Journal
SOCIAL SCIENCE & MEDICINE
Volume 237, Issue -, Pages -Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2019.112454
Keywords
Central and Eastern Europe; Cohort study; Comparative study; Depressive symptoms; Depression; England; Neighbourhoods; Social cohesion
Funding
- European Commission [667661]
- Ageing Population: Determinants, Policies and Interventions in European Cities
- Primus Research Programme [247054]
- Charles University
- Russian grant RFBR [19-013-00681]
- RAS budget [0324-2018-0001]
- US National Institute on Aging and a consortium of UK government departments, including the Department for Work and Pensions and the Department of Health
- Wellcome Trust [064947, 081081]
- MacArthur Foundation 'MacArthur Initiative on Social Upheaval and Health' [712058]
- US National Institute on Aging [ROl AG23522-01]
- ESRC [ES/S008349/1] Funding Source: UKRI
- MRC [MR/N01104X/1, MR/N01104X/2, G1001799] Funding Source: UKRI
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Rationale: Two gaps in the literature arise on the relationship between social cohesion and depressive disorders. Firstly, there is a lack of studies comparing countries with diverse communal bonds and population-level differences in depression. Secondly, most work on explanatory mechanisms has overwhelmingly focussed on social network and social support pathways. Objectives: We compared the prospective association between perceived neighbourhood social cohesion and depressive symptoms among older adults in England, the Czech Republic, Poland and Russia; and examined whether psychological and health behavioural pathways mediated this association. Methods: Harmonized data on 26,081 adults from the English Longitudinal Study of Ageing (ELSA), and the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) studies were analysed. Prospective associations between perceived neighbourhood social cohesion at baseline and depressive symptoms at follow-up were assessed using multivariable negative binomial regression. The psychological (through control of life, and control at home) and health behavioural (through smoking and drinking) pathways were tested using path analysis. Results: Low cohesion predicted a higher number of depressive symptoms at follow-up among English (b = 0.106, p = 0.001), Czech (b = 0.203, p < 0.001), Polish (0.115, p < 0.001) and Russian adults (b = 0.087, p < 0.001). Indirect effects via psychological mechanisms were strong and explained 64% (Poland), 82% (Russia), 84% (England) and 95% (Czech Republic) of the total indirect effects from low cohesion to elevated symptoms in these populations. Indirect effects via health behaviours were much weaker by comparison. Conclusions: Prospective associations between low social cohesion and increased depressive symptoms were largely congruent among older adults from England and three Central and Eastern European countries. These associations operated via a psychological, but not a health behavioural, pathway among ageing adults living in diverse parts of Europe.
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