The structure, function, and quality of the social convoy for improvements in depressive symptoms in urban and rural China: A 3-year longitudinal cohort study.

OBJECTIVE

To delve into the intricate relationship between the social convoy characteristics and the improvement in depressive symptoms (IDS) over three years among middle-aged and older adults in China, focusing on the potential moderating role of the rural-urban divide.

METHODS

The study analyzed data from 2229 respondents aged 45 and above from the 2015 and 2018 surveys of China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies Depression Scale was used to determine the presence of depressive symptoms. Questions on social support, social network size, and satisfaction with social relationships of the CHARLS questionnaire measured the features of social convoy. Logistic regression models were employed to evaluate the association between social convoy features and IDS and the interactions between urban-rural status and the independent variables.

RESULTS

In the overall sample, having emotional support (OR=1.299), being satisfied with family (OR=1.536), life in general (OR=2.114) and healthcare services (OR=1.383) were significantly associated with the improvement in depressive symptoms (all p < 0.01). Satisfaction with life in general was a shared factor for IDS in rural (OR=2.011) and urban groups (OR=3.292, both p < 0.01). Emotional support was an additional contributor for urban registrants (OR=2.207, p = 0.002), and being satisfied with family (OR=1.552) and healthcare services (OR=1.499) for rural registrants (both p < 0.05).

CONCLUSION

These findings suggest that the function and quality of the social convoy play divergent roles in alleviating depression among urban and rural middle-aged and older adults. The study underscores the necessity of addressing mental health challenges through a tailored whole-of-society approach.