TY - JOUR
T1 - Gender, marital and educational inequalities in mid- to late-life depressive symptoms
T2 - cross-cohort variation and moderation by urbanicity degree
AU - Ruiz, Milagros A
AU - Beenackers, Marielle A
AU - Doiron, Dany
AU - Gurer, Asli
AU - Sarr, Aliou
AU - Sohel, Nazmul
AU - Timmermans, Erik J
AU - Wissa, Rita
AU - Chaix, Basile
AU - Huisman, Martijn
AU - Krokstad, Steinar
AU - Kubinova, Ruzena
AU - Malyutina, Sofia
AU - Raina, Parminder
AU - Tamosiunas, Abdonas
AU - van Lenthe, Frank J
AU - Bobak, Martin
N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.
PY - 2021/4/12
Y1 - 2021/4/12
N2 - BACKGROUND: Although ageing populations are increasingly residing in cities, it is unknown whether depression inequalities are moderated by urbanicity degree. We estimated gender, marital and educational inequalities in depressive symptoms among older European and Canadian adults, and examined whether higher levels of urbanicity, captured by population density, heightened these inequalities.METHODS: Harmonised cross-sectional data on 97 826 adults aged ≥50 years from eight cohorts were used. Prevalence ratios (PRs) were calculated for probable depression, depressed affect and depressive symptom severity by gender, marital status and education within each cohort, and combined using random-effects meta-analysis. Using a subsample of 73 123 adults from six cohorts with available data on population density, we tested moderating effects measured by the number of residents per square kilometre.RESULTS: The pooled PRs for probable depression by female gender, unmarried or non-cohabitating status and low education were 1.48 (95% CI 1.28 to 1.72), 1.44 (95% CI 1.29 to 1.61) and 1.29 (95% CI 1.18 to 1.41), respectively. PRs for depressed affect and high symptom severity were broadly similar. Except for one Dutch cohort with findings in an unexpected direction, there was no evidence that population density modified depressive symptom inequalities.CONCLUSIONS: Despite cross-cohort variation in gender, marital status and educational inequalities in depressive symptoms, there was weak evidence that these inequalities differed by levels of population density.
AB - BACKGROUND: Although ageing populations are increasingly residing in cities, it is unknown whether depression inequalities are moderated by urbanicity degree. We estimated gender, marital and educational inequalities in depressive symptoms among older European and Canadian adults, and examined whether higher levels of urbanicity, captured by population density, heightened these inequalities.METHODS: Harmonised cross-sectional data on 97 826 adults aged ≥50 years from eight cohorts were used. Prevalence ratios (PRs) were calculated for probable depression, depressed affect and depressive symptom severity by gender, marital status and education within each cohort, and combined using random-effects meta-analysis. Using a subsample of 73 123 adults from six cohorts with available data on population density, we tested moderating effects measured by the number of residents per square kilometre.RESULTS: The pooled PRs for probable depression by female gender, unmarried or non-cohabitating status and low education were 1.48 (95% CI 1.28 to 1.72), 1.44 (95% CI 1.29 to 1.61) and 1.29 (95% CI 1.18 to 1.41), respectively. PRs for depressed affect and high symptom severity were broadly similar. Except for one Dutch cohort with findings in an unexpected direction, there was no evidence that population density modified depressive symptom inequalities.CONCLUSIONS: Despite cross-cohort variation in gender, marital status and educational inequalities in depressive symptoms, there was weak evidence that these inequalities differed by levels of population density.
KW - Ageing
KW - depression
KW - social epidemiology
KW - urbanisation
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85095957520&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33154147
U2 - https://doi.org/10.1136/jech-2020-214241
DO - https://doi.org/10.1136/jech-2020-214241
M3 - Article
C2 - 33154147
SN - 0143-005X
VL - 75
SP - 442
EP - 449
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 5
M1 - 214241
ER -