Socioeconomic status and the risk of major depression: the Canadian National Population Health Survey
- 1Departments of Psychiatry and of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
- 2Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- 3Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario Canada
- Correspondence to JianLi Wang, Faculty of Medicine, University of Calgary, Room 127, Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1;
Contributors The first author accepts full responsibility for the work and/or the conduct of the study, had access to the data and controlled the decision to publish.
- Accepted 22 July 2009
- Published Online First 13 August 2009
Background There are few longitudinal studies investigating the risk of major depression by socioeconomic status (SES). In this study, data from the longitudinal cohort of Canadian National Population Health Survey were used to estimate the risk of major depressive episode (MDE) over 6 years by SES levels.
Methods The National Population Health Survey used a nationally representative sample of the Canadian general population. In this analysis, participants (n=9589) were followed from 2000/2001 (baseline) to 2006/2007. MDE was assessed using the Composite International Diagnostic Interview—Short Form for Major Depression.
Results Low education level (OR=1.86, 95% CI 1.28 to 2.69) and financial strain (OR=1.65, 95% CI 1.19 to 2.28) were associated with an increased risk of MDE in participants who worked in the past 12 months. In those who did not work in the past 12 months, participants with low education were at a lower risk of MDE (OR=0.43, 95% CI 0.25 to 0.76), compared with those with high education. Financial strain was not associated with MDE in participants who did not work. Working men who reported low household income (12.9%) and participants who did not work and reported low personal income (5.4%) had a higher incidence of MDE than others.
Conclusions SES inequalities in the risk of MDE exist in the general population. However, the inequalities may depend on measures of SES, sex and employment status. These should be considered in interventions of reducing inequalities in MDE. MDE history is an important factor in studies examining inequalities in MDE.
- Socioeconomic status
- major depression
- population-based longitudinal study
- employment status
- cohort ME
- employed CG
- health status ME
Funding Other funders: This study was supported by a grant from the Canadian Institutes of Health Research (CIHR). JLW holds a CIHR New Investigator award. CD is a recipient of the CIHR/PHAC Applied Public Health Chair.
Competing interests None.
Ethics approval This study was conducted with the approval of the Conjoint Health Research Ethics Board of the University of Calgary.
Provenance and peer review Not commissioned; externally peer reviewed.