Is there an association between mental health and economic prosperity? A longitudinal ecological study in England, 2011–2019

OBJECTIVES: To understand the association between population mental health and economic prosperity at the small area level in England and explore regional differences. DESIGN: A longitudinal small area-level analysis exploring the association between a proxy for population mental health and economic prosperity across 6789 small areas in England from 2011 to 2019 (N×T=61 101). We apply linear regression models with fixed effects at the area level. Mental health in each area is proxied by a standardised index constructed from administrative data on the use of services related to mental health. SETTING: National study of geographical areas in England. PARTICIPANTS: Small areas of England. OUTCOME: Economic prosperity is measured by gross disposable household income (GDHI) per capita at the small area level. RESULTS: A one SD increase in the index is linked to a 1.9% (95% CI 1.4% to 2.5%) rise in GDHI. The association varies depending on the region, with the strongest association in the North East. CONCLUSIONS: There is evidence of a positive association between proxies for better population mental health and subsequent household income per capita, varying by region. While we cannot infer causality, these findings are consistent with the view that improving mental health may support local economic prosperity.