The measurement of poverty in psychiatric epidemiology in LMICs: critical review and recommendations

Purpose Studies exploring the relationship between poverty and mental health in low and middle income countries (LMICs) have produced somewhat conflicting results. This has partly been attributed to poorly operationalized and oversimplified poverty measures. This paper has two aims: (1) to review how socio-economic outcomes in psychiatric epidemiology in LMICs are measured; (2) based on this review, to provide a set of generic recommendations for measuring poverty in psychiatric epidemiology in LMIC. This is relevant for mental health researchers, and for practitioners and policy makers who use mental health research findings. Methods This review was part of a broader systematic review examining the association between poverty and mental illness. An analytic framework was developed to examine the definition and measurement of poverty in these studies. Results The majority of studies provided no definition for the concept of poverty being used, and very few measured poverty through standardized or validated methods. Many poverty indicators were broken down into extremely openended and vague categories, with no details on how the parameters were defined or derived, and no documentation of the time period and unit of analysis for which the poverty variable was measured. Conclusions This review revealed that using poverty as an indicator in mental health research in LMIC is still in its infancy, with much room for improvement. The implications of poor measurement of poverty in psychiatric epidemiology are discussed. The recommendations provided will hopefully help researchers in psychiatric epidemiology use the concept of poverty in a much more critical, systematic and appropriate manner.