Abstract
Given that public transportation networks are often worse in rural areas than in urban areas, it is difficult for elderly non-drivers to access health-promoting goods, services, and resources related to mental health. Moreover, geographical location, assessed by elevation, could modify this association in a rural area. The aim of this study was to test whether the association between car driving (being a driver or not) and depression, as measured by the Zung Self-Rating Depression Scale (SDS), varied by elevation. Data were collected from a cross-sectional study conducted in the town of Ohnan located in a rural area of Japan. After excluding participants with missing data (n = 26), 876 participants were analysed in this study. After adjustment for potential confounders, being a non-driver had a significantly higher odds ratio of SDS (40+) among elderly people living at a low elevation (odds ratio = 2.17, 95% confidence interval = 1.28–3.71). However, similar findings were not observed among elderly people living at a high elevation. These results suggest that car driving importantly predicts depression in elderly people living at relatively low elevations in rural areas.
Highlights
Depression is a significant contributor to the global burden of disease, and the world mental health survey conducted in 17 countries found that, on average, about 1 in 20 people reported having an episode of depression in the previous year [1]
The aim of this study was to test whether the association between car driving and depression varied by elevation in rural areas
Interaction effect between elevation and car driving on odds ratios (ORs) of Self-Rating Depression Scale (SDS) score (40+) was statistically significant (p = 0.041)
Summary
Depression is a significant contributor to the global burden of disease, and the world mental health survey conducted in 17 countries found that, on average, about 1 in 20 people reported having an episode of depression in the previous year [1]. Several risk factors have been indicated, including socio-economic factors (e.g., educational attainment), physical activity, and other health-related factors (e.g., activities of daily living, and current history of the disease) [2,3,4]. It is important to note that car driving could be considered a potential risk factor for depression in rural areas [5]. Given that public transportation networks are often worse in rural areas than in urban areas, elderly residents who do not drive can find it difficult to access health-promoting goods, services, and resources [5,6,7]. We hypothesised that elderly people who do not drive are more likely to. Public Health 2016, 13, 738; doi:10.3390/ijerph13070738 www.mdpi.com/journal/ijerph
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