Socioeconomic inequality in mental health disorders: A cross-sectional study from the Tehran University of Medical Sciences employees’ cohort study

Understanding socioeconomic inequalities in health helps identify vulnerable groups and guide targeted interventions. Mental health disorders significantly affect well-being and productivity. This study assessed the prevalence and socioeconomic inequalities in depression, anxiety, and stress among employees of the Tehran University of Medical Sciences. This cross-sectional study analyzed data from the Tehran University of Medical Sciences Employees' Cohort (TEC) baseline phase, comprising 4,442 individuals. The Depression, Anxiety, and Stress Scale-42 (DASS-42) was utilized to measure mental health disorders. Education level and wealth index were considered as socioeconomic indicators. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were employed to estimate socioeconomic inequality. The age-adjusted prevalence of depression, anxiety, and stress was 8.7%, 8.6%, and 11.5%, respectively. The relative wealth-related inequality analysis revealed that, after adjusting for age, sex, marital status, and education level, the prevalence of depression, anxiety, and stress in the lowest wealth index was 2.54, 2.89, and 1.65 times higher than in the highest wealth index, respectively. Additionally, the relative education-related inequality analysis indicated that, adjusted for age, sex, marital status, and wealth index, individuals with primary education or no formal education had 2.58, 2.99, and 2.14 times higher prevalence of depression, anxiety, and stress compared to those with a doctoral degree, respectively. Significant disparities in the prevalence of mental health disorders were found across educational and wealth index levels. Targeted interventions and policies should aim to achieve and sustain long-term benefits for vulnerable and disadvantaged groups.