Depression symptoms as mediators of inequalities in self-reported health: the case of Southern European elderly

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Leao, T (Author) FMUP; Perelman, J (Author) Other

Journal

Title: Journal of Public Health

Vol. 40 No. 3

Pages: 756-763

ISSN: 1741-3842

Publisher: Oxford University Press

Indexing

ISI Web of Knowledge - 11 Citations

Other information

Authenticus ID: P-00Q-5H2

DOI: 10.1093/pubmed/fdx173

Abstract (EN): Background Inequalities in the distribution of self-reported health (SRH) have been widely reported. Its higher expressivity among women, elderly and least educated groups has been partly attributed to differences in their health perceptions. However, this subjectivity may be masking the burden of mental illness in these groups. Thus, we sought to understand if depression symptoms mediate inequalities in SRH. Methods SHARE waves 4 and 6, pertaining to Spain, Italy and Portugal, were used (n(2011) = 8517, n(2015) = 11 046). Inequalities in SRH were calculated, comparing the risk amongst education level, gender and age groups, adjusting for chronic diseases, functional limitations and country fixed effects. We then tested depression symptoms as mediators. Results Depression symptoms were associated with poor SRH (odds ratio (OR)(2011) = 1.379, OR2015 = 1.384, P < 0.001). Their inclusion reduced the magnitude of the association between SRH and education, annulled the statistical significance for age, and reversed the gender effect. As expected, chronic diseases and functional limitations remained significant predictors of poor SRH. Conclusions Depression symptoms, together with chronic diseases and functional limitations, explain the poorer SRH of the least educated, female and older groups in the Southern European population. Therefore, tackling inequalities in SRH must require focusing on mental health issues, which disproportionately affect the most vulnerable groups.

Language: English

Type (Professor's evaluation): Dissemination

No. of pages: 8