Income inequality widens the existing income-related disparity in depression risk in post-apartheid South Africa: Evidence from a nationally representative panel study. (May 2017)

• Record Type: Journal Article
• Authors: Burns, Jonathan K.; Tomita, Andrew; Lund, Crick
• Is Part Of: Health & place. Volume 45(2017:May)
• Page Start: 10
• Page End: 16
• Publication Date: 2017-05
• Subjects: Income inequality -- Poverty -- Depressive symptoms -- South Africa; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2017.02.005
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: Aim: Income inequality (II) and poverty are major challenges in South Africa (SA) yet little is known about their interaction on population mental health. We explored relationships between district II, household income (HHI) and depressive symptoms in national panel data. Method: We used 3 waves (2008, 2010, 2012) of the SA National Income Dynamics Study (n=25936) in adjusted mixed effects logistic regression to assess if the relationship between HHI and depressive symptoms is dependent on level of II. Depressive symptoms were assessed with Centre for Epidemiologic Studies Depression scale, and District inequality ratios (P10P90) derived from HHI distributions in 53 districts. Results: Lower HHI and increasing II were associated with depressive symptoms. The interaction term between HHI and II on depressive symptoms was significant (β=0.01, 95% CI: <0.01-0.01); with increasing II and decreasing HHI, depression risk increased. Conclusion: II widens income-related disparities in depression risk in SA, with policy implications for understanding socioeconomic determinants of mental health and informing global efforts to reduce disparities in high poverty and inequality contexts. Highlights: Low household income is a risk factor for depression in South Africa (SA). Income inequality is a risk factor for depression in SA, a country with extreme levels of inequality. Income inequality widens the existing income-related disparity in depression risk in SA.