Intergenerational income mobility and psychotropic drug dispensation in a 1953 Stockholm cohort: a diagonal reference model approach

Eur J Epidemiol. 2026 Jul 4. doi: 10.1007/s10654-026-01425-y. Online ahead of print.

ABSTRACT

The theoretical link between intergenerational social mobility and mental health has long been explored in the social sciences. Declining social mobility in high-income countries alongside rising mental health concerns have reignited interest in this research area. Sweden, while experiencing similar trends, remains a country known for its high social mobility. To investigate the relationship between social mobility and mental health, we used psychotropic drug dispensation as a proxy for mental health problems. We analyzed survey and register data of a 1953 Stockholm cohort (n = 11,199), followed up for psychotropic drug dispensation between ages 52-66. We measure social mobility using parental income at ages 10 and 17 and adult income between ages 37-48. Using diagonal reference models, we analyzed the association between income mobility and psychotropic drug use, stratified by gender. Adjustments were made for growing up in a single-parent household, cognitive ability, social skills, marital status, and previous hospitalization. An income gradient in psychotropic drug dispensation for the stable income group was observed, with a more pronounced pattern among men than women. Net of social origin and destination, income mobility was related to psychotropic drug dispensation among men, but not women. Downward mobility increased, while upward mobility decreased the probability of dispensing psychotropic drugs among men (0.046, p = 0.029 vs. – 0.047, p < 0.020). These results remained robust after adjustments (0.048, p = 0.010 vs. – 0.044, p < 0.017). Our findings suggest that income mobility is associated with middle-aged men’s use of psychotropic drugs. Further research is needed to confirm these results in different contexts and age groups.

PMID:42400737 | DOI:10.1007/s10654-026-01425-y