How Income Inequality and Race Concentrate Depression in Low-Income Women in the US; 2005-2016

Aim: To estimate the association between income and depressive symptoms in adult women, ages 20 years and older. Methods: Data for this study came from the 2005-2016 National Health and Nutrition Examination Survey (NHANES). We measured the presence of depressive symptoms by using a 9-item PHQ (Public Health Questionnaire, PHQ-9) and the Poverty to Income Ratio (PIR) as a proxy for income. We employed Negative Binomial Regression (NBRG) and logistic regression models in a sample of 11,420 women. We adjusted models by age, racial/ethnic groups, marital status, education, health insurance, comorbidity, and utilization of mental health professionals. We calculated the Gini Coefficient (GC) as a measure of income inequality, using PIR. Results: Between 2005 and 2016, 20.1% of low-PIR women suffered from depression (PHQ >= 10) compared with 12.0% of women in medium-PIR and 5.0% in high-PIR. The highest probabilities of being depressed were in Black Non-Hispanics (BNH) and Hispanics (12.0%), and then in White NH (WNH; 9.1%). The results of NBRG have shown that women in medium-PIR (0.90 [CI: 0.84-0.97]) and high-PIR 0.76 (CI: 0.70-0.82) had a lower incidence-rate ratio than women in low-PIR. The logistic regression results showed that income is protective in High-PIR groups (OR = 0.56, CI [0.43-0.73]). Conclusion: Policies to treat depression should prioritize the needs of low-income women of all racial groups and women.

Automated summary

The aim of this study was to estimate the association between income and depressive symptoms in adult women. The results showed that women with lower income had a higher risk of depression, and non-Hispanic Black and Hispanic women had the highest rates of depression among all racial/ethnic groups. After adjustment, women with medium and high income had lower incidence rates, and higher income was shown to be protective against depression.