Global mental illness risks linked to commercial factors

By Dr. Liji Thomas, MDReviewed by Benedette Cuffari, M.Sc.Sep 2 2024

Study: Commercial determinants of mental ill health: An umbrella review. Image Credit: PeopleImages.com / Yuri A / Shutterstock.com

A recent review published in the journal PLOS Global Public Health identifies commercial factors that may increase the risk of mental illness in both low- and high-resource settings.

Causes and risk factors for mental illness

About one in eight people are diagnosed with mental illness; however, researchers predict that many more people experience mental health issues. To date, most studies have focused on individual risk factors and childhood environments that may increase the future risk of developing mental health diseases, which neglects the role of sociopolitical, economic, and commercial factors that determine health.

Although researchers have defined the social determinants of health (SDOH), which include housing, employment, and household income, little research has examined the effects of the commercial determinants of mental health (CDMH), which include the systems, practices, and pathways through which commercial actors contribute to health and equity. CDMH can refer to the marketing, advertising, and consumption of unhealthy commodities and the role of industries in manipulating sociopolitical and economic settings for their personal benefit.

Smoking and mental illness

Children and teenagers who inhale second-hand smoke are at an increased risk for depression. Likewise, smoking and second-hand smoke during pregnancy significantly increase the likelihood of postpartum depression, suicidal thinking, and suicide.

Panic disorder is five times more likely to develop among daily smokers as compared to those who do not smoke every day. Moreover, generalized anxiety disorder (GAD) was 15 times more common among heavy smokers who smoke one or more packs every day as compared to those who smoke less than one pack every day.

The risk of depression was 62% higher among smokers and second-hand smokers as compared to non-smokers. However, the risk of depression was reduced to 32% if baseline depression levels were compared with its prevalence at follow-up.

Suicide risk is consistently higher among current smokers. The risk of completed suicide in current smokers was 81-240% that of non-smokers, with a dose-dependent relationship. Suicide risk increases by 24% for every increment of ten cigarettes each day.

The risk of suicidal thoughts, including planning and attempting suicide, increases by two- to three-fold among current smokers as compared to non-smokers. Conversely, the prevalence of anxiety and/or depression significantly decreases after smoking cessation.

Alcohol and mental illness

Alcoholism is associated with depression in a dose-dependent manner. Drinking during pregnancy can lead to depression and anxiety in the offspring when assessed at or after three years.

Suicide risk rose by 79-259% among drinkers in various studies. Suicidal ideation and attempts were also raised by 86% and 213%, respectively, among drinkers.

Drinking was associated with an increased short-term suicide risk. At any level, drinking increases the risk of suicidal thinking, attempts, and completion. In contrast, alcohol restriction policies reduced suicide rates by 90%.

Ultra-processed foods and mental illness

The consumption of ultra-processed foods (UPFs) increased the risk of depression and/or anxiety by 40-50%. Red and processed meats slightly increase the risk for depression as compared to those who do not eat these meat products.

Sugary drinks and total added sugar intake were associated with a higher depression rate in a dose-dependent manner.

Gambling and mental illness

Gambling addiction doubled the odds of major depression and tripled the likelihood of any major mental illness in one study.

Suicidal deaths increased 14-fold among gambling addicts between 20 and 74 years of age as compared to the general population. Between 20 and 49 years, the increase was 18-fold higher.

Social media and mental illness

The time spent on social media increased the risk of depression by 72% among girls as compared to 20% among boys. Moreover, the problematic use of social media increased the likelihood of suicidal ideation among adolescents by two-fold.

Fossil fuels and mental illness

Air pollution is a population-wide problem that has been associated with an increased risk of depression, anxiety, and suicide. In fact, suicide risk increases by 9% for every seven degrees Celsius rise in ambient temperature.

Conclusions

The study findings suggest strong associations between drinking, smoking, air pollution, and poor mental health. Drinking and smoking were associated with suicide.

UPF, gambling, social media addiction, and increased ambient temperature were also associated with an increased risk of depression and, except for UPF, suicidal behavior. Anxiety risk rose with air pollution, whereas suicidal behaviors increased with social media use.

Mental illness associated with CDMH affects both the consumer and their family, their community, and those at risk of physical violence from the users. Physical health is also impacted in multiple ways, including liver and lung disease, violence near gambling or alcohol venues, and air/noise pollution from fossil fuel-powered traffic.

Thus, a systematic approach is crucial to elucidate how these factors affect health. Standardized measurements and methodologies, accurate definitions of addiction and harmful levels of usage, and the identification of overlapping and confounding factors require detailed attention to improve how researchers record data.

Commercial determinants should be routinely included within frameworks to examine and improve mental health.”