Socioeconomic inequalities in depression: a meta-analysis

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• Low socioeconomic status (SES) is generally linked to adverse health outcomes, including psychiatric morbidity.
• The association between SES and depression is complex and debated.
• Understanding this relationship is crucial for public health interventions.

Purpose of the Study:

• To conduct a meta-analysis evaluating the association between SES and depression.
• To determine the magnitude, shape, and influencing factors of this relationship.
• To investigate socioeconomic inequalities in depression prevalence, incidence, and persistence.

Main Methods:

• A systematic search identified 51 prevalence, 5 incidence, and 4 persistence studies.
• Random effects models were used to analyze odds ratios comparing lowest vs. highest SES groups.
• Meta-regression assessed dose-response relationships and covariate influences.

Main Results:

• Individuals with low SES had significantly higher odds of being depressed (OR = 1.81).
• Low SES was associated with lower odds of new depression episodes (OR = 1.24) but higher odds of persistent depression (OR = 2.06).
• A dose-response relationship was found for education and income, indicating a gradient effect.

Conclusions:

• Compelling evidence supports socioeconomic inequality in depression.
• This inequality is heterogeneous, influenced by measurement of depression, SES, region, and time.
• Intervention strategies are needed to address socioeconomic disparities in depression, particularly concerning its course.