Calderon-Villarreal Alheli, Mujica Oscar J, Bojorquez Ietza
El Colegio de la Frontera Norte El Colegio de la Frontera Norte Tijuana Mexico El Colegio de la Frontera Norte, Tijuana, Mexico.
Pan American Health Organization/World Health Organization Pan American Health Organization/World Health Organization Washington, DC United States of America Pan American Health Organization/World Health Organization, Washington, DC, United States of America.
Rev Panam Salud Publica. 2020 Feb 5;44:e9. doi: 10.26633/RPSP.2020.9. eCollection 2020.
To assess the association between intersectional disadvantage and clinically significant depressive symptoms (CSDS), describing the magnitude of social inequalities in the prevalence of symptoms among adult women in Tijuana, Mexico.
This was a cross-sectional study. CSDS were assessed using the Centers for Epidemiological Studies Depression Scale among a probability sample of 2 345 women from 18 - 65 years of age in 2014. CSDS prevalence was calculated according to categories of three social stratifiers: socioeconomic status (SES), educational attainment, and fertility (number of children). Social inequality was measured with the slope index of inequality (SII) and the concentration index (CIx). Intersectionality among stratifiers was explored descriptively and with multivariable regression analysis.
CSDS prevalence was 17.7% (95%CI: 15.1% - 21.0%). The SII and CIx showed inequity in all social stratifiers. The absolute difference in CSDS prevalence between the lowest and highest ends of the SES gradient was 21.9% (95%CI: 21.5% - 22.4%). Among the most disadvantaged women, i.e., those at the intersection of lowest SES, lowest educational attainment, and highest fertility, the CSDS prevalence was 39.5% (95% CI: 26.0% - 52.9%).
Disadvantage along multiple axes was associated with CSDS. Efforts to improve the mental health of women should include equity-oriented policies that address its social determinants.
评估交叉性劣势与具有临床意义的抑郁症状（CSDS）之间的关联，描述墨西哥蒂华纳成年女性中症状患病率方面的社会不平等程度。
这是一项横断面研究。2014年，在2345名年龄在18至65岁的女性概率样本中，使用流行病学研究中心抑郁量表评估CSDS。根据社会经济地位（SES）、教育程度和生育情况（子女数量）这三个社会分层因素的类别计算CSDS患病率。用不平等斜率指数（SII）和集中指数（CIx）衡量社会不平等。对分层因素之间的交叉性进行描述性探索，并进行多变量回归分析。
CSDS患病率为17.7%（95%置信区间：15.1% - 21.0%）。SII和CIx在所有社会分层因素中均显示出不平等。SES梯度最低端和最高端之间CSDS患病率的绝对差异为21.9%（95%置信区间：21.5% - 22.4%）。在最弱势的女性中，即处于最低SES、最低教育程度和最高生育情况交叉点的女性，CSDS患病率为39.5%（95%置信区间：26.0% - 52.9%）。
多方面的劣势与CSDS相关。改善女性心理健康的努力应包括针对其社会决定因素的公平导向政策。
