Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study

The association between lifestyle risk score and mental health in Iranian overweight and obese women: a cross-sectional study

Background

Since evidence on the relationship between a combination of lifestyle factors and mental health in the Iranian population is limited, this study employed a cross-sectional design which is a quick and low-cost method to provide more information on the potential association between lifestyle and mental health. This study addresses this gap by focusing on Iranian overweight and obese women.

Methods

This cross-sectional study analyzed 278 Iranian overweight and obese women. A multistage random sampling method was used to recruit the participants. The lifestyle risk score (LRS) was created based on diet, physical activity (PA), sleep, obesity, and sociodemographic characteristics. Multinomial logistic regression analysis was used to evaluate the association between LRS and the odds of depression, anxiety, and stress. Participants were assigned a score of 0 for each healthy behavior and a score of 1 for each unhealthy behavior. A higher LRS indicates an unhealthier lifestyle. A binary logistic regression analysis was used to examine LRS and the stress and depression anxiety stress scale (DASS).

Results

Significant positive associations between high LRS and moderate and severe depression were found (p < 0.05). Furthermore, there were significant positive associations between higher LRS and mild and extremely severe stress (p < 0.05).

Conclusion

This is the first study that examined associations between LRS and total DASS-21 and demonstrated that participants with lower LRS had lower levels of depression and stress. This study highlights the crucial role of healthy lifestyle choices in psychological wellbeing. These findings inform the design of interventions to address mental health disorders in Iran. Further prospective studies, including a larger sample size of both genders, are needed to expand our understanding of lifestyle scores' associations with mental health.

The Impact of Socioeconomic Inequality on Mental Health among Adolescents in Qazvin, Iran: Blinder-Oaxaca Decomposition Method

Background

Mental health is integral to public health in adolescents. Although previous studies have shown that low socioeconomic status (SES) is associated with mental disorders (MD), it is unclear which mental health domains are most important. Thus, our study aimed to investigate the associations between 5 domains of mental disorder and SES inequality in adolescents.

Methods

We conducted a cross-sectional study among adolescents (N = 1724). Associations between SES inequality with mental disorders, such as emotional symptoms, conduct problems, hyperactivity, peer relationship problems, and prosocial behavior, were examined. We used the concentration index (CI) to determine inequality. The gap between the low and high socioeconomic groups was decomposed into its determinants using the Blinder-Oaxaca decomposition method.

Results

Mental health's overall CI was -0.085 (P ˂ 0.001). The emotional problem was primarily caused by SES inequality (-0.094 [P = 0.004]). Decomposition of the gap between the 2 economic groups showed that physical activity, school performance, exercise, parents' smoking status, and gender were the most important determinants of inequality.

Conclusion

SES inequality plays a vital role in adolescents' mental health. It seems that the emotional problem domain of mental health might be more amenable to interventions than other domains.

Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults

BACKGROUND

Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety.

METHODS

The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality.

RESULTS

The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality.

CONCLUSION

Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.