Linking socioeconomic status to depressive symptoms in aging populations – Nature

Report on the Link Between Socioeconomic Status and Late-Life Depressive Symptoms in Aging Populations

Introduction and Alignment with Sustainable Development Goals (SDGs)

Late-life depressive symptoms represent a significant global health challenge, directly impacting the achievement of Sustainable Development Goal 3 (Good Health and Well-being). This issue is particularly acute among older adults facing persistent socioeconomic disadvantages, highlighting a critical intersection with SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities). This report summarizes a study that examines how socioeconomic status (SES) across the entire life course predicts the incidence of depressive symptoms in later life. The research integrates dynamic SES trajectories, psychosocial mechanisms, and cultural contexts to provide a comprehensive understanding of the social determinants of mental health among aging populations, thereby informing strategies to advance the 2030 Agenda for Sustainable Development.

Methodology

The study utilized harmonized longitudinal data from six global aging cohorts, reflecting a commitment to SDG 17 (Partnerships for the Goals) through international data collaboration. The total sample size was 64,479 participants.

• Data Sources:
  1. Health and Retirement Study (HRS)
  2. China Health and Retirement Longitudinal Study (CHARLS)
  3. Survey of Health, Ageing and Retirement in Europe (SHARE)
  4. English Longitudinal Study of Ageing (ELSA)
  5. Mexican Health and Aging Study (MHAS)
  6. Korean Longitudinal Study of Aging (KLoSA)
• Analytical Approach:
  • A moderated chain mediation model was employed to test the indirect effects of frailty and social activity, as well as the buffering role of family support.
  • Cross-lagged panel network analysis was used to explore symptom-level directional associations over time.

Key Findings and SDG Implications

The results demonstrate a consistent link between socioeconomic advantage and improved mental health, with significant implications for several SDGs.

1. Socioeconomic Status and Mental Health: Higher childhood SES, higher adult SES, and trajectories of stable high or upward SES mobility were consistently associated with a lower risk of developing late-life depressive symptoms. This finding directly illustrates how progress on SDG 1 and SDG 10 is fundamental to achieving the mental health targets of SDG 3.
2. Mediating Social and Health Pathways: The association between SES and depression was partially mediated by frailty and reduced social activity. This indicates that socioeconomic disadvantage contributes to poor physical health and social isolation, which in turn increases depression risk. Addressing these pathways is crucial for creating inclusive communities (SDG 11) and promoting well-being for all ages (SDG 3).
3. The Role of Social Support: Family support was found to moderate the pathway between frailty and depressive symptoms, acting as a key protective buffer. This highlights the importance of strengthening social support systems as a culturally embedded strategy to enhance resilience and mental health.
4. Gender-Specific Disparities: Subgroup analysis revealed that SES protection was stronger among men. Conversely, stable middle SES was more beneficial for women. This underscores the need for gender-sensitive policies to achieve SDG 5 (Gender Equality) by addressing the unique socioeconomic vulnerabilities that impact the mental health of women and men differently.
5. Global and Regional Differences: Network analysis showed that the temporal effects of adult SES on depressive symptoms were particularly pronounced in low- and middle-income countries, emphasizing the urgent need to reduce inequalities (SDG 10) in these regions to prevent widening mental health gaps.

Conclusion and Policy Recommendations for Achieving SDGs

Socioeconomic advantage accumulated across the lifespan provides significant protection against late-life depressive symptoms, primarily through psychosocial pathways. Culturally embedded factors, such as family support, are critical buffers against health-related stressors.

• To advance the SDGs, policies must be integrated, equity-focused, and culturally sensitive.
• Strategies should combine poverty reduction (SDG 1) and the reduction of inequalities (SDG 10) with public health initiatives aimed at promoting mental health and well-being (SDG 3).
• Interventions should focus on strengthening social pathways, such as promoting social activity and leveraging family support systems, to build resilient and healthy aging populations.
• A life course approach is essential, recognizing that investments in childhood and adult socioeconomic conditions yield long-term benefits for mental health in later life.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on late-life depressive symptoms and socioeconomic status (SES) connects to several Sustainable Development Goals (SDGs) by focusing on the intersection of health, inequality, and social factors across the lifespan.

• SDG 3: Good Health and Well-being: The primary focus of the article is on mental health, specifically “late-life depressive symptoms,” which it identifies as a “pressing global health issue.” The entire study is dedicated to understanding the determinants of mental health in aging populations, directly aligning with the goal of ensuring healthy lives and promoting well-being for all at all ages.
• SDG 10: Reduced Inequalities: The article’s central theme is the inequality in health outcomes based on economic status. It explicitly examines how “persistent socioeconomic disadvantages,” “childhood SES, adult SES and SES mobility” create disparities in the risk of depression. By analyzing data from low-, middle-, and high-income countries and finding consistent associations, it highlights global inequalities in mental health. The call for “equity-focused” strategies reinforces this connection.
• SDG 1: No Poverty: While the article uses the term “socioeconomic status,” this is directly related to poverty. The finding that lower childhood and adult SES are risk factors for depression demonstrates the long-term health consequences of living with economic disadvantages. Addressing poverty, especially in early life, is implied as a crucial step to mitigate these health risks.
• SDG 5: Gender Equality: The article includes a “subgroup analysis” that reveals gender-specific differences in how SES affects mental health. It states that there is “stronger SES protection among men, with stable middle SES benefiting women more.” This finding points to gender-based disparities in health and well-being, highlighting that the social and economic determinants of health affect men and women differently.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, the following specific SDG targets are relevant:

1. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Explanation: The article directly addresses the promotion of mental health by investigating the risk factors for “late-life depressive symptoms.” Its findings on the protective role of high SES, social activity, and family support contribute to understanding how to prevent poor mental health in aging populations.
2. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • Explanation: The study demonstrates how economic status across the lifespan leads to unequal health outcomes among older adults. It shows that individuals with “persistent socioeconomic disadvantages” are at a higher risk of depression, indicating a failure of social and economic systems to protect the well-being of all, irrespective of their economic status or age.
3. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.
   • Explanation: The differing risk of depression based on SES is a clear “inequality of outcome.” The article’s conclusion that “socioeconomic advantage across the lifespan protected against late-life depressive symptoms” underscores the need for policies that ensure socioeconomic factors do not determine health outcomes.
4. Target 1.2: By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions.
   • Explanation: The article’s emphasis on the detrimental, long-term impact of low “childhood SES” on adult mental health implies that reducing childhood poverty is a critical strategy for improving population health later in life. Low SES is a key dimension of poverty, and its link to depression highlights the non-monetary costs of poverty.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

The article mentions or implies several indicators that can be used to measure progress towards these targets:

• Incidence of depressive symptoms: The study’s primary outcome is “incident depressive symptoms” among older adults. This is a direct indicator for monitoring mental health and well-being under Target 3.4.
• Health outcomes disaggregated by socioeconomic status: The core of the analysis is the comparison of depression risk across different SES groups (“childhood SES, adult SES and SES mobility”). Measuring the prevalence of mental health conditions stratified by income, education, or other SES metrics serves as a powerful indicator for Target 10.3, tracking inequalities of outcome.
• Health outcomes disaggregated by sex: The “subgroup analysis” by sex provides a clear indicator for SDG 5. Tracking the differential impact of SES on depression for men and women can measure progress in reducing gender-based health disparities.
• Levels of social support and activity: The article identifies “reduced social activity” as a mediator and “family support” as a buffer. The prevalence of social engagement and the availability of family or community support systems can be used as indicators of a supportive environment for mental well-being, relevant to Target 3.4 and 10.2.
• Prevalence of frailty: Frailty is identified as a key mediator between SES and depression. The prevalence of frailty in aging populations, particularly among low-SES groups, can serve as an indicator of overall health vulnerability and inequality.

4. Table of SDGs, Targets, and Indicators

Source: nature.com