Fernández-Niño Julián Alfredo, Manrique-Espinoza Betty Soledad, Bojorquez-Chapela Ietza, Salinas-Rodríguez Aarón
Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico.
PLoS One. 2014 Sep 24;9(9):e108127. doi: 10.1371/journal.pone.0108127. eCollection 2014.
Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health - specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico.
Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model.
Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not.
The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.
抑郁症是全球老年人中第二常见的精神障碍。迄今为止，关于健康的社会决定因素，特别是社会经济剥夺、收入不平等和社会资本对抑郁症的影响方式的分析结果仅部分具有结论性。我们研究的目的是估计墨西哥地方、市和州层面的收入不平等和社会经济剥夺与老年人抑郁症状患病率之间的关联。
基于对8874名60岁及以上老年人的全国代表性样本进行横断面研究。我们应用了流行病学研究中心抑郁量表（CES-D）的简短七项版本来确定抑郁症状的存在。此外，为了选择主要的背景变量，我们使用了墨西哥国家人口委员会在地方、市和州层面的剥夺指数，以及市和州层面的基尼指数。最后，我们使用多水平逻辑回归模型估计收入不平等和社会经济剥夺与抑郁症状存在之间的关联。
地方层面（OR = 1.28；p < 0.10）和市层面（OR = 1.16；p < 0.01）的社会经济剥夺与抑郁症状的存在显著相关，而收入不平等则不然。
我们的研究结果证实，健康的社会决定因素与老年人的心理健康相关。然而，需要进一步研究以确定在地方和市层面与该人群抑郁症相关的具体社会经济剥夺成分。
