Economic inequalities in South Africa are becoming a major determinant of mental health, with poverty; poor living conditions; limited access to healthcare and education; workplace stress; social exclusion and historical trauma contributing to higher rates of depression and anxiety. (Delwyn Verasamy/M&G)
The South African economy continues to face significant challenges that deeply affect the daily lives of its citizens, particularly in terms of buying power and the cost of living.
The economy has shown limited growth, with GDP rates struggling to exceed 1% to 2% annually, reflecting structural weaknesses such as a heavy reliance on commodity exports that make it vulnerable to global market fluctuations. High inflation, often exceeding the South African Reserve Bank’s target range of 3% to 6%, further erodes purchasing power, making everyday goods and services increasingly expensive.
The country’s unemployment rate remains alarmingly high at around 32.1%, with youth unemployment exceeding 60%. This dire situation results in reduced household incomes, increased dependency on social grants and greater financial strain on employed family members who often support extended families.
Rising living costs add to this burden; utilities such as electricity have become more expensive, exacerbated by frequent power outages. Transport costs have also surged due to higher fuel prices, affecting daily commutes and the cost of goods. Housing affordability remains a critical issue, with an increasing number of people living in informal settlements or facing high rents in urban areas.
Food prices have risen sharply, making it difficult for lower-income households to afford nutritious meals. Wage growth has not kept pace with inflation, leading to decreased real income for many workers, which affects their ability to save or invest in education and healthcare. Although a minimum wage has been instituted, it often falls short of covering basic living costs, causing ongoing financial stress for minimum-wage earners.
Corruption remains a pervasive problem. Funds intended for public services, such as job creation and education, are often misappropriated, reducing the quality and availability of these essential services. This exacerbates economic inequality, as resources that could be used for development and poverty alleviation are syphoned off by corrupt officials.
In addition, only about 7 million people out of a population of over 60 million contribute to personal income tax, placing a heavy burden on a small segment of the population to fund public services and infrastructure.
For regular South Africans, daily life is a struggle. Many live paycheck to paycheck, with little to no savings, and financial pressure is compounded by high levels of personal debt.
Access to quality healthcare and education is uneven, with public services often underfunded and overburdened, and private services, although better in quality, remain out of reach for most, due to high costs.
Economic inequality remains stark, with a significant gap between the wealthy and the poor. Opportunities for social mobility are limited due to systemic barriers in education quality, employment opportunities and access to capital.
Economic recessions and factors such as unemployment, decreased income and overwhelming debt are closely linked to poor mental health, higher incidences of common mental disorders, substance abuse and suicidal behaviour. Economic inequalities in South Africa have an impact on mental health, particularly contributing to increased rates of depression and anxiety.
High unemployment rates and low wages mean many South Africans struggle to afford basic necessities, such as food, housing and healthcare. This constant struggle can lead to chronic stress, which is a major risk factor for both depression and anxiety. Lack of access to nutritious food can result in malnutrition, which is linked to poor mental health. Hunger and the stress of not knowing where the next meal will come from can severely affect mental well-being.
For those who live in informal settlements with poor infrastructure, overcrowding and limited access to clean water and sanitation, these conditions contribute to a heightened sense of insecurity and helplessness, fostering anxiety and depression.
High levels of crime and violence fuelled by economic desperation in economically disadvantaged areas add to the stress burden. Constant exposure to such environments can lead to trauma, which is closely associated with anxiety disorders and depression.
Economic inequality often translates into unequal access to healthcare services, including mental healthcare. While the National Health Insurance has been introduced, the effective realisation of that insurance is going to take a long time.
Those in poorer communities may have limited or no access to professional mental health support, making it difficult to manage or treat symptoms of disorders effectively. Economic hardship can also lead to lower levels of mental health literacy and higher stigma around seeking help. This can prevent individuals from recognising symptoms and seeking care.
Economic inequality restricts access to quality education. Poor education limits employment opportunities, perpetuating the cycle of poverty and stress. Lack of education can also mean less awareness and understanding of mental health issues, leading to delayed treatment and support.
For those who are employed, job insecurity and poor working conditions can be significant stressors. Inadequate pay, lack of benefits and unsafe work environments contribute to a continuous state of anxiety and fear of unemployment. In some cases, economic pressures force individuals to work multiple jobs or long hours, causing burnout and mental exhaustion, which are contributors to depression and anxiety.
Apartheid has left a legacy of economic inequality that continues to affect mental health across generations. The psychological impact of historical oppression and continued economic disadvantage can manifest as intergenerational trauma, influencing the mental health of successive generations.
Economic inequalities often intersect with other forms of discrimination, such as race, gender and disability. This multi-layered exclusion can amplify feelings of hopelessness and helplessness, which are core features of depression. Poverty can also lead to social isolation. Individuals may feel excluded from social activities due to financial constraints, leading to loneliness and depressive symptoms.
Economic inequalities in South Africa are becoming a major determinant of mental health, with poverty; poor living conditions; limited access to healthcare and education; workplace stress; social exclusion and historical trauma contributing to higher rates of depression and anxiety. Addressing these inequalities is crucial for improving mental health outcomes and ensuring a healthier, more equitable, society.
Karabo Mokgonyana is a legal and development practitioner who focuses on human rights protection, international trade and investment and peace and security.