Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status

Abstract

BackgroundThere is substantial evidence that lower objective socioeconomic status (SES)—as measured by education, occupation, and income—is associated with a higher risk of depression. Less is known, however, about associations between perceptions of social status and the prevalence of depression. This study investigated associations of both objective SES and subjective social status (SSS) with depressive symptoms among adults in Germany.MethodsData were obtained from the 2013 special wave of the German Health Update study, a national health survey of the adult population in Germany. Objective SES was determined using a composite index based on education, occupation, and income. The three single dimensions of the index were also used individually. SSS was measured using the MacArthur Scale, which asks respondents to place themselves on a 10-rung ‘social ladder’. Regression models were employed to examine associations of objective SES and SSS with current depressive symptoms, as assessed with the eight-item Patient Health Questionnaire depression scale (PHQ-8 sum score ≥10).ResultsAfter mutual adjustment, lower objective SES and lower SSS were independently associated with current depressive symptoms. The associations were found in both sexes and persisted after further adjustment for sociodemographic factors, long-term chronic conditions, and functional limitations. Mediation analyses revealed a significant indirect relationship between objective SES and depressive symptoms through SSS. When the three individual dimensions of objective SES were mutually adjusted, occupation and income were independently associated with depressive symptoms. After additional adjustment for SSS, these associations attenuated but remained significant.ConclusionsThe findings suggest that perceptions of low social status in adults may be involved in the pathogenesis of depression and play a mediating role in the relationship between objective SES and depressive symptoms. Prospective studies are needed to establish the direction of effects and to address questions of causality.

Development and initial validation of the Perceived Scarcity Scale

“…Results from Study 4 are consistent with previous research that has established relationships between objective and subjective measures of SES and stress (Senn et al, ), health (Cohen et al, ), mental health (Hoebel, Maske, Zeeb, & Lampert, ), and QOL (Kim & Park, ; Mielck, Vogelmann, & Leidl, ). However, the fact that the PScS accounted for this much unique variance, beyond the traditional set of SES indicators and SSS, provides strong support for the significance of the construct and the need for the measure presented herein.…”

Spatial Modeling of Depression and Its Related Factors Using a Spatial Generalized Linear Mixed Model in Mashhad, Iran: A Cross-Sectional Study

“…These results were supported by previous studies (23)(24)(25). Also, socioeconomic status was significantly related to the depression, which is consistent with several previous pieces of evidence, including studies by Freeman et al (26), Domenech-Abella et al (27), Hoebel et al (28), and Azizoddin et al (29).…”

Trend to symptom-based depression in sub-elite and sports athletes

“…Also, women athletes had 1point difference to change the classification, a value almost equal than sports athletes. This finding corroborates with investigations that women are more affected by symptoms of depression than men (Hoebel et al, 2017, Junge and Feddermann-Demont, 2016, Storch et al, 2005, including among athletes (Covassin et al, Gorczynski et al, 2017, Yang et al, 2007. This evidence is possibly given by men having more difficulty or feeling more repressed in expressing their emotions (Rao and Hong, 2015).…”