International Institute for Population Sciences, Mumbai, 400088, India.
BMC Psychiatry. 2022 Jun 18;22(1):409. doi: 10.1186/s12888-022-04064-1.
Social exclusion has far-reaching consequences that extend beyond regular activities and access to resources and knowledge; social exclusion is a major social determinant of health. However, there is a lack of evidence on social exclusion and health outcomes among India's older adults. Thus, the current study investigates the association of social exclusion with depressive symptoms among Indian older adults.
This study used information on 30,366 older adults from Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018. Social exclusion scores were calculated, and two broad domains of social exclusion, i.e., exclusion from civic activity & social relations and exclusion from services, were considered in the study. The depressive symptom was calculated using the CES-D score. Using logistic regression models, the average marginal effects of selected covariates and domains of social exclusion on depressive symptoms were estimated to assess the links between social exclusion and depressive symptoms.
With the increase in the social exclusion score in the selected domains, the prevalence of depressive symptoms among older also increased. Elderly persons who do not vote or live alone in the domain of being excluded from civic & social activities and older adults excluded from services were observed to have a higher prevalence of depressive symptoms. Adjusting for sociodemographic factors, the average marginal effects suggested that older with four scores of civic activity & social relation exclusion, two scores of service exclusion and four scores of overall social exclusion were estimated to have a higher prevalence of depressive symptoms, respectively.
This study's findings shed light on social exclusion and its relationship to depressive symptoms among older Indians. Older health care services should be expanded in breadth while also addressing social exclusion, resulting in considerable improvements in older individuals' mental health.
社会排斥的影响深远，不仅局限于常规活动以及对资源和知识的获取，它还是影响健康的一个主要社会决定因素。然而，目前缺乏关于印度老年人社会排斥与健康结果之间关系的证据。因此，本研究调查了社会排斥与印度老年人抑郁症状之间的关联。
本研究使用了 2017-2018 年印度纵向老龄化研究（LASI）第 1 波的 30366 名老年人的数据。计算了社会排斥得分，并考虑了社会排斥的两个广泛领域，即公民活动和社会关系排斥以及服务排斥。使用 CES-D 得分计算了抑郁症状。使用逻辑回归模型，估计了选定的协变量和社会排斥领域对抑郁症状的平均边际效应，以评估社会排斥与抑郁症状之间的关系。
在所选择的领域中，社会排斥得分的增加与老年人抑郁症状的发生率增加有关。在被排除在公民和社会活动之外的领域中不投票或独居的老年人以及被排除在服务之外的老年人，观察到抑郁症状的发生率更高。在调整社会人口因素后，平均边际效应表明，在公民活动和社会关系排斥方面有四个得分、在服务排斥方面有两个得分以及在总体社会排斥方面有四个得分的老年人，其抑郁症状的发生率估计更高。
本研究的结果揭示了社会排斥及其与印度老年人抑郁症状之间的关系。应扩大老年人保健服务的范围，同时解决社会排斥问题，从而显著改善老年人的心理健康。
