The Impact of Socioeconomic Inequalities On Late-Life Depression Trajectories

Background and Purpose

Previous researchers have consistently shown that socioeconomic inequalities are significant predictors of health disparities, particularly along gender and racial lines. Despite increased attention to health disparities, few researchers have focused on the impact of socioeconomic inequalities on late-life depression trajectories. This study investigated the associations between socioeconomic inequalities and depression trajectories.

Methods

Longitudinal panel data from the Health and Retirement Study (1994-2006) was used to estimate the impact of socioeconomic inequalities on the initial level of depression and its rate of change. The latent growth curve model is used to analyze individual differences in intra-individual changes in depression over time, incorporating time-varying and time-invariant covariates into the model. The moderating effects of gender and race were also examined by multiple group comparison analysis.

Results

Higher initial levels of income and assets were significantly associated with less depression over time. Increases in income or assets also predicted slower rate of change in depression. In addition, higher levels of education significantly predicted lower initial levels of depression, but, unexpectedly, its faster rate of changes. With regard to employment status, people who work full-time or part-time were less likely to be depressed at baseline compared to those who are not in the labor force, but employment status did not predict the rate of change in depression over time. The multiple group comparison models showed that higher levels of income, assets, and education were significant predictors of lower initial levels of depression in both males and females. In particular, females who work full-time or part-time were less likely to be depressed at baseline. Higher income and assets also predicted slower rate of change in depression only for females. Unexpectedly, highly educated females tended to experience faster rate of change in depression. Highly educated people, especially females, might become more depressed when their high self-expectations were not met. In addition, higher income, assets, and education significantly predicted lower initial level of depression for Whites. Higher assets and education predicted lower initial levels of depression for Blacks. Increases in income and assets significantly predicted slower rate of change in depression only for Whites. Working full-time or part-time predicted less depression for both Whites and Blacks only at baseline. Conclusions and Implications

This study concluded that socioeconomic inequalities were significantly related to late-life depression trajectories. In particular, females are more likely than males to become depressed at a faster rate when they suffer financial hardships such as loss of income and assets. Economic status changes have impacts on depression only for Whites. Financial supports or social engagement through employment opportunities might reduce the negative impact of socioeconomic inequalities on depression. Also, based on the results of study, which show different depression trajectories by gender and race, addressing disparities in depression might require a culturally sensitive approach that needs to take into account the social and cultural strengths.