Exploring multilevel social determinants of depressive symptoms for Tanzanian adolescents: evidence from a cross-sectional study

Abstract

BackgroundDepression has substantial and enduring impacts for adolescents, particularly those living in poverty. Yet, evidence on its determinants in low-income countries remains scarce. We examined the social determinants of depressive symptoms for Tanzanian adolescents.MethodsWe used cross-sectional data for 2458 adolescents (aged 14–19), to describe associations with depressive symptoms within and across five domains—demographic, economic, neighbourhood, environmental and social-cultural—using linear mixed models. We estimated depressive symptoms using the 10-item Centre for Epidemiological Studies Depression Scale, which ranges from 0 to 30 and increases with additional symptoms.ResultsFactors associated with depressive symptoms in the fully adjusted models included experiencing five or more household economic shocks (β=2.40; 95% CI 1.48 to 3.32), experiencing droughts/floods (β=0.76; 95% CI 0.36 to 1.17), being in a relationship (β=1.82; 95% CI 1.30 to 2.33), and having moderate (β=1.26; 95% CI 0.80 to 1.71) or low (β=2.27; 95% CI 1.81 to 2.74) social support. Exclusive schooling was protective compared with being engaged in both school and paid work (β=1.07; 95% CI 0.05 to 2.61) and not engaged in either (β=0.73; 95% CI 0.24 to 1.22). Household size and relationship status were more important factors for girls, while employment status, and extreme precipitation were more important for boys.ConclusionMental health is associated with determinants from multiple domains. Results suggest that environmental shocks related to climate change contribute to poor mental health in adolescents, highlighting an important area for intervention and research.

Effects of Adolescent-Focused Integrated Social Protection on Depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania’s Cash Plus Intervention

“…Low self-esteem (as compared with high self-esteem) and engaging in both school and paid work (as compared with exclusive schooling) were associated with poorer mental health at baseline ( 25 ), and our study found modest protective intervention effects on these pathways. However, the pathway indicators examined here do not fully explain the effects on mental health.…”

“…The secondary goal of this study was to acquire a mechanistic understanding of impacts on mental health by estimating effects on potential pathways. We selected time-variant indicators, aligned with the intervention curriculum, topics, or goals, that were identified in a previous study as important factors related to depressive symptoms in the baseline sample of this evaluation ( 25 ): employment/education status, having a romantic partner, self-esteem, quality of life, and locus of control (LOC).…”

Changes in mental health problems during the COVID-19 pandemic in Mexican youth: Insights from the Voces-19 study

“…In our analysis, being a student was associated with a higher probability of CMD, in comparison to those who worked. Since other research has found that studying is protective of mental health among adolescents (Prencipe et al, 2021), it is possible that the higher odds of CMD among students had to do with the pandemic situation, when schools were suspended or classes moved online. Similar to other studies (Patrick & Schulenberg, 2013), we found working to be associated with higher odds of substance use.…”

High doses of a national preschool program are associated with the long-term mitigation of adverse outcomes in cognitive development and life satisfaction among children who experience early stunting: a multi-site longitudinal study in Vietnam

“…This measure has proven to be reliable and valid across a range of child and adolescent ages and in diverse cultural contexts [e.g., (56,57)], including in other samples in Vietnam (58). It has been widely used with school-age children [e.g., (59)(60)(61)] and adolescents in diverse low-, middle-and high-income countries [e.g., (62)], including the 51 nations participating in the Health Behaviour of School-Age Children Study co-ordinated by WHO [e.g., (63)]. However, it is more useful for examining within-country differences and patterns of change within individuals than for comparing levels of life satisfaction between countries (64).…”