Does Social Support Affect the Relationship between Socioeconomic Status and Depression? A Longitudinal Study from Adolescence to Adulthood

National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, FIN-00300 Helsinki, Finland.
Journal of Affective Disorders (Impact Factor: 3.38). 07/2007; 100(1-3):55-64. DOI: 10.1016/j.jad.2006.09.019
Source: PubMed


The aim of this prospective longitudinal study of adolescents was to investigate socioeconomic differences in adult depression and in the domain of social support from adolescence to adulthood. We also studied the modifying effect of social support on the relationship between socioeconomic status (SES) and depression.
All 16-year-old ninth-grade school pupils of one Finnish city completed questionnaires at school (n=2194). Subjects were followed up using postal questionnaires when aged 22 and 32 years.
At 32 years of age there was a social gradient in depression, with a substantially higher prevalence among subjects with lower SES. Low parental SES during adolescence did not affect the risk of depression at 32 years of age, but the person's lower level of education at 22 years did. Lower level of support among subjects with lower SES was found particularly in females. Some evidence indicated that low level of social support had a greater impact on depression among lower SES group subjects. However, this relationship varied depending on the domain of social support, life stage and gender. On the other hand, the results did not support the hypothesis that social support would substantially account for the variation in depression across SES groups.
The assessments and classifications of social support were rather brief and crude, particularly in adolescence and early adulthood.
It is important to pay attention to social support resources in preventive programs and also in the treatment settings, with a special focus on lower SES group persons.

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    • "to poor emotional support from relatives and friends ( Laitinen , Ek , and Sovio 2002 ) ; sibling or maternal ties attenuate the harmful effects of stressful life events on teen depression ( Gass et al . 2007 ; Ge et al . 2009 ; Waite et al . 2011 ) ; and among low - SES teens , low social support from parents increases risk for adult depression ( Huurre et al . 2007 ) . We submit that , for disadvantaged and geographically isolated rural teenagers , family ties may be especially crucial due to relative food insecurity , scarce employment opportunities , and limited child - care options , which can increase parental strain , sibling caregiving , and early adult role transitions for rural teens ( Bro"
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    ABSTRACT: In adolescence, vital sources of support come from family relationships; however, research that considers the health-related impact of ties to both parents and siblings is sparse, and the utility of such ties among at-risk teens is not well understood. Here we use two waves of panel data from the population of 8th and 12th grade students in a geographically isolated, rural, northeastern U.S. county to assess whether socioeconomic status (SES) moderates the effects of parental and sibling attachments on three indicators of adolescent health: obesity, depression, and problem substance use. Our findings indicate that, net of stressful life events, prior health, and sociodemographic controls, increases in parental and sibling attachment correspond with reduced odds of obesity for low-SES adolescents, reduced odds of depression for high-SES adolescents, and reduced odds of problem substance use for low-SES adolescents. Results suggest also that sibling and maternal ties are more influential than paternal ties, at least with regard to the outcomes considered. Overall, the findings highlight the value of strong family ties for the physical, psychological, and behavioral health of socioeconomically strained rural teens, and reveal the explanatory potential of both sibling and parental ties for adolescent health.
    Rural Sociology 12/2014; 80(1). DOI:10.1111/ruso.12055 · 1.89 Impact Factor
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    • "Common explanations for socioeconomic inequalities in anxiety and depression are that SES stratifies life stressors and coping resources [36, 37]. Adverse life events, poorer coping styles and weaker social support are examples of factors that are associated with disadvantaged SES and account for some of the socioeconomic variation in depression [37–39]. Although the incidence and persistence of symptoms were both stratified by SES in this study, it may not be the same resources and stressors that are responsible for these effects. "
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    ABSTRACT: Purpose Socioeconomic inequalities in anxiety and depression widen with increasing age. This may be due to differences in the incidence or persistence of symptoms. This paper investigates the widening of inequalities in anxiety and depression over the lifecourse. Methods Data were from the West of Scotland Twenty-07 Study, constituting three cohorts aged approximately 16, 36 and 56 years at baseline and re-visited at 5-yearly intervals for 20 years. Symptoms were measured using the Hospital Anxiety and Depression Scale. Adjusting for age and sex, multilevel models with pairs of interviews (n = 6,878) nested within individuals (n = 3,165) were used for each cohort to estimate associations between current symptoms and education or household social class for both those with and without earlier symptoms, approximating socioeconomic differences in incidence and persistence. Results Inequalities in current symptom levels were present for both those with and without earlier symptoms. In the youngest cohort, those with less education were more likely to experience persistent depression and to progress from anxiety to depression. At older ages there were educational and social class differences in both the persistence and incidence of symptoms, though there was more evidence of differential persistence than incidence in the middle cohort and more evidence of differential incidence than persistence in the oldest cohort. Conclusions Differential persistence and symptom progression indicate that intervening to prevent or treat symptoms earlier in life is likely to reduce socioeconomic inequalities later, but attention also needs to be given to late adulthood where differential incidence emerges more strongly than differential persistence.
    Social Psychiatry 06/2013; 48(12). DOI:10.1007/s00127-013-0720-0 · 2.54 Impact Factor
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    • "Only few studies have examined how socioeconomic factors might influence the association between social relations and health. In terms of potential moderating effects of SES on the association of social relations and health, a study by Knesebeck did not support the hypothesis of differential vulnerability [15], while Huure and colleagues found partial evidence [39]. Stronger evidence was found by Heritage and colleagues in a french study [40]. "
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    ABSTRACT: ABSTRACT: Social relations have repeatedly been found to be an important determinant of health. However, it is unclear whether the association between social relations and health is consistent throughout different status groups. It is likely that health effects of social relations vary in different status groups, as stated in the hypothesis of differential vulnerability. In this analysis we explore whether socioeconomic status (SES) moderates the association between social relations and health. In the baseline examination of the Heinz Nixdorf Recall study, conducted in a dense populated Western German region (N = 4,814, response rate 56%), SES was measured by income and education. Social relations were classified by using both structural as well as functional measures. The Social Integration Index was used as a structural measure, whilst functional aspects were assessed by emotional and instrumental support. Health was indicated by self-rated health (1 item) and a short version of the CES-D scale measuring the frequency of depressive symptoms. Based on logistic regression models we calculated the relative excess risk due to interaction (RERI) which indicates existing moderator effects. Our findings show highest odds ratios (ORs) for both poor self-rated health and more frequent depressive symptoms when respondents have a low SES as well as inappropriate social relations. For example, respondents with low income and a low level of social integration have an OR for a high depression score of 2.85 (95% CI 2.32-4.49), compared to an OR of 1.44 (95% CI 1.12-1.86) amongst those with a low income but a high level of social integration and an OR of 1.72 (95% CI 1.45-2.03) amongst respondents with high income but a low level of social integration. As reference group those reporting high income and a high level of social integration were used. The analyses indicate that the association of social relations and subjective health differs across SES groups as we find moderating effects of SES. However, results are inconsistent as nearly all RERI scores are positive but do not reach a significant level. Also moderating effects vary between women and men and depending on the indicators of SES and social relations used. Thus, the hypothesis of differential vulnerability can only partially be supported. In terms of practical implications, psychosocial and health interventions aiming towards the enhancement of social relations should especially consider the situation of the socially deprived.
    International Journal for Equity in Health 10/2011; 10(1):43. DOI:10.1186/1475-9276-10-43 · 1.71 Impact Factor
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