Community Social Capital, Built Environment, and Income-Based Inequality in Depressive Symptoms Among Older People in Japan: An Ecological Study From the JAGES Project
Open Access
- 1 January 2018
- journal article
- research article
- Published by Japan Epidemiological Association in Journal of Epidemiology
- Vol. 28 (3), 108-116
- https://doi.org/10.2188/jea.je20160216
Abstract
Background: Although reducing socioeconomic inequalities in depression is necessary, their associated factors have rarely been studied. This study aimed to screen the potential contextual factors associated with income-based inequality in older adults’ depression. Methods: Using data from the Japan Gerontological Evaluation Study (JAGES) of 2013, we conducted an ecological study covering 77 communities in Japan. Our measures of socioeconomic inequalities in depression were the slope index of inequalities (SII) and the relative index of inequalities (RII) of the prevalence of depressive symptoms across three income levels. We categorized available community-level factors, including socio-demographic factors, social participation, social relationships, subjective changes in the residential area, and the built environment. These indicators were aggregated from individual responses of 51,962 and 52,958 physically independent men and women, respectively, aged 65 years or more. We performed multiple linear regression analyses to explore factors with statistical significance of a two-tailed P-value less than 0.05. Results: Factors associated with shallower gradients in depression for men included higher participation in local activities and reception or provision of social support, which did not show significant association among women. Perceived increases in unemployment and economic inequalities were positively associated with larger inequalities in both genders (P < 0.05). The built environment did not indicate any significant association. Conclusions: A community environment fostering social activities and relationships might be associated with smaller income-based inequalities in depression. There is a need for more deterministic studies for planning of effective community interventions to address socioeconomic inequalities in depression.Keywords
Funding Information
- Japan Agency for Medical Research and Development (N/A)
This publication has 41 references indexed in Scilit:
- Social Capital, Diversity and Giving or Receiving Help Among NeighboursSocial Indicators Research, 2013
- The association between residential area characteristics and mental health outcomes among men and women in BelgiumArchives of Public Health, 2011
- The importance of gender and conceptualization for understanding the association between collective social capital and health: A multilevel analysis from northern SwedenSocial Science & Medicine (1982), 2011
- Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adultsAging & Mental Health, 2009
- Association between depression and socio-economic status among community-dwelling elderly in Japan: The Aichi Gerontological Evaluation Study (AGES)Health & Place, 2008
- Social and emotional support and its implication for healthCurrent Opinion in Psychiatry, 2008
- Reliability, validity and factor structure of the GDS‐15 in Iranian elderlyInternational Journal of Geriatric Psychiatry, 2006
- Depression in Japanese community-dwelling elderly—prevalence and association with ADL and QOLArchives of Gerontology and Geriatrics, 2004
- Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical reviewJournal of Epidemiology and Community Health, 2001
- The Anatomy of Income DistributionThe Review of Economics and Statistics, 1962