the same level of deprivation across countries and country groups. As shown, this factor has a large impact on the results, which are very different from those shown in Figure 13.6 Although mental well-being at each level of deprivation is higher, on average, in the EU15 countries compared with the CC3 countries, there is very little difference between the two least deprived groups in the NMS12 and EU15 countries. Overall, however, Figure 14 does show that the gap in mental well-being between the least and most deprived groups is lowest in the EU15 countries and largest in the CC3 countries. Looking first at the ranking of countries for those with the lowest level of deprivation, it emerges that Malta, Turkey and Latvia have the lowest level of mental well-being using the WHO-5 index, with values of between 59 and 61 respectively, followed by Italy and Austria with values of about 62. On the other hand, Hungary and Bulgaria have the highest levels of well-being, with values of about 72, followed by Norway and Ireland, with scores of 70 and 71 respectively.
Variation between the countries with the highest levels of deprivation is very significant – although, once again, Turkey has the lowest well-being scores, while Finland and Hungary appear to have comparatively high scores (Figure 14). The inequality or gap between deprivation groups in a country has a bearing on the pattern here. For instance, whereas those with the lowest level of deprivation in Bulgaria had high average levels of mental well-being when compared internationally, Bulgarians with the highest deprivation rating scored quite badly at 44, although Turkey and Cyprus attained even lower scores of about 39. The well-being rating of those with high levels of deprivation appears to be best in Finland and Spain, which record scores of 58 and 57 respectively.
6 Income quartiles were constructed within countries. This means, for example, that those in the highest income quartile in different countries
Figure 14: Average WHO-5 mental well-being score, by level of deprivation CC3 NMS 12 EU15EU27 TR MT AT RO UK IT NL LU HR SI CY EE LV CZ PT IE LT ES FR PL DE SE EL DK MK FI HU NO SK BG BE Highest Lowest 2 3 0 10 20 30 40 50 60 70 80
Note: MK refers to the former Yugoslav Republic of Macedonia. Source: EQLS (2007), authors’ calculations