Jin Yinzi, Zhu Dawei, He Ping
Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
Soc Sci Med. 2020 Feb 19;249:112848. doi: 10.1016/j.socscimed.2020.112848.
To our knowledge, no prior studies have investigated these bidirectional pathways between poverty and depressive symptoms to identify potential mechanisms.
This study aimed to investigate the interrelationship between poverty and depressive symptoms by examining two causal theories: social causation, which claims that the condition of poverty causes mental health disorders, and social selection, which suggests that those with poor mental health are more likely to drift into poverty.
We obtained data from 17,250 adults aged 45 years or above from the China Health and Retirement Longitudinal Studies, first conducted in 2011-2012. Participants were tracked for 4 years, with baseline measurements taken as well as two 2-year follow-up visits. Structural equation models were used to examine the pathways in two directions at baseline, 2-year follow-up and 4-year follow-up.
We found significant total effects and indirect effects of poverty on depressive symptoms at baseline, which were mediated through deterioration of household living conditions, decrease in social participation, and decline in life satisfaction. In the opposite direction, depressive symptoms directly led individuals to drift into poverty at baseline and at follow-up.
This study suggested that social causation and social selection may operate concurrently. Proactive interventions, especially ones focusing on modifiable protective factors that our findings identified as mediators in the link between poverty and depression, are urgently needed to break the vicious cycle of poverty and depression and create a virtuous cycle of increasing returns.
据我们所知，此前尚无研究对贫困与抑郁症状之间的这些双向路径进行调查，以确定潜在机制。
本研究旨在通过检验两种因果理论来调查贫困与抑郁症状之间的相互关系：社会因果关系，即贫困状况导致心理健康障碍；社会选择，即心理健康状况不佳的人更有可能陷入贫困。
我们从中国健康与养老追踪调查中获取了17250名45岁及以上成年人的数据，该调查于2011 - 2012年首次开展。对参与者进行了4年的跟踪，进行了基线测量以及两次为期2年的随访。使用结构方程模型在基线、2年随访和4年随访时检验两个方向的路径。
我们发现贫困在基线时对抑郁症状有显著的总体效应和间接效应，这些效应通过家庭生活条件恶化、社会参与减少和生活满意度下降介导。在相反方向上，抑郁症状在基线和随访时直接导致个体陷入贫困。
本研究表明社会因果关系和社会选择可能同时起作用。迫切需要采取积极干预措施，特别是关注我们的研究结果确定为贫困与抑郁之间联系中介的可改变保护因素的干预措施，以打破贫困与抑郁的恶性循环，创造一个收益递增的良性循环。
