Research Department of Epidemiology and Public Health, University College London, London, UK
Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
J Epidemiol Community Health. 2021 May;75(5):442-449. doi: 10.1136/jech-2020-214241. Epub 2020 Nov 5.
Although ageing populations are increasingly residing in cities, it is unknown whether depression inequalities are moderated by urbanicity degree. We estimated gender, marital and educational inequalities in depressive symptoms among older European and Canadian adults, and examined whether higher levels of urbanicity, captured by population density, heightened these inequalities.
Harmonised cross-sectional data on 97 826 adults aged ≥50 years from eight cohorts were used. Prevalence ratios (PRs) were calculated for probable depression, depressed affect and depressive symptom severity by gender, marital status and education within each cohort, and combined using random-effects meta-analysis. Using a subsample of 73 123 adults from six cohorts with available data on population density, we tested moderating effects measured by the number of residents per square kilometre.
The pooled PRs for probable depression by female gender, unmarried or non-cohabitating status and low education were 1.48 (95% CI 1.28 to 1.72), 1.44 (95% CI 1.29 to 1.61) and 1.29 (95% CI 1.18 to 1.41), respectively. PRs for depressed affect and high symptom severity were broadly similar. Except for one Dutch cohort with findings in an unexpected direction, there was no evidence that population density modified depressive symptom inequalities.
Despite cross-cohort variation in gender, marital status and educational inequalities in depressive symptoms, there was weak evidence that these inequalities differed by levels of population density.
尽管老龄化人口越来越多地居住在城市，但尚不清楚抑郁不平等是否受到城市程度的调节。我们估计了老年欧洲和加拿大成年人中性别、婚姻和教育程度与抑郁症状之间的不平等，并检验了城市人口密度是否会加剧这些不平等。
使用来自 8 个队列的 97826 名年龄≥50 岁的成年人的协调横断面数据。在每个队列中，根据性别、婚姻状况和教育程度计算了可能患有抑郁症、抑郁情绪和抑郁症状严重程度的患病率比（PR），并使用随机效应荟萃分析进行了综合。使用来自六个队列的 73123 名成年人的子样本（具有居民每平方公里人数的可用数据），我们检验了以每平方公里居民人数衡量的调节效应。
女性、未婚或非同居状态和低教育程度的总体 PR 分别为 1.48（95%CI 1.28 至 1.72）、1.44（95%CI 1.29 至 1.61）和 1.29（95%CI 1.18 至 1.41）。抑郁情绪和高症状严重程度的 PR 大致相似。除了一个荷兰队列的结果出乎意料之外，没有证据表明人口密度改变了抑郁症状的不平等。
尽管在性别、婚姻状况和教育程度方面存在抑郁症状的不平等，但在跨队列差异中，这些不平等与人口密度水平的关系很微弱。
