Individual and area-level socioeconomic status and their association with depression amongst community-dwelling elderly in Singapore.

OBJECTIVES: Neighborhood socioeconomic status (SES) can be associated with depression. We aimed to assess prevalence of depression amongst community-dwelling elderly in a multiethnic, urban, low-SES, Asian neighborhood, comparing against a higher SES neighborhood. METHOD: The study population involved all residents aged ≥60 years in two Singaporean housing estates comprising owner-occupied public housing (higher SES) and public rental housing (low SES) in 2012. Having lifetime prevalence of depression was defined as having a score ≥5 on the Geriatric Depression Scale-15 or a history of depression. Demographic/clinical details were collected via questionnaire. Those with depression were referred to local polyclinics. Multilevel multivariate logistic regression determined predictors of depression and depression screening. RESULTS: Participation was 61.5% (559/909). In the low-SES community, 26.2% (104/397) had depression, compared with 14.8% (24/162) in the higher SES community. After adjusting for other sociodemographic variables, staying in a low-SES community (public rental housing) was independently a ssociated with depression [adjusted odds ratio (aOR) = 1.68, 95% confidence interval (CI) = 1.02-2.84]. Within the low-SES community, not being married (aOR = 2.27, CI = 1.35-3.70), falls (aOR = 2.72, CI = 1.59-4.67), visual impairment (aOR = 2.37, CI = 1.28-4.39), and poorer social network (aOR = 3.70, CI = 1.96-7.14) were associated with depression. CONCLUSION: Residing in a low-SES community was independently associated with depression after controlling for individual SES.

Factors influencing the decision to pursue emergency medicine as a career among medical students in Singapore.

INTRODUCTION: The introduction of the residency programme in Singapore allows medical students to apply for residency in their graduating year. Our study aimed to determine the interest levels and motivating factors for pursuing emergency medicine (EM) as a career among medical students in Singapore. METHODS: A self-administered questionnaire was distributed to Year 1-5 medical students in 2012. Participants indicated their interest in pursuing EM as a career and the degree to which a series of variables influenced their choices. Influencing factors were analysed using multinomial logistic regression. RESULTS: A total of 800 completed questionnaires were collected. 21.0% of the participants expressed interest in pursuing EM. Perceived personality fit and having done an elective in EM were strongly positive influencing factors. Junior medical students were more likely to cite the wide diversity of medical conditions and the lack of a long-term doctor-patient relationship to be negative factors, while senior medical students were more likely to cite personality fit and perceived prestige of EM as negative factors. CONCLUSION: Careful selection of EM applicants is important to the future development of EM in Singapore. Our study showed that personality fit might be the most important influencing factor in choosing EM as a career. Therefore, greater effort should be made to help medical students explore their interest in and suitability for a particular specialty. These include giving medical students earlier exposure to EM, encouraging participation in student interest groups and using appropriate personality tests for career guidance.