Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore

Abstract

Objectives: Neighborhood socioeconomic status (SES) can be associated with depression. We aimed to assess prevalence of depression amongst community-dwelling elderly in a multiethnic, urban, low-SES, Asian neighborhood, comparing against a higher SES neighborhood.Method: The study population involved all residents aged ≥60 years in two Singaporean housing estates comprising owner-occupied public housing (higher SES) and public rental housing (low SES) in 2012. Having lifetime prevalence of depression was defined as having a score ≥5 on the Geriatric Depression Scale-15 or a history of depression. Demographic/clinical details were collected via questionnaire. Those with depression were referred to local polyclinics. Multilevel multivariate logistic regression determined predictors of depression and depression screening.Results: Participation was 61.5% (559/909). In the low-SES community, 26.2% (104/397) had depression, compared with 14.8% (24/162) in the higher SES community. After adjusting for other sociodemographic variables, staying in a low-SES community (public rental housing) was independently associated with depression [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) = 1.02–2.84]. Within the low-SES community, not being married (aOR = 2.27, CI = 1.35–3.70), falls (aOR = 2.72, CI = 1.59–4.67), visual impairment (aOR = 2.37, CI = 1.28–4.39), and poorer social network (aOR = 3.70, CI = 1.96–7.14) were associated with depression.Conclusion: Residing in a low-SES community was independently associated with depression after controlling for individual SES.

Keywords:

• depression
• socioeconomic status
• neighborhood
• Asia

Acknowledgements

We thank the Neighborhood Health Screening Organising Committee 2012, Saw Swee Hock School of Public Health, Health Promotion Board, Southwest Community Development Council, Taman Jurong Community Centre, Macpherson Community Centre, SingHealth Polyclinic (Geylang), and National Healthcare Group Polyclinic (Jurong) organizations for providing the non-financial resources to organize this program and for supporting this study.

Additional information

Funding

The Saw Swee Hock School of Public Health provided funding support for the purchasing of medical consumables.