THUNDER BAY – Health – Unhealthy behaviour is an issue that leads to problems in social, justice and personal lives. “Clinicians and practitioners should recognize that there may be high rates of depression, anxiety and stress, as well as health-compromising behaviors, in low-income populations, and they should assess mental health as well as these behaviors.” Referring patients for mental health counselling or stress reduction techniques may help to improve their health behaviors.

Poor mental health leads to unhealthy behavior in low-income adults – not the other way around, according to a new study by Dr. Jennifer Walsh and colleagues from the Centers for Behavioral and Preventive Medicine at The Miriam Hospital in the US. In this study, stress and anxiety predicted subsequent health-compromising behaviors, such as smoking, binge drinking, illegal drug use, unprotected sex and unhealthy diets.

Unhealthy Behavior a Coping Mechanism 

An individual dealing with the stresses of poverty in today’s society faces prejudice, lower self esteem, and a ‘boom or bust’ relationship with money. One possible explanation for these findings is that health compromising behaviors may be used as coping mechanisms to manage the effects of stress and anxiety. The study is published online in the Springer journal, Translational Behavioral Medicine², and is part of an issue focusing on multiple health behavior change.

[sws_pullquote_right]In Thunder Bay, a single woman on Ontario Works will receive about $200 per month in a cheque [/sws_pullquote_right]

In Thunder Bay, a single woman on Ontario Works will receive about $200 per month in a cheque. Her rent will be covered, those funds are to cover food, clothing, and transportation. Most social programs in the city offer transit tickets to people to encourage them to attend various programs. On a monthly budget of $200, regular trips to the Dew Drop Inn, Shelter House and Food Banks is required just to get enough food to survive.

Even getting access to the clothing or other resources needed to apply for a job is difficult. Many people on Ontario Works in the city end up with little to do, and some end up on an ever downward cycle. The ‘unhealthy behavior’ cited in the study.

For example if a person on Ontario Works were to decide to improve their personal level of physical fitness, and start attending a class, chances are they could never afford it. Even taking in a trip to the Canada Games Complex, the total cost would quickly overwhelm their budget.

Canada’s federal Conservative government is cutting funding to many of the groups that have provided research and support on these issues. The Ontario Native Womans Association stated, “Aboriginal women are considered to be the most vulnerable population in Canada. Not only do they have the poorest health rating in Canada and the highest levels of chronic disease, but from a social perspective they also remain at highest risk of health concerns due to circumstances such as severe poverty. According to Statistics Canada, 36% of Aboriginal women live in poverty which is more than double the rate of poverty for their non-Aboriginal counterparts.”

Dr. Dawn Harvard, acknowledges the current financial climate, she does not believe that severe cuts to initiatives led by Aboriginal women are the answer. “These decisions may prove to be less cost-effective over the long term”.

Dr. Walsh and her team explored the relationship between health-compromising behaviors and mental health in the context of socioeconomic disadvantage to determine whether mental health problems lead to subsequent unhealthy behaviors, or whether these behaviors lead to mental health problems.

A total of 482 adults, receiving care at a sexually transmitted infection clinic, took part in the study. They were asked to complete an online interview at the start of the study and then three, six, nine and twelve months later. The researchers assessed a number of behaviors: substance use (binge drinking, smoking, illegal drug use), exercise, as well as sexual, dietary and sleep behaviors. They also measured levels of anxiety, depression and perceived stress.

Health-compromising behaviors, including substance use, unprotected sex, poor diet and insufficient or excessive sleep, were common among patients attending the clinic. Participants with very low incomes reported a higher number of health-compromising behaviors, as well as more symptoms of depression and anxiety and higher levels of stress, compared to those participants with higher incomes.

The authors found that symptoms of depression and anxiety, as well as perceived stress, predicted later levels of unhealthy behaviors, when both socioeconomic status and earlier behaviors were taken into account. In contrast, unhealthy behaviors did not predict later mental health. These results show that unhealthy behaviors follow depression, anxiety and stress, rather than giving rise to them.

The authors suggest that targeting mental health may offer a way to promote improvements across health behaviors.