Lei Xiaoyan, Sun Xiaoting, Strauss John, Zhang Peng, Zhao Yaohui
Peking University, China.
University of California, Los Angeles, USA.
Soc Sci Med. 2014 Nov;120:224-32. doi: 10.1016/j.socscimed.2014.09.028. Epub 2014 Sep 18.
We examine the prevalence of depressive symptoms among the mid-aged and elderly in China and examine relationships between depression and current SES factors such as gender, age, education and income (per capita expenditures). In addition, we explore associations of depressive symptoms with measures of early childhood health, recent family deaths and current chronic health conditions. We use data from the China Health and Retirement Longitudinal Study (CHARLS) national baseline, fielded in 2011/12, which contains the ten question version of the Center for Epidemiologic Studies-Depression scale (CES-D) for 17,343 respondents aged 45 and older. We fill a major gap by using the CHARLS data to explore the general patterns of depression and risk factors among the Chinese elderly nationwide, which has never been possible before. We find that depressive symptoms are significantly associated with own education and per capita expenditure, and the associations are robust to the inclusion of highly disaggregated community fixed effects and to the addition of several other risk factors. Factors such as good general health during childhood are negatively associated with later depression. There exist strong gender differences, with females having higher depression scores. Being a recent widow or widower is associated with more depressive symptoms, as is having a series of chronic health problems, notably having moderate or severe pain, disability or problems with measures of physical functioning. Adding the chronic health problems to the specification greatly reduces the SES associations with depressive symptoms, suggesting that part of the pathways behind these associations are through these chronic health factors.
我们考察了中国中老年人抑郁症状的患病率,并研究了抑郁与当前社会经济地位因素(如性别、年龄、教育程度和收入(人均支出))之间的关系。此外,我们还探讨了抑郁症状与儿童早期健康指标、近期家庭死亡情况以及当前慢性健康状况之间的关联。我们使用了中国健康与养老追踪调查(CHARLS)2011/12年全国基线调查数据,该数据包含针对17343名45岁及以上受访者的10题版流行病学研究中心抑郁量表(CES-D)。我们利用CHARLS数据填补了一项重大空白,得以探究全国范围内中国老年人抑郁的总体模式及风险因素,而这在此前是无法做到的。我们发现,抑郁症状与个人教育程度和人均支出显著相关,并且在纳入高度细分的社区固定效应以及添加其他几个风险因素后,这些关联依然稳健。儿童时期总体健康状况良好等因素与后期抑郁呈负相关。存在明显的性别差异,女性的抑郁得分更高。近期丧偶与更多的抑郁症状相关,患有一系列慢性健康问题也是如此,尤其是有中度或重度疼痛、残疾或身体功能指标方面的问题。在模型设定中加入慢性健康问题后,社会经济地位与抑郁症状之间的关联大幅减弱,这表明这些关联背后的部分路径是通过这些慢性健康因素实现的。