SynthesisThe Lancet. Public health2022
How do income changes impact on mental health and wellbeing for working-age adults? A systematic review and meta-analysis.
Synthesis in The Lancet. Public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 142 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
142 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Pooled it
- Global Prevalence of Overactive Bladder: A Systematic Review and Meta-analysis.International urogynecology journal · 2025Pooled it
- Factors associated with mental health disorders in undergraduate students: A meta-analysis.Narra J · 2025Pooled it
- Preventing depression in high-income countries-A systematic review of studies evaluating change in social determinants.PloS one · 2025Pooled it
- Quality of life among people living with mental illness and predictors in Africa: a systematic review and meta-analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Pooled it
- Pooled it
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- Causal Assessment of Income Inequality on Self-Rated Health and All-Cause Mortality: A Systematic Review and Meta-Analysis.The Milbank quarterly · 2024Pooled it
- Depression and anxiety among pregnant women during COVID 19 pandemic in Ethiopia: a systematic review and meta-analysis.Frontiers in global women's health · 2024Pooled it
- Healthcare utilization and chronic condition clusters in multimorbidity patients using weighted k-means: a register-based study in Denmark.Health information science and systems · 2026Article
- Early risk factors and six month posttraumatic stress disorder symptom severity following trauma.European journal of psychotraumatology · 2026Article
- Income Volatility and Risk of All-Cause Mortality and Cause-Specific Hospitalization Among Adults With Depression: A Nationwide Cohort Study.Journal of Korean medical science · 2026Article
- Extreme wealth loss and subsequent mental well-being among adults aged ≥50 years: a multicohort study.Journal of global health · 2026Article
- Understanding county-level mental health determinants to guide community prevention efforts.Proceedings (Baylor University. Medical Center) · 2026Article
- Mental Health, Gender Dysphoria, and Quality of Life in Trans Individuals Following Top Surgery: Protocol for a Prospective Cohort Study.JMIR research protocols · 2026Article
- Return to work experience on structural constraints and gendered differences among nasopharyngeal carcinoma survivors: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Caregiver distress explains links between objective and subjective socioeconomic status and adolescent internalizing and externalizing behaviors.Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) · 2026Article
- Financial, housing, food, and healthcare insecurities and their independent and joint associations with depressive symptoms and stress in a U.S. cohort of adults with and without HIV.Social science & medicine (1982) · 2026Article
- Associations of deprivation and income-poverty with anxiety and stress among Hong Kong adults: a longitudinal household survey.BMJ open · 2026Observational
- Teacher Discipline Intensity and Adolescents' Mental Health Problems: A Moderated Moderation Effect Based on CEPS 2013-2014 Survey Data.Behavioral sciences (Basel, Switzerland) · 2026Article
82 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors.
Funding
Abstract
backgroundLower incomes are associated with poorer mental health and wellbeing, but the extent to which income has a causal effect is debated. We aimed to synthesise evidence from studies measuring the impact of changes in individual and household income on mental health and wellbeing outcomes in working-age adults (aged 16-64 years).
methodsFor this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Science, PsycINFO, ASSIA, EconLit, and RePEc on Feb 5, 2020, for randomised controlled trials (RCTs) and quantitative non-randomised studies. We had no date limits for our search. We included English-language studies measuring effects of individual or household income change on any mental health or wellbeing outcome. We used Cochrane risk of bias (RoB) tools. We conducted three-level random-effects meta-analyses, and explored heterogeneity using meta-regression and stratified analyses. Synthesis without meta-analysis was based on effect direction. Critical RoB studies were excluded from primary analyses. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). This study is registered with PROSPERO, CRD42020168379.
findingsOf 16 521 citations screened, 136 were narratively synthesised (12·5% RCTs) and 86 meta-analysed. RoB was high: 30·1% were rated critical and 47·1% serious or high. A binary income increase lifting individuals out of poverty was associated with 0·13 SD improvement in mental health measures (95% CI 0·07 to 0·20; n=42 128; 18 studies), considerably larger than other income increases (0·01 SD improvement, 0·002 to 0·019; n=216 509, 14 studies). For wellbeing, increases out of poverty were associated with 0·38 SD improvement (0·09 to 0·66; n=101 350, 8 studies) versus 0·16 for other income increases (0·07 to 0·25; n=62 619, 11 studies). Income decreases from any source were associated with 0·21 SD worsening of mental health measures (-0·30 to -0·13; n=227 804, 11 studies). Effect sizes were larger in low-income and middle-income settings and in higher RoB studies. Heterogeneity was high (I
interpretationIncome changes probably impact mental health, particularly where they move individuals out of poverty, although effect sizes are modest and certainty low. Effects are larger for wellbeing outcomes, and potentially for income losses. To best support population mental health, welfare policies need to reach the most socioeconomically disadvantaged.
fundingWellcome Trust, Medical Research Council, Chief Scientist Office, and European Research Council.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.