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State-Level Income Inequality and County-Level Social Capital in Relation to Individual-Level Depression in Middle-Aged Adults: A Lagged Multilevel Study

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  • Saloni Dev

    (Department of Health Sciences, Northeastern University, Boston, MA 02115, USA)

  • Daniel Kim

    (Department of Health Sciences, Northeastern University, Boston, MA 02115, USA)

Abstract

In the US, the incidence of depression and suicide have followed escalating trends over the past several years. These trends call for greater efforts towards identifying their underlying drivers and finding effective prevention strategies and treatments. One social determinant of health that plausibly influences the risk of depression is income inequality, the gap between the rich and poor. However, research on this association is still sparse. We used data from the National Longitudinal Survey of Youth 1979 and the US Census to investigate the multilevel lagged associations of state-level income inequality with the individual-level odds of depression in middle-aged adults, controlling for state- and individual-level factors. We also examined the independent associations of county-level social capital with depression and explored whether it mediated the income inequality relationship. Higher income inequality at the state level predicted higher odds of individual-level depression nearly 2 decades later [OR for middle vs. lowest tertile of income inequality = 1.35 (95% CI: 1.02, 1.76), OR for highest vs. lowest tertile = 1.34 (95% CI: 1.01, 1.78)]. This association was stronger among men than women. Furthermore, there was evidence that county-level social capital independently predicted depression and that it mediated the income inequality association. Overall, our findings suggest that policies attenuating levels of income inequality at the US state level and that leverage social capital may protect against one’s likelihood of developing depression.

Suggested Citation

  • Saloni Dev & Daniel Kim, 2020. "State-Level Income Inequality and County-Level Social Capital in Relation to Individual-Level Depression in Middle-Aged Adults: A Lagged Multilevel Study," IJERPH, MDPI, vol. 17(15), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:15:p:5386-:d:390235
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    References listed on IDEAS

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    1. Daniel Kim & Beth Ann Griffin & Mohammed Kabeto & José Escarce & Kenneth M Langa & Regina A Shih, 2016. "Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
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    4. Kawachi, I. & Kennedy, B.P. & Lochner, K. & Prothrow-Stith, D., 1997. "Social capital, income inequality, and mortality," American Journal of Public Health, American Public Health Association, vol. 87(9), pages 1491-1498.
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    6. Ichida, Yukinobu & Kondo, Katsunori & Hirai, Hiroshi & Hanibuchi, Tomoya & Yoshikawa, Goshu & Murata, Chiyoe, 2009. "Social capital, income inequality and self-rated health in Chita peninsula, Japan: a multilevel analysis of older people in 25 communities," Social Science & Medicine, Elsevier, vol. 69(4), pages 489-499, August.
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