Understanding the Relationship Between Learning Problems, Social Stress, and Mental Health in Low-Income Women

Background and Purpose: Previous research has examined the presence of barriers to self-sufficiency in low-income women, including mental health and learning problems. Poverty itself causes difficulty with meeting basic needs and accessing recommended services, which could be further complicated by a learning problem. This study explored the impact of learning problems, poverty, and social stress factors on mental health outcomes for a sample of low income women, and examined potential interactions between factors. Although many previous studies have examined the prevalence of barriers in samples of low-income individuals, little is known about the relationship and interaction between barriers specifically considering the impact of stress and poverty.

Methods: Secondary data from a University-affiliated program in a southern state that assesses for barriers to self-sufficiency in TANF-eligible individuals was analyzed. The non-probability sample consisted of 7,033 women ages 18 and above. All participants were originally referred to the program by their TANF case manager or Child Protective Service worker due to suspected mental health problems, substance abuse, learning problems, and/or intimate partner violence victimization. Other poverty-related barriers such as difficulty with transportation, obtaining medical care, and finding stable housing were also assessed by the program. Bivariate analyses, including t-tests and chi-square, were conducted to examine factors that significantly affected depression and anxiety. Significant factors at the bivariate level were analyzed using logistic regression to examine the relationship between learning problems, poverty, social stress, and depression and anxiety.

Results: Main effects for all factors were significant at less than the .001 level, and odds-ratios for depression and anxiety were significantly increased by learning problems, poverty related stress, single parenting, and unsatisfactory social support, even after controlling for other significant factors such as physical health problems, substance abuse, and intimate partner victimization. The presence of poverty-related barriers and other social stress factors were strongly associated with increased odds of depression and anxiety.

Conclusions and Implications: Although future research needs to further examine the impact of social stress factors on mental health outcomes in this population, these findings suggest that a significant portion of participants identified as having mental health needs could be experiencing symptoms of depression and anxiety related to social stress factors such as poverty, insufficient social support, and learning problems rather than having a medical-model mental illness. Findings indicate that social workers serving TANF-eligible individuals need to assess and identify the underlying issues that contribute to the mental health symptoms rather than immediately refer for mental health services. Case management and services to meet basic needs could potentially be more helpful for a large number of TANF-eligible individuals rather than only mental health services, or in combination with mental health services. Policy-makers should address the issue of poverty and ensure that all citizens have access to housing, food, and other basic needs, and should also consider funding case management programs to serve the TANF-eligible population.