Effect of income inequality, community infrastructure and individual stressors on adult depression.

This paper considers the impact of variables at three different levels-city, community and individual-on the depression of adults aged 45 years and above in China. Evidence shows that community factors, such as infrastructure and elderly centres, are critical to reduce depression but the effect of city-level factors such as lowering income inequality and improving public health investment is different for the segments of poor and non-poor as well as the rural and urban residents. This highlights the need to consider targeted policy mix options to avoid resource misallocation. Lastly, Chinese females' depression has worsened over time with ageing, particularly those who drink alcohol or are less educated are prone to depression prompting the need for specialist women health centres.

How do different chronic condition comorbidities affect changes in depressive symptoms of middle aged and older adults?

BACKGROUND: Different types of chronic condition comorbidities can have dissimilar effects on the improvements or deterioration of mental health in older adults. This study aims to examine the impacts of different types of chronic conditions on inter-temporal trends of depressive symptoms. METHODS: Data on 11,457 adults from age 45 in the China Health and Retirement Longitudinal Study (CHARLS) 2011-2015 were used to estimate the prevalence of comorbidities. We used latent class analysis to identify patterns of how depressive symptoms changed over time, then estimated the odds ratios of worsening or improved levels of depression by types of chronic conditions. RESULTS: Prevalence of depression differed by types of chronic condition comorbidities. Dyslipidemia, asthma, liver disease, kidney disease, stomach or other digestive disease, and arthritis or rheumatism were significant risk factors for worsening of depressive symptoms over time among people with low levels of depressive symptoms at baseline. Among people with higher levels of depression at baseline, arthritis, stroke, digestive, and memory-related diseases were risk factors for not improving. LIMITATIONS: Findings are unlikely to be generalizable to subpopulations with severe levels of physical or mental disabilities as they are unlikely to be captured in the surveys. CONCLUSIONS: Given these specific physical health conditions' effects on mental health, clinicians can consider patients' mental health in their repertoire with regards to particular diseases.