Economic Aspect
Economic Impact:
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Depression is associated with significant functional impairment, ranging from reduced work functioning, absenteeism, impaired productivity, decreased job retention and early retirement across a wide variety of occupations. This drives individuals into economic poverty, depriving them of social networks and status within the community.
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The economic burden due to depression is attributed significantly to high treatment gap, lost productivity and comorbid conditions. Depression as a comorbid condition contributes to the growing economic burden, with 38%of the total costs due to depression itself.
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Recent evidence shows that on average, and Indian family spends around 1500 per month towards care of affected persons, which includes consultation, drugs and transport related costs. With the significant treatment gap and the high indirect costs associated with morbidity, depression will have diverse and far-reaching social and economic consequences in India.
(WHO, 2018).
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Economic factors for Depression:
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People who experienced acute (sudden economic crisis) or chronic (poor income households) economic adversities are more vulnerable to develop to developing depression. Individuals living in conflict zones or at times of natural disasters are also likely to experience depression to a greater extent.
(WHO, 2018).
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Evidence indicates that Economics of India affects the problem of depression in the following ways:
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1. Poverty
2. Low literacy
3. Urbanization
4. Natural disasters and conflicts
1) Poverty
Poverty imposes an oppressive weight on India, especially in the rural areas where almost three out of four Indians and 77 percent of the Indian poor live. Although poverty has been reduced during the past four decades, it remains painfully high.
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Poverty and mental health interact in a “vicious cycle.” People with CMDs are more likely to drift into poverty due to increased health expenditure, reduced productivity, lost employment, school dropout, reduced social support, and stigma associate with these conditions. Poverty also increases the risk for developing CMDs through social exclusion, high stressors, reduced social capital, malnutrition, obestric risks and increased risk violence and trauma, all of which increase the risk for higher prevalence of mental disorders. Furthermore, lack of access to equality and continued care disposed individuals to have a long and protracted illness. With one in five Indians being poor (Reserve Bank of India, September 2013), it is imperative to consider mental disorder alongside other diseases associated with poverty and within the overall developmental agenda of the country.
(WHO, 2018).
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Poverty is easily understood as an individual -level risk factor, an ecological perspective on suicide that analyses the problem at a community level also suggests that areas of poverty, deprivation, unemployment and poor education are associated with higher suicide rates (Whitley, Gunnell, Dorling, & Smith, 1999).
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This video explains how poverty can affect one's mental health. This explains why depression is so prevalent in India since poverty is so high.
This video, narrated by Mark Tully, shows a glimpse of what life is like for one family living in the slum of Kamla Nehru Nagar (Bihar, central India). Slum-dwellers are vulnerable. With no permanent roof over their heads, little prospect of a secure job and poor access to basic sanitation, bad health and social exclusion is rife. Children can become easy victims of crime, prostitution and child labour. This video shows how preventable diseases take a huge toll on slum-dwelling families.
2) Low literacy
287 million, or 37% of the world’s illiterate people, are Indian according to UNESCO.
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While education is every child’s basic right, severe poverty and deprivation, population growth, war zones and natural catastrophes are depriving many children of a world of books and learning.
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India’s literacy rate is about 74% - leaving a quarter of the population without basic reading and writing skills.
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Poverty and illiteracy are closely linked - and with the second largest population in the world, India is home to one-third of all world poverty.
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While 22% of Indians fall below the poverty line, it has been estimated that more than half of the nation’s population lacks even basic literacy skills.
(Hunter, 2017).
Depression and Low Literacy Shared Characteristics:
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Worthlessness
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Shame
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Low self-esteem
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Poor self-efficacy
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External locus of control
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3) Urbanization
Rapid and often unplanned urban growth is often associated with poverty, environmental degradation, and population demands that outstrip service capacity.
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Urbanization has brought its own set of problems pertaining to mental health and well-being. Mostly because of increased speed and decreased costs of communication and transportation, cities are growing increasingly diverse in their population. Consequently, cultural factors have taken center stage in the understanding of urban mental health.
(India, 2012).
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This video shows the urban challenges, the need to create new cities, need of better urban planning, challenges of urbanization in India. This can give you an understanding on how urbanization relates to depression.
4) Natural Disasters and Conflicts
Studies have shown that mental health effects following conflicts tend to be worse than those from natural disasters.
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Indian studies have reported the prevalence of psychiatric morbidity after natural disaster ranging from 8% to 89%.
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Common Reactions After A Natural Disaster That May Lead To Depression
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Disbelief and shock
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Fear and anxiety about the future
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Disorientation; difficulty making decisions or concentrating
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Apathy and emotional numbing
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Nightmares and reoccurring thoughts about the event
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Irritability and anger
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Sadness and depression
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Feeling powerless
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Changes in eating patterns; loss of appetite or overeating
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Crying for “no apparent reason”
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Headaches, back pains and stomach problems
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Difficulty sleeping or falling asleep
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Increased use of alcohol and drugs
Economic aspects include the cost, benefit, employment, fiscal policies, production, distribution, and consumption of goods/services in India and how those things affect the problem of depression.