In 2013, Bloomberg, an international news agency headquartered in New York, United States, ranked Nigeria as the most stressful country in the world. The country pipped another African country, South Africa to the top post. The Bloomberg researchers analyzed different variables in 74 countries including annual homicide rate, GDP per capita, insecurity, income inequality, corruption, unemployment, health care quality, crime rate, suicide rate and air pollution to arrive at their conclusion.
At the most basic level, stress is the body’s response to pressures from a situation or life event. What contributes to stress can vary hugely from person to person and differs according to our genetic makeup, the environment we live in and our social and economic circumstances. The last three of which were focused on by the Bloomberg study.
Sometimes, stress response can be an appropriate, or even beneficial reaction. However, there can be times when stress becomes excessive and too much to deal with. If this level of stress is frequently encountered, or persists over time, the effects can result in wear and tear on the body. Feeling stressed for a long period of time is often called chronic, or long-term stress, and it can impact on both physical and mental health.
While stress is not a mental health diagnosis, it is however closely related to one’s mental health in two important ways:
- Stress can cause mental health problems and make existing problems worse. One survey of recent studies found that people who had stress related to their jobs had an 80% higher risk of developing depression within a few years than people with lower stress.
- Mental health problems can cause stress. Some people might find coping with the day-to-day symptoms of their mental health problem, as well as potentially needing to manage medication, heath care appointments or treatments, can become extra sources of stress.
This can start to feel like a vicious circle, and it might be hard to see where stress ends and where mental health problem begins. It also gives some credence to the Bloomberg report as Nigeria has Africa’s highest caseload of depression, and ranks 15th in the world in the frequency of suicide, according to World Health Organization (WHO). The health body also estimates that one in four Nigerians – some 50 million people – are suffering from some sort of mental illness.
However, Nigeria is not adequately equipped to deal with the problem as there are less than 150 psychiatrists in this country of 200 million, and WHO estimates that fewer than 10 percent of mentally ill Nigerians have access to the care they need.
With the lack of mental health staff and facilities, persistent underfunding and poor societal attitudes towards mental illness, Nigeria faces a mental health crisis making reform of its mental health law that is in keeping with international standards an urgent need to drive change. It is also important to tackle the factors that were highlighted in the Bloomberg report, as failure to do so might expose people to persistent high levels of stress that increases the risk of mental health issues.
With that in mind, we used the Bloomberg model to find out which were the most stressful environments amongst the states.
Our Methodology
Seven equally weighted variables were considered: violent crime rates, GDP per capita, income inequality, corruption perception, unemployment rate, environmental pollution and life expectancy.
The states were then allotted points for each variable based on their relative position in that category's ranking. The state with the least-stressful measure for each variable received 0 point, while the state with the highest stress level received 100 points. All other states were scored depending on their position between the two extremes. Points for the seven variables were averaged for a final score from 0 to 100, with a higher score indicating a more stressful living environment.
Violent Crime Rates
Research has shown that violent crime is a predominant contributing factor to the development of mental health problems, with victims having an elevated risk to most likely suffer from acute stress disorder (ASD) as well as the subsequent post-traumatic stress disorder (PTSD).
The violent crime rates for each of the states were obtained from the National Bureau of Statistics’ Crime Statistics Report for 2017. The category of the reported crimes used was offences against persons, which they stated are those offences against human beings — e.g. murder, manslaughter, infanticide, concealment of birth, rape and other physical abuse, etc. We got the number of such crimes committed in each state, and divided it by the projected population for each state in 2017 (obtained from Kingmakers.com.ng) and then multiplied it by 100,000 to get the violent crime rate.
GDP per Capita
A Gallup survey carried out in 2007 in more than 130 countries finds citizens from nations throughout Africa and in Central and South Asia, Eastern Europe, and the Caribbean reporting the lowest subjective well-being. Although the countries span many regions of the globe and may lack a common historical or cultural background, they did share similarities on key economic indicators, especially in having some of the lowest GDP per capita in the world.
The 2018 GDP per capita projections for each state as calculated by Kingmakers.com.ng were used.
Income Inequality
Richard Wilkinson and Kate Pickett, two London-based epidemiologists, provided some evidence that showed the correlation between countries where high income inequality exists and their populations who tend to suffer more from issues ranging from chronic stress, anxiety and depression to bipolar disorder and addiction.
The data was obtained from the Demographic and Health Surveys (DHS) Program for Nigeria for the year 2018. Income inequality refers to the extent to which income is distributed in an uneven manner among a population. We used the Gini coefficient to track inequality and it is based on the comparison of cumulative proportions of the population against cumulative proportions of income they receive, and it ranges between 0 in the case of perfect equality and 100 in the case of perfect inequality.
Corruption Prevalence
Bad economic conditions of a nation fuelled by corruption, even in peace time, can mimic wartime situations. Political economies that appear to be in a constant state of agitation and upheaval can be a traumatizing ecosystem that may produce psychosis similar to PTSD.
Corruption prevalence rates were obtained from the National Bureau of Statistics Corruption Report for 2019. The prevalence rate was calculated by the number of people who reported paying a bribe divided by the projected population for the state in 2019.
Unemployment Rate
The relationship between unemployment and poor health has been well documented. The unemployed tend to have higher levels of impaired mental health including depression, anxiety, and stress, as well as higher levels of mental health hospital admissions, chronic disease (cardiovascular disease, hypertension, and musculoskeletal disorders), and premature mortality.
The unemployment rate for each of the states was obtained from the National Bureau of Statistics. The quarterly reports for that year were obtained, and the average of which was used.
Environmental Pollution
Evidence shows that environmental pollution is associated with perceptions of individual powerlessness and neighbourhood disorder, leading to higher levels of psychological distress.
We could not find any data on environmental pollution by state so we used the percentage of households in each that had no access to improved sanitation facilities as research has pointed out there is a direct correlation between unimproved sanitation facilities and environmental pollution. The data was obtained from The Demographic and Health Surveys (DHS) Program for Nigeria for the year 2018.
Life Expectancy at Birth
Being under heavy stress can shorten an individual’s life expectancy by 2.8 years. This is based on a study in which researchers from the Finnish Institute for Health and Welfare calculated the effects of multiple risk factors, including lifestyle-related ones, to the life expectancy of men and women.
The life expectancy at birth for each state for 2018 as calculated by Kingmakers.com.ng were used.
The Results
Bauchi emerged top of the rankings for the most stressful living environment in Nigeria, with the top half dominated by Northern states with the exception of Cross Rivers, which came in at the 7th position, and Ebonyi which came in at 12th.
At the other end, Anambra had the least stressful living environment, followed closely by Imo and Ogun. A surprise position in the rankings was that of Borno, which not only featured in the bottom half of the rankings but was second to Benue from the Northern states and the best ranking state from the North East zone which currently still suffers from the insecurity created by the Boko Haram terrorist group. However, the North East region is on average the most stressful region of the country, while the South West is the least stressful region.
