Abstract：
BACKGROUND: Meta-reviews synthesising research on social class and mental health and wellbeing are currently limited and focused on specific facets of social class (e.g., social capital) or mental health and wellbeing (e.g., mental health disorders), and none sought to identify mechanisms in this relationship.
OBJECTIVE: The present meta-review sought to (1) assess the overall relationship between social class and mental health and wellbeing, (2) determine the mechanisms that act in this relationship, and (3) evaluate the strength of evidence available.
METHODS: The protocol was prospectively registered on PROSPERO (CRD42021214731). We systematically searched twelve databases in September 2022 and identified 149 eligible reviews from 38,257 records screened. Quality of evidence was assessed with the JBI levels of evidence and risk of bias with the ROBIS tool.
RESULTS: A large but low-quality evidence base points to class-based inequalities in mental health and wellbeing, with the strongest available evidence linking lower social positions to an increased risk of depression. In terms of different facets of stratification, the best available evidence suggests that deprivation (e.g., poverty), socioeconomic status, income, and subjective social status are consequential for individuals\' mental health and wellbeing. However, high-quality evidence for the roles of education, occupation, other economic resources (e.g., wealth), and social capital is currently limited. Most reviews employed individual-level measures (e.g., income), as opposed to interpersonal- (e.g., social capital) or community-level (e.g., neighbourhood deprivation) measures. Considering mechanisms, we found some evidence for mediation via subjective social status, sense of control, and experiences of stress and trauma. There was also some evidence that higher socioeconomic status can provide a buffer for neighbourhood deprivation, lower social capital, and lower subjective social status.
CONCLUSIONS: Future research employing experimental or quasi-experimental methods, and systematic reviews with a low risk of bias, are necessary to advance this area of research.
OBJECTIVE: The present meta-review sought to (1) assess the overall relationship between social class and mental health and wellbeing, (2) determine the mechanisms that act in this relationship, and (3) evaluate the strength of evidence available.
METHODS: The protocol was prospectively registered on PROSPERO (CRD42021214731). We systematically searched twelve databases in September 2022 and identified 149 eligible reviews from 38,257 records screened. Quality of evidence was assessed with the JBI levels of evidence and risk of bias with the ROBIS tool.
RESULTS: A large but low-quality evidence base points to class-based inequalities in mental health and wellbeing, with the strongest available evidence linking lower social positions to an increased risk of depression. In terms of different facets of stratification, the best available evidence suggests that deprivation (e.g., poverty), socioeconomic status, income, and subjective social status are consequential for individuals\' mental health and wellbeing. However, high-quality evidence for the roles of education, occupation, other economic resources (e.g., wealth), and social capital is currently limited. Most reviews employed individual-level measures (e.g., income), as opposed to interpersonal- (e.g., social capital) or community-level (e.g., neighbourhood deprivation) measures. Considering mechanisms, we found some evidence for mediation via subjective social status, sense of control, and experiences of stress and trauma. There was also some evidence that higher socioeconomic status can provide a buffer for neighbourhood deprivation, lower social capital, and lower subjective social status.
CONCLUSIONS: Future research employing experimental or quasi-experimental methods, and systematic reviews with a low risk of bias, are necessary to advance this area of research.
摘要：
背景：综合关于社会阶层和心理健康和福祉的研究的元评论目前受到限制，并且集中在社会阶层的特定方面（例如，社会资本)或心理健康和福祉(例如，精神健康障碍)，没有人试图确定这种关系中的机制。
目的：本元综述旨在（1）评估社会阶层与心理健康和幸福之间的整体关系，(2)确定在这种关系中起作用的机制，(3)评估可用证据的强度。
方法：该方案在PROSPERO（CRD42021214731）上前瞻性注册。我们在2022年9月系统地搜索了12个数据库，从筛选的38257条记录中确定了149条合格的评论。使用JBI证据水平评估证据质量，并使用ROBIS工具评估偏倚风险。
结果：大量但低质量的证据基础指出了心理健康和幸福方面基于阶级的不平等，最有力的证据表明，较低的社会地位与抑郁风险增加有关。就分层的不同方面而言，现有的最佳证据表明，剥夺(例如，贫困)，社会经济地位,收入,和主观社会地位对个人的心理健康和福祉都有影响。然而,教育作用的高质量证据，职业,其他经济资源(例如，财富)，社会资本目前是有限的。大多数审查采用个人层面的措施(例如，income),与人际相反-(例如，社会资本)或社区层面(例如，邻里剥夺)措施。考虑到机制，我们发现了一些通过主观社会地位进行调解的证据，控制感，以及压力和创伤的经历。还有一些证据表明，较高的社会经济地位可以为邻里剥夺提供缓冲，较低的社会资本，较低的主观社会地位。
结论：未来的研究采用实验或准实验方法，和具有低偏见风险的系统评价，有必要推进这一领域的研究。
目的：本元综述旨在（1）评估社会阶层与心理健康和幸福之间的整体关系，(2)确定在这种关系中起作用的机制，(3)评估可用证据的强度。
方法：该方案在PROSPERO（CRD42021214731）上前瞻性注册。我们在2022年9月系统地搜索了12个数据库，从筛选的38257条记录中确定了149条合格的评论。使用JBI证据水平评估证据质量，并使用ROBIS工具评估偏倚风险。
结果：大量但低质量的证据基础指出了心理健康和幸福方面基于阶级的不平等，最有力的证据表明，较低的社会地位与抑郁风险增加有关。就分层的不同方面而言，现有的最佳证据表明，剥夺(例如，贫困)，社会经济地位,收入,和主观社会地位对个人的心理健康和福祉都有影响。然而,教育作用的高质量证据，职业,其他经济资源(例如，财富)，社会资本目前是有限的。大多数审查采用个人层面的措施(例如，income),与人际相反-(例如，社会资本)或社区层面(例如，邻里剥夺)措施。考虑到机制，我们发现了一些通过主观社会地位进行调解的证据，控制感，以及压力和创伤的经历。还有一些证据表明，较高的社会经济地位可以为邻里剥夺提供缓冲，较低的社会资本，较低的主观社会地位。
结论：未来的研究采用实验或准实验方法，和具有低偏见风险的系统评价，有必要推进这一领域的研究。
