Institute of Population Research, Peking University, Beijing, China.
Peking University Sixth Hospital, Beijing, China.
BMC Psychiatry. 2022 Apr 28;22(1):297. doi: 10.1186/s12888-022-03937-9.
There was little evidence concerning the association of community socioeconomic status (SES) and the cross-level interaction between community- and individual-level SES with depressive symptoms in China. This study aimed to investigate the association of community-level SES with depressive symptoms among Chinese middle-aged and older people and to examine whether individual-level SES moderates this relationship.
Using data from the China Health and Retirement Longitudinal 2011-2018 Study, the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) short form was used to measure depressive symptoms in 35,546 Chinese individuals aged 45 years and older. Community SES was calculated as a sum of z scores of the average years of schooling and household income per capita, which were derived by aggregating the individual measures to the community level. Two-level hierarchical linear regression was used.
Community SES was negatively related to CES-D-10 scores (coef=-0.438). A 1-SD increase in individual SES was associated with lower CES-D-10 scores (coef=-0.490). The cross-level interaction on individual- and community-level SES was significantly associated with depressive symptoms, indicating that with the increase of individual-level SES, the effect of community-level SES on depression decreases. Stratified analyses observed robust associations of community SES with CES-D scores between urban and rural residents.
This study showed that individuals who live in lower-SES communities had more severe depressive symptoms, particularly individuals with low SES. Additional attention should be given to the community socioeconomic context of middle-aged and older adults with lower SES, which may be helpful to reduce SES inequalities in depressive symptoms in China.
在中国，关于社区社会经济地位（SES）与社区和个体水平 SES 之间的交叉水平交互与抑郁症状之间的关联的证据很少。本研究旨在调查社区 SES 与中国中老年人群抑郁症状之间的关联，并检验个体 SES 是否调节这种关系。
本研究使用了来自中国健康与退休纵向研究 2011-2018 年的数据，使用 10 项流行病学研究中心抑郁量表（CES-D-10）短表来衡量 35546 名 45 岁及以上的中国人的抑郁症状。社区 SES 被计算为平均受教育年限和人均家庭收入的 z 分数的总和，这些分数是通过将个体指标汇总到社区层面得出的。采用两水平层次线性回归。
社区 SES 与 CES-D-10 评分呈负相关（系数为-0.438）。个体 SES 的 1-SD 增加与 CES-D-10 评分较低相关（系数为-0.490）。个体和社区 SES 的交叉水平交互与抑郁症状显著相关，这表明随着个体 SES 的增加，社区 SES 对抑郁的影响降低。分层分析观察到社区 SES 与城乡居民 CES-D 评分之间存在稳健的关联。
本研究表明，生活在 SES 较低社区的个体抑郁症状更严重，尤其是 SES 较低的个体。应更多关注 SES 较低的中老年人的社区社会经济背景，这可能有助于减少中国 SES 不平等与抑郁症状之间的差距。
