Dataset Information

Is wealth associated with depressive symptoms in the United States?

ABSTRACT:

Purpose

The aim of the study was to assess the relation between family wealth and depression in U.S. adults.

Methods

Participants were 5134 members of the 2015-2016 National Health and Nutrition Examination Survey who were aged 18 years or older and completed the depression screener. Using the Patient Health Questionnaire and household demographics interview data, we calculate the adjusted odds of depressive symptoms for persons with low relative to high family savings, using multivariable logistic regression. We estimate predicted probabilities of having depressive symptoms for low and high family savings groups at low, middle, and high family income categories.

Results

Overall, 57.4% of the total weighted population had low family savings (below $20,000), and 23.7% of the weighted population had depressive symptoms. Persons with low family savings had 1.49 times higher odds (95% confidence interval, 1.01-2.21) of having depressive symptoms than persons with high family savings, controlling for gender, age, race, education, marital status, family size, and family income. Predicted probabilities of depressive symptoms were higher for low family savings groups than high family savings groups at every income level.

Conclusions

Family wealth is associated with lower prevalence of current depressive symptoms in U.S. adults. Wealth may be an important determinant of population mental health, separate and independent from income.

SUBMITTER: Ettman CK

PROVIDER: S-EPMC7891298 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Is wealth associated with depressive symptoms in the United States?

Ettman Catherine K CK Cohen Gregory H GH Galea Sandro S

Annals of epidemiology 20200208

<h4>Purpose</h4>The aim of the study was to assess the relation between family wealth and depression in U.S. adults.<h4>Methods</h4>Participants were 5134 members of the 2015-2016 National Health and Nutrition Examination Survey who were aged 18 years or older and completed the depression screener. Using the Patient Health Questionnaire and household demographics interview data, we calculate the adjusted odds of depressive symptoms for persons with low relative to high family savings, using mult ...[more]

PMID: 32147320

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Project description:Importance:Low income has been associated with poor health outcomes. Owing to retirement, wealth may be a better marker of financial resources among older adults. Objective:To determine the association of wealth with mortality and disability among older adults in the United States and England. Design, Setting, and Participants:The US Health and Retirement Study (HRS) and English Longitudinal Study of Aging (ELSA) are nationally representative cohorts of community-dwelling older adults. We examined 12 173 participants enrolled in HRS and 7599 enrolled in ELSA in 2002. Analyses were stratified by age (54-64 years vs 66-76 years) because many safety-net programs commence around age 65 years. Participants were followed until 2012 for mortality and disability. Exposures:Wealth quintile, based on total net worth in 2002. Main Outcomes and Measures:Mortality and disability, defined as difficulty performing an activity of daily living. Results:A total of 6233 US respondents and 4325 English respondents aged 54 to 64 years (younger cohort) and 5940 US respondents and 3274 English respondents aged 66 to 76 years (older cohort) were analyzed for the mortality outcome. Slightly over half of respondents were women (HRS: 6570, 54%; ELSA: 3974, 52%). A higher proportion of respondents from HRS were nonwhite compared with ELSA in both the younger (14% vs 3%) and the older (13% vs 3%) age cohorts. We found increased risk of death and disability as wealth decreased. In the United States, participants aged 54 to 64 years in the lowest wealth quintile (Q1) (≤$39 000) had a 17% mortality risk and 48% disability risk over 10 years, whereas in the highest wealth quintile (Q5) (>$560 000) participants had a 5% mortality risk and 15% disability risk (mortality hazard ratio [HR], 3.3; 95% CI, 2.0-5.6; P < .001; disability subhazard ratio [sHR], 4.0; 95% CI, 2.9-5.6; P < .001). In England, participants aged 54 to 64 years in Q1 (≤£34,000) had a 16% mortality risk and 42% disability risk over 10 years, whereas Q5 participants (>£310,550) had a 4% mortality risk and 17% disability risk (mortality HR, 4.4; 95% CI, 2.7-7.0; P < .001; disability sHR, 3.0; 95% CI, 2.1-4.2; P < .001). In 66- to 76-year-old participants, the absolute risks of mortality and disability were higher, but risk gradients across wealth quintiles were similar. When adjusted for sex, age, race, income, and education, HR for mortality and sHR for disability were attenuated but remained statistically significant. Conclusions and Relevance:Low wealth was associated with death and disability in both the United States and England. This relationship was apparent from age 54 years and continued into later life. Access to health care may not attenuate wealth-associated disparities in older adults.

Project description:ImportanceMarked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters.ObjectiveTo describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors.Design, setting, and participantsThis survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC.Main outcome and measureDepressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index.ResultsThe 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity.Conclusions and relevanceIn this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed.

Dataset Information

Is wealth associated with depressive symptoms in the United States?

Purpose

Methods

Results

Conclusions

Publications

Is wealth associated with depressive symptoms in the United States?

Similar Datasets

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