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Income Inequality,Socioeconomic Deprivation and Depressive Symptoms among Older Adults in Mexico
Authors:Julián Alfredo Fernández-Ni?o  Betty Soledad Manrique-Espinoza  Ietza Bojorquez-Chapela  Aarón Salinas-Rodríguez
Institution:1. Center for Evaluation Research and Surveys, National Institute of Public Health, Cuernavaca, Morelos, Mexico.; 2. Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico.; Federal University of Rio de Janeiro, Brazil,
Abstract:

Objective

Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico.

Methods

Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model.

Results

Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not.

Conclusions

The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.
Keywords:
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