The short- and long-term effects of the Great Recession on late-life depression in Europe: The role of area deprivation

• Published in: Social science & medicine (1982) Vol. 294; p. 114697
• Main Author: Aretz, Benjamin
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-02-2022; Pergamon Press Inc
• Subjects: Aged; Area deprivation; Built environment; Depression - epidemiology; Depression - psychology; Deprivation; Deprived areas; Disadvantaged; Economic crisis; Economic Recession; Effects; EURO-D; Europe - epidemiology; Fixed effects estimation; Great Recession; Health disparities; Humans; Inequality; Late-life depression; Long term; Mental depression; Mental Health; Mental health services; Middle Aged; Older people; Panel data; Recessions; SHARE; Short term; Socioeconomic Factors; Spain - epidemiology; Unemployment; Unemployment - psychology; Europe; Spain; Area deprivation; Fixed effects estimation; Late-life depression; EURO-D; Great recession; SHARE; Economic crisis
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2021.114697

The prevalence of depression increases in times of economic crises. Less is known about whether people living in advantaged or disadvantaged areas suffer equally from negative effects of crisis.
To explore the role of area deprivation on the short- and long-term effects of the Great Recession in Europe on late-life depression.
Individual panel data from Austria, Belgium, Denmark, France, Germany, Italy, Spain, Sweden, Switzerland of the SHARE (age 50+, n = 6866) between 2004 and 2017 were used. Late-life depression (LLD) was measured by the EURO-D scale (4+ symptoms). Area deprivation was assessed by a country-specific z-standardized scale measuring perceived access to various services and quality of the social and built environment. Quarterly country-level GDP and yearly unemployment data were explored to define country-specific durations of the Great Recession. Individual fixed effects panel regressions were estimated controlling for time-varying socioeconomic and health-related confounders.
Prevalence and incidence of late-life depression was generally higher in deprived than in non-deprived areas, and these differences in prevalence and incidence increased during the Great Recession. Regressions showed that the Great Recession was related to a 23% higher long-term risk of late-life depression (OR: 1.23, CI: 1.05–1.44) for all study participants. In the short-term of the Great Recession, people from deprived areas had a 22% higher risk of late-life depression (OR: 1.22, CI: 1.02–1.46) than people from non-deprived areas.
The findings suggest that older adults exposed to adverse area determinants suffer more from the negative short-term effects of a severe economic crisis on depression and mental health inequalities may have increased between people living in deprived versus non-deprived areas. This potential increase in mental health inequalities warrants particular attention for those people living in deprived areas.
•Living environment is important in older ages but its role during crises is unknown.•Great Recession is related to a generally higher risk of depression in the long run.•People from deprived areas suffered more from the short-term effects on depression.•Better area quality is important to avoid increasing mental health inequalities.