Kim Woorim, Kim Tae Hyun, Lee Tae-Hoon, Ju Yeong Jun, Park Eun-Cheol
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
Int J Equity Health. 2016 Jul 18;15(1):111. doi: 10.1186/s12939-016-0402-0.
Mental health inequality along the economic strata is prominent in South Korea, particularly as intergenerational material transfer is becoming increasingly important in gaining economic status. Therefore, this study aimed to investigate the relationship between current and childhood economic status and depressive symptoms in adults aged 20 or above.
This study used data from the Korean Welfare Panel Study (KOWEPS), 2010 to 2013. A total of 9,645 individuals aged 20 years or above without depressive symptoms in 2010 were analyzed. The effect of childhood and current economic status, categorized into low, middle, and high groups, on depressive symptoms was investigated using hierarchical logistic regression models. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 11) scale. Subgroup analysis was performed based on education level.
Compared to the middle current-middle childhood economic status group, the low-low group (OR: 1.88, CI: 1.61-2.20), low-middle group (OR: 1.68, CI: 1.43-1.98), and low-high group (OR: 1.64, CI: 1.34-2.01) were more likely to have depressive symptoms. The high-low group (OR: 0.68, CI: 0.55-0.84), high-middle group (OR: 0.67, CI: 0.56-0.81), and high-high group (OR: 0.45, CI: 0.27-0.75) were less likely to have depressive symptoms. This trend was generally maintained with regard to education level, but the effects were not statistically significant in the high current economic status groups among participants with a university degree or above.
Low current economic status was associated with a higher likelihood of depressive symptoms. In particular, the low current-low childhood economic status group showed the highest likelihood of depressive symptoms, suggesting the adverse mental health effects of prolonged poverty. Therefore, the findings reveal that mental health inequalities are present along the economic strata and require proper addressing of the mental health of lower income individuals.
在韩国,不同经济阶层间的心理健康不平等现象较为突出,尤其是代际物质转移在获取经济地位方面变得越来越重要。因此,本研究旨在调查20岁及以上成年人当前和童年时期的经济状况与抑郁症状之间的关系。
本研究使用了2010年至2013年韩国福利面板研究(KOWEPS)的数据。对2010年时年龄在20岁及以上且无抑郁症状的9645名个体进行了分析。使用分层逻辑回归模型研究分为低、中、高组的童年和当前经济状况对抑郁症状的影响。抑郁症状采用流行病学研究中心抑郁量表(CES-D 11)进行测量。根据教育水平进行亚组分析。
与当前经济状况为中等且童年经济状况为中等的组相比,当前经济状况为低且童年经济状况为低的组(比值比:1.88,置信区间:1.61 - 2.20)、当前经济状况为低且童年经济状况为中等的组(比值比:1.68,置信区间:1.43 - 1.98)以及当前经济状况为低且童年经济状况为高的组(比值比:1.64,置信区间:1.34 - 2.01)更易出现抑郁症状。当前经济状况为高且童年经济状况为低的组(比值比:0.68,置信区间:0.55 - 0.84)、当前经济状况为高且童年经济状况为中等的组(比值比:0.67,置信区间:0.56 - 0.81)以及当前经济状况为高且童年经济状况为高的组(比值比:0.45,置信区间:0.27 - 0.75)出现抑郁症状的可能性较小。这一趋势在教育水平方面总体保持,但在大学及以上学历参与者的当前高经济状况组中,影响无统计学意义。
当前经济状况较低与出现抑郁症状的可能性较高相关。特别是当前经济状况为低且童年经济状况为低的组出现抑郁症状的可能性最高,表明长期贫困对心理健康有不利影响。因此,研究结果显示不同经济阶层存在心理健康不平等现象,需要妥善关注低收入个体的心理健康。