Meaning of socioeconomic status for mental health of adolescents in East China

Determinants of depressive symptoms at individual, school and province levels: a national survey of 398,520 Chinese children and adolescents

OBJECTIVES

The aims of this study were to describe the national distribution of depressive symptoms in Chinese children and adolescents, to examine the determinants of depressive symptoms at individual, school and province levels and to assess the gender and age differences in the effect of school factors on depressive symptoms.

STUDY DESIGN

This was a national cross-sectional study.

METHODS

A school-based online survey was conducted in mainland China from between December 1, 2021, and January 1, 2022. A total of 398,520 eligible participants were included in the analysis. School-level data were drawn from students, headteachers and Baidu Maps, and province-level data were obtained from the national human development report. The Patient Health Questionnaire-2 was used to measure depressive symptoms.

RESULTS

Areas with the highest mean scores for depressive symptoms were in the northeastern, inner central and southwestern regions of China. At the individual level, younger age, male sex, being an only child, Han ethnicity, lower body mass index, more days of exercise, less drinking and smoking behaviours, higher subjective family socio-economic status (SES) and popularity in school were related to fewer depressive symptoms; however, objective family SES and maternal education were not related to fewer depressive symptoms. The school-level variables of public status, psychological activities and psychological courses and province-level variable of higher Human Development Index were associated with fewer depressive symptoms. The effect of psychological courses and activities on depressive symptoms was greater in females.

CONCLUSIONS

The results showed multilevel factors related to depressive symptoms and emphasised the importance of implementing school-based psychological activities to ameliorate depressive symptoms in Chinese children and adolescents across age and gender.

Intergenerational reproduction and self-assessed mental health in adulthood in China

Physical and mental health disparities by socioeconomic status in China are well documented but the effects of the intergenerational reproduction in socioeconomic status on adult mental health have received little attention to date. We utilized cross-sectional data from the 2017 Chinese General Social Survey to examine the significance of intergenerational socioeconomic reproduction for differences in self-assessed mental health in a national sample of Chinese adults between the ages of 23 and 65. We documented substantial elasticities between the socioeconomic status of the survey respondents and their parents: father's education, mother's education and childhood social class were all associated with both respondent education and respondent household income. We also found that associations between parental socioeconomic status and their adult children's self-assessed mental health were partly explained by the children's own socioeconomic status. However, these pathways were noticeably moderated by age cohort. Among younger people, associations between parental socioeconomic status and mental health were mostly explained by educational attainment whereas among older people associations between parental socioeconomic status and mental health were mostly explained by household income. In general, parental socioeconomic status appear to have a greater influence on the mental health of people who grew up after the Chinese economic reform of the 1970s.

Family socioeconomic status and adolescent depression in urban and rural China: A trajectory analysis

Background

Depression is increasingly prevalent among Chinese adolescents, with socioeconomic status (SES) serving as a significant predictor. Understanding the link between family SES and depression is of paramount concern. This study aimed to delineate the developmental paths of depressive symptoms among urban and rural Chinese adolescents, focusing on the influence of family SES on these trajectories.

Methods

Data from the China Family Panel Studies (CFPS) for 2012, 2016, and 2018 were used in this study. Participants were individuals aged 10 to 15 in the 2012 wave who also participated in the 2016 and 2018 waves (N = 1214). Family SES was measured by household income, parental education, and occupational status, while depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES-D) scale. Employing the Growth Mix Model (GMM) unveiled depression trajectories, while logistic regression scrutinized the impact of family SES on these trajectories.

Results

The study identified three depression trajectories in urban adolescents: high-decreasing, low-stable, and low-rising levels of depressive symptoms, and two depression trajectories in rural adolescents: high-decreasing and low-stable levels of depressive symptoms. On average, rural adolescents reported higher depression levels than urban peers. In urban areas, adolescents with higher maternal education and parental occupation were more likely to be classified in the low-stable trajectory, while in rural areas only maternal education had predictive power for depression trajectories.

Conclusions

Depression trajectories differ between urban and rural in China. Maternal education is an important factor influencing rural sample grouping. Targeted interventions could be implemented to reduce depression in adolescents.

Changes in mental health levels among Chinese physical education college students from 1995 to 2019

To explore the changes in the mental health levels of Chinese physical education college students, the present study conducted a cross-temporal meta-analysis of 43 papers that adopted the Symptom Checklist 90 (SCL-90) from 1995 to 2019. The results showed that the average scores of the seven SCL-90 factors were negatively correlated with the year of data collection. The socioeconomic indicators (GDP, per capita GDP and household consumption level) were significantly negatively correlated with the eight dimension scores of the SCL-90 (except for phobic anxiety). The mean effect sizes of the sex differences in the seven dimension scores (except depression and phobic anxiety) were lower than the small effect size. In conclusion, Chinese physical education college students' mental health levels have increased in the past 25 years. This phenomenon may be related to Chinese socioeconomic growth, the implementation of national sports policies, and the provision of mental health education for college students. In addition, although the increasing trend in the mental health level of female students was more obvious, there were no significant sex differences.

The association between healthcare needs, socioeconomic status, and life satisfaction from a Chinese rural population cohort, 2012–2018

This study aimed to examine the prevalence of unmet healthcare needs and clarify its impact on socioeconomic status (SES) and life satisfaction in a longitudinal cohort of the Chinese rural population. Data used in this study were obtained from a nationally representative sample of 1387 eligible rural residents from the Chinese Family Panel Studies. Generalized estimating equation (GEE) logistic regression models were used to examine the factors associated with unmet healthcare needs and the impact of unmet healthcare needs on respondents’ perceived SES and life satisfaction. Approximately 34.6% of respondents were male, 18.2% were ≤ 40 years, and 66.7% had completed primary education or below. Around 19% and 32.6% of individuals who healthcare needs were met reported an above average socioeconomic status and life satisfaction, respectively in the baseline survey. GEE models demonstrated that unmet healthcare needs were significantly associated with low perceived SES (Odds ratio = 1.57, p < 0.001) and life satisfaction (Odds ratio = 1.23, p = 0.03) adjusted by covariates. Respondents who were older, reported moderate or severe illness, and with chronic conditions were more likely to report the unmet healthcare needs.Unmet healthcare needs are longitudinally associated with low SES and life satisfaction among the Chinese rural population, the disparity in access to healthcare exists among this population.