Sánchez-Moreno Esteban, Gallardo-Peralta Lorena P
Department of Sociology, Methods and Theory, Research Institute in Development and Cooperation (IUDC-UCM), Universidad Complutense de Madrid, Donoso Cortés, 63, 28015 Madrid, Spain.
Dirección de Investigación, Postgrado y Transferencia Tecnológica (DIPTT), Universidad de Tarapacá, Arica, Chile.
Eur J Ageing. 2021 Dec 17;19(3):663-675. doi: 10.1007/s10433-021-00670-2. eCollection 2022 Sep.
This study analysed the association between income inequality and depression from a multilevel perspective among older adults in Europe, including an examination of the role of social support. The data came from Eurostat's European Health Interview Survey (EHIS). Selected participants were aged 65 years or above ( = 68,417) and located in 24 European countries. The outcome variable (depression) was measured using the eight-item Patient Health Questionnaire (PHQ-8). The resulting dataset included individual-level (level-1) and aggregate-level (level 2) exposure variables. Level-1 included income quintiles and social support as exposure variables and sex, age, living alone, limitation in activities of daily living and general activity limitation as control variables. Level 2 included the Gini coefficient, healthcare expenditure and dependency ratio. A multilevel linear regression analysis was performed with maximum likelihood (ML) estimation. All the income quintiles from 1 to 4 showed higher average scores for depression than quintile 5 (the highest). Higher social support scores were associated with lower scores for depression. An interaction was found between income quintile and social support, with higher levels of social support associated with lower scores for depression in quintiles 1 and 2. Higher Gini coefficient scores were associated with higher scores for depression. A significative random slope for social support was also found, meaning that the relationship between social support and depression differed across countries. No significant interaction was found between the Gini coefficient and social support. The study findings suggest that more unequal societies provide a less favourable context for the mental health of older adults. There are also significant country-dependent differences in terms of the relationship between support and mental health among older adults.
The online version contains supplementary material available at 10.1007/s10433-021-00670-2.
本研究从多层次视角分析了欧洲老年人收入不平等与抑郁症之间的关联，包括考察社会支持的作用。数据来自欧盟统计局的欧洲健康访谈调查（EHIS）。选定的参与者年龄在65岁及以上（n = 68417），分布在24个欧洲国家。结果变量（抑郁症）使用八项患者健康问卷（PHQ - 8）进行测量。最终数据集包括个体层面（1级）和总体层面（2级）的暴露变量。1级包括收入五分位数和社会支持作为暴露变量，以及性别、年龄、独居、日常生活活动受限和一般活动受限作为控制变量。2级包括基尼系数、医疗保健支出和抚养比。采用最大似然（ML）估计进行多层次线性回归分析。所有1至4的收入五分位数的抑郁症平均得分均高于五分位数5（最高）。较高的社会支持得分与较低的抑郁症得分相关。在收入五分位数和社会支持之间发现了一种交互作用，即社会支持水平较高与五分位数1和2中较低的抑郁症得分相关。较高的基尼系数得分与较高的抑郁症得分相关。还发现了社会支持的显著随机斜率，这意味着社会支持与抑郁症之间的关系在不同国家有所不同。在基尼系数和社会支持之间未发现显著的交互作用。研究结果表明，社会不平等程度越高，对老年人心理健康的环境越不利。在老年人的支持与心理健康之间的关系方面，也存在显著的国家依赖性差异。
在线版本包含可在10.1007/s10433 - 021 - 00670 - 2获取的补充材料。
