Joan Domènech-Abella1, Jordi Mundó2, Matilde Leonardi3, Sommath Chatterji4, Beata Tobiasz-Adamczyk5, Seppo Koskinen6, Jose Luis Ayuso-Mateos7, Josep Maria Haro8. 1. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Department of Sociology, Universitat de Barcelona, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. Electronic address: j.domenech@pssjd.org. 2. Department of Sociology, Universitat de Barcelona, Barcelona, Spain. 3. Department of Neurology, Public Health and Disability, Italian National Neurological Institute "Carlo Besta" Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico), Milan, Italy. 4. Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland. 5. Chair of Epidemiology and Preventive Medicine, Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland. 6. National Institute for Health and Welfare, Helsinki, Finland. 7. Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. 8. Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Abstract
BACKGROUND: Socioeconomic status, as measured by education, occupation or income, is associated with depression. However, data are lacking on the psychosocial, material and behavioral mediators of these associations. We have examined the association of education, occupation and income with depression and the potential mediations using community-based data. METHODS: A total of 7,966 older adults were interviewed in Finland, Poland and Spain. The differential associations between depression and SES, mediator variables, country of residence and cofounder variables, such as chronic physical conditions, were assessed through logistic regression models. Meditation analyses were carried out using khb method for Stata 13.1. RESULTS: Education, followed by household income, were the SES indicators most frequently significantly associated with depression. These SES markers, but not occupation, showed an independent effect in this association. Psychosocial factors and loneliness in particular showed the strongest associations with depression among mediator variables. However, material factors and, especially, financial strain had a higher mediating function in the association between SES and depression. Overall, SES markers, chronic conditions and mediation factors were more positive in Finland than in Poland and Spain. CONCLUSION: Improving psychosocial and material dimensions as well as access to the educational system for older adults might result in a reduction in the prevalence of depression in the general population and particularly among individuals with low SES.
BACKGROUND: Socioeconomic status, as measured by education, occupation or income, is associated with depression. However, data are lacking on the psychosocial, material and behavioral mediators of these associations. We have examined the association of education, occupation and income with depression and the potential mediations using community-based data. METHODS: A total of 7,966 older adults were interviewed in Finland, Poland and Spain. The differential associations between depression and SES, mediator variables, country of residence and cofounder variables, such as chronic physical conditions, were assessed through logistic regression models. Meditation analyses were carried out using khb method for Stata 13.1. RESULTS: Education, followed by household income, were the SES indicators most frequently significantly associated with depression. These SES markers, but not occupation, showed an independent effect in this association. Psychosocial factors and loneliness in particular showed the strongest associations with depression among mediator variables. However, material factors and, especially, financial strain had a higher mediating function in the association between SES and depression. Overall, SES markers, chronic conditions and mediation factors were more positive in Finland than in Poland and Spain. CONCLUSION: Improving psychosocial and material dimensions as well as access to the educational system for older adults might result in a reduction in the prevalence of depression in the general population and particularly among individuals with low SES.
Authors: Manuel García-Goñi; Alexandrina P Stoyanova; Roberto Nuño-Solinís Journal: Int J Environ Res Public Health Date: 2021-01-08 Impact factor: 3.390