An exploratory analysis of factors associated with depression in a vulnerable group of young people living in informal settlements in South Africa.

Depression amongst young people is a major health challenge and is often shaped by social marginalisation. Informal settlements are growing rapidly. There is a need to deepen understandings of depression amongst young people in these contexts. We sought to understand factors associated with depressive symptomology amongst 232 young people (122 women, 110 men) aged 18-30 in urban informal settlements in South Africa. We conducted a cross-sectional analysis of baseline data collected for the Stepping Stones and Creating Futures pilot. Logistic regression modelled relationships between depressive symptomology, livelihoods and violence. Symptomatic depression in this population was 49.5% for men and 57.9% for women. In multiple regression, depression in men was associated with stealing because of hunger (adjusted Odds Ratio (aOR) 5.78, p = .03), being more controlling in relationships (aOR 0.81, p = .008) and being more ashamed about lack of work (aOR 0.75, p = .01). For women, depressive symptoms were associated with greater stress about lack of work (aOR 0.72, p < .0001) and food insecurity (aOR 5.57, p = .039). The study emphasises that socio-economic factors, shaped by local understandings of gender, play a significant role in depressive symptomology. We suggest reducing economic distress may have an important role in reducing depression in this population.