个体和区域层面社会经济学特征对中老年人抑郁症状的影响——基于中国健康与养老追踪调查数据的分析

Association of individual and area level socioeconomic status with depressive symptoms for older adults-evidence from China Health and Retirement Longitudinal Study

目的基于中国健康与养老追踪调查数据分析个体和区域层面社会经济学特征对中老年人抑郁症状的影响。方法本研究采用队列研究设计,基于运用中国健康与养老追踪调查的数据,筛选基线调查中无抑郁的研究对象,追踪观察随访7年过程中入选对象出现抑郁症状的情况,采用描述性统计分析、多因素logistic分析、交叉分析等方法,分析性别、个人年收入、受教育程度、城乡和地区等因素对中老年人抑郁症状的影响。结果7年追踪随访结果显示,研究对象抑郁症状的检出率是42.24%;女性出现抑郁症状的风险显著高于男性(OR=1.782);中学(包括中专)、小学及以下出现抑郁症状的风险显著高于大专及以上者(OR=1.476、2.134);年收入≤10000元者出现抑郁症状的风险显著高于年收入>10000元者(OR=1.251);同时,农村地区出现抑郁症状风险显著高于城市(OR=1.389);中部和西部地区出现抑郁症状的风险显著高于东部地区(OR=1.342、1.730)。联合作用结果显示,与高收入高学历男性相比,低收入低学历女性、高收入低学历女性、低收入中等学历女性、高收入中等学历女性出现抑郁症状的风险比值排在前4位(OR=5.050、3.662、3.047、2.641);与东部城市男性相比,西部农村女性、中部农村女性、西部城市女性、东部农村女性出现抑郁症状的风险比值排在前4位(OR=4.286、3.216、2.642、2.158)。结论个体和区域层面社会经济学因素对中老年人抑郁症状的患病风险有显著影响,应加强对低社会经济地位中老年人的精神健康管理。

Objective To analyze the impact of individual and regional level socioeconomic characteristics on the mental health of middle-aged and older adults based on data from the China Health and Retirement Longitudinal Study.Methods This study was a cohort study.Using the data from the China Health and Retirement Longitudinal Study,subjects without depression were screened in the baseline survey,the depression status of the selected subjects was tracked and observed for seven years.Descriptive statistical analysis,multivariate logistic analysis,joint analysis were used to analyze the influence of factors such as gender,personal annual income,education level,urban and rural areas,and eastern,central,and western regions on the risk of depression among middle-aged and elderly people.Results The 7-year follow-up results showed that the prevalence of depression symptoms in the study subjects was 42.24%;compared with men,women′s risk of developing depression symptoms was significantly increased(OR=1.782);compared with junior college education and above,middle school(including technical secondary school),primary and lower education levels had a significantly increased risk of developing depression symptoms(OR=1.476,2.134);compared with annual income of more than 10000 yuan,subjects with an annual income of 10000 yuan or below had significantly increased risk of developing depression symptoms(OR=1.251).At the same time,compared with the urban area,the risk of developing depression symptoms was significantly increased in the rural areas(OR=1.389).Compared with the eastern area,the risk of developing depression symptoms was significantly higher in the central and western areas(OR=1.342,1.730).The joint analysis results showed that compared with high-income and high-education men,low-income low-education women,high-income low-education women,low-income middle-education women,and high-income middle-education women were at the top four odd ratios for developing depression symptoms(OR=5.050,3.662,3.047,2.641);compared with men in eastern cities,rural women in the west,rural women in the middle,women in the western cities,and rural women in the east ranked the first four odd ratios for developing depression symptoms(OR=4.286,3.216,2.642,2.158).Conclusion Socioeconomic factors at the individual and regional levels have a significant impact on the risk of developing depressive symptoms in middle-aged and older adults,and mental health management of middle-aged and older adults with low socioeconomic status should be strengthened.