PhD defence M. (Maria) Gültzow

Brief summary:

Mental health and ill-health are not equally distributed across the population. However, even though there is a vast amount of literature that describes these differences across subgroups and suggests points for intervention, these differences persist. The overarching aim of this dissertation was to gain a deeper understanding of the underlying mechanisms that contribute to subgroup differences in mental health and ill-health. This thesis used the potential outcomes framework, the g-formula, marginal structural models and genetically informed designs with the aim to add knowledge about the impact of determinants that are potential targets for interventions (i.e. health behavior, obesity, or socioeconomic factors), and determinants that are not intended as potential intervention targets but might substantially explain subgroup differences in mental health and illhealth (i.e. genetics). The focus was on investigating two mechanisms that might explain why some subgroups are better off than others, namely differential exposure and differential impact. Differential exposure indicates that the variation in mental health is partly driven by the unequal distribution of intermediary determinants across subgroups, whereas differential impact indicates that subgroup variations are driven by a stronger effect of intermediary determinants on mental health among certain subgroups.