Association between socioeconomic welfare and depression among older adults: Evidence from the China health and Retirement Longitudinal Study

This study aims to examine the association between province-level socioeconomic welfare factors and depression symptoms among older adults in China. Province-level socioeconomic characteristics were merged with microdata for respondents over 65 years from the 2018 China Health and Retirement Longitudinal Study (CHARLS) Wave 4 (N = 6657). Principal component analysis (PCA) was used to extract three socioeconomic welfare factors constructed from 14 province-level variables. A Bayesian mixed-effects logistic model was applied to measure the association between the three socioeconomic welfare factors and depression symptoms while controlling for socio-demographic variables. The PCA showed that economic welfare, medical resource welfare, and social service welfare together explained 72.2 percent of the total variance of the 14 province-level variables. It was found that increasing economic welfare was significantly associated with a lower probability of depression symptoms (OR = 0.806, 95%CI: [0.674, 0.967]), while medical facilities were associated with a higher probability of depression symptoms (OR = 1.181, 95%CI: [1.029, 1.354]) among Chinese older adults. Uncertainty existed as to whether having access to social welfare (OR = 0.941, 95%CI: [0.835, 1.060]) was associated with prevalence of depression. Thus, improved socioeconomic welfare systems for older adults (which possibly require an increase in spending) are necessary to contribute further to reduced depression risk in China. Policymakers should also improve the utilization of medical resources to mitigate the incidence of depression among the elderly in China.