Abstract
BackgroundMental health inequality along the economic strata is prominent in South Korea, particularly as intergenerational material transfer is becoming increasingly important in gaining economic status. Therefore, this study aimed to investigate the relationship between current and childhood economic status and depressive symptoms in adults aged 20 or above.MethodsThis study used data from the Korean Welfare Panel Study (KOWEPS), 2010 to 2013. A total of 9,645 individuals aged 20 years or above without depressive symptoms in 2010 were analyzed. The effect of childhood and current economic status, categorized into low, middle, and high groups, on depressive symptoms was investigated using hierarchical logistic regression models. Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 11) scale. Subgroup analysis was performed based on education level.ResultsCompared to the middle current-middle childhood economic status group, the low-low group (OR: 1.88, CI: 1.61-2.20), low-middle group (OR: 1.68, CI: 1.43-1.98), and low-high group (OR: 1.64, CI: 1.34-2.01) were more likely to have depressive symptoms. The high-low group (OR: 0.68, CI: 0.55-0.84), high-middle group (OR: 0.67, CI: 0.56-0.81), and high-high group (OR: 0.45, CI: 0.27-0.75) were less likely to have depressive symptoms. This trend was generally maintained with regard to education level, but the effects were not statistically significant in the high current economic status groups among participants with a university degree or above.ConclusionLow current economic status was associated with a higher likelihood of depressive symptoms. In particular, the low current-low childhood economic status group showed the highest likelihood of depressive symptoms, suggesting the adverse mental health effects of prolonged poverty. Therefore, the findings reveal that mental health inequalities are present along the economic strata and require proper addressing of the mental health of lower income individuals.
Highlights
Mental health inequality along the economic strata is prominent in South Korea, as intergenerational material transfer is becoming increasingly important in gaining economic status
Higher proportions of individuals with depressive symptoms can be seen in the low current economic status group categories, followed by the middle and high current economic status group categories
The low current-low childhood economic status group had the highest percentage of individuals with depressive symptoms (33.1 %) whereas the high current-high childhood economic status group had the lowest percentage of individuals with depressive symptoms (4.0 %)
Summary
Mental health inequality along the economic strata is prominent in South Korea, as intergenerational material transfer is becoming increasingly important in gaining economic status. Depression is an important public health problem predicted to become the most common cause of disability internationally by 2020 [1]. It is a noticeable burden to disability-adjusted life years (DALYs) in South Korea and has been ranked as one of its top leading causes [2]. Depression is significant as the prevalence of major depressive disorder has persistently increased from 4.2 % in 2001 to 6.7 % in 2011 in South Korea [3]. South Korea ranks first among the Organization for Economic Cooperation and Development (OECD) countries in suicide rate and suicide is the fourth leading cause of mortality [6].
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