Christiani Yodi, Byles Julie, Tavener Meredith, Dugdale Paul
Priority Research Centre for Gender, Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Australia.
Priority Research Centre for Gender, Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Australia.
J Affect Disord. 2015 Aug 15;182:76-81. doi: 10.1016/j.jad.2015.04.042. Epub 2015 May 2.
Difficult living conditions in urban areas could result in an increased risk of developing depression, particularly among women. One of the strong predictors of depression is poverty, which could lead to inequality in risk of depression. However, previous studies found conflicting results between poverty and depression. This study examines whether depression was unequally distributed among young and middle-adult women in Indonesia׳s major cities and investigate the factors contributed to the inequality.
Data from 1117 young and middle-adult women in Indonesia׳s major cities (Jakarta, Surabaya, Medan, and Bandung) were analysed. Concentration Index (CI) was calculated to measure the degree of the inequality. The CI was decomposed to investigate the factor contributing most to the inequality.
The prevalence of depression was 15% and more concentrated among lower economic group (CI=-0.0545). Compared to the middle-adult group, the prevalence of depression among women in the young-adult group was significantly higher (18% vs 11%, p<0.05) and more equally distributed (CI=-0.0343 vs CI=-0.1001). Household consumption expenditure was the factor that contributed most to inequality in both group. Other factors contributing to inequality were smoking in young-adult group and marital status in middle-adult group. Contribution of education to inequality varied for different age groups.
Depression is more concentrated among the lower economic groups, with household expenditure being the major factor contributing to the inequality. This finding emphasises the importance of primary care level mental health services, particularly in poorer urban communities.
This study is based on a cross-sectional data, and only assesses social determinants of depression. These determinants are important to address in addition to biological determinants and other factors.
城市地区艰难的生活条件可能导致患抑郁症的风险增加，尤其是在女性中。抑郁症的一个重要预测因素是贫困，这可能导致抑郁症风险的不平等。然而，先前的研究在贫困与抑郁症之间发现了相互矛盾的结果。本研究调查抑郁症在印度尼西亚主要城市的年轻和中年女性中是否分布不均，并探讨导致这种不平等的因素。
对来自印度尼西亚主要城市（雅加达、泗水、棉兰和万隆）的1117名年轻和中年女性的数据进行了分析。计算集中指数（CI）以衡量不平等程度。对集中指数进行分解，以调查对不平等贡献最大的因素。
抑郁症患病率为15%，且更集中在经济较低群体中（CI = -0.0545）。与中年组相比，年轻成年组女性的抑郁症患病率显著更高（18%对11%，p<0.05）且分布更均匀（CI = -0.0343对CI = -0.1001）。家庭消费支出是两组不平等的最大促成因素。导致不平等的其他因素在年轻成年组中是吸烟，在中年组中是婚姻状况。教育对不平等的贡献在不同年龄组中有所不同。
抑郁症在经济较低群体中更为集中，家庭支出是导致不平等的主要因素。这一发现强调了初级保健层面心理健康服务的重要性，特别是在较贫困的城市社区。
本研究基于横断面数据，仅评估抑郁症的社会决定因素。除了生物学决定因素和其他因素外，这些决定因素也很重要。
