Is a Change in Perception of Socioeconomic Status Related to the Economy Associated with Depression?
Katzenstein Frankel, Miriam
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Background: Socioeconomic status (income, education and occupation) can be measured subjectively via a self-report instrument. Recently, subjective socioeconomic status (SES) has shown to be more predictive of negative health and cardiac outcomes than objective SES. Cardiovascular disease (CVD) is associated with high morbidity and mortality rates in the U.S. Negative associations between CVD and SES are well established. Economic strain is another risk factor associated with CVD. Subjective socioeconomic differences related to the recent economic recession have been explored minimally as it relates to economic strain and depression. Aims: The current study examines the change in subjective SES related to the economic recession, and economic strain as it relates to depression within a cardiovascular and community sample. Methods: Cardiac participants were recruited from a cardiovascular disorders clinic (n = 29) at a New York area hospital from 2010-2012, and through an online snowball community sampling (n = 39). Subjective SES was assessed using the MacArthur Scale of Subjective Social Status ladder adapted to examine perceived change in SES related to the economic downturn. Economic strain was assessed using the Economic Strain Model (Pearlin, 1981), and the Center for Epidemiological Studies-Depression Scale (CES-D) was used to measure depressive symptoms (Radloff, 1977). Results: There were significant correlations between economic strain and depression (CESD) (r = -.34; p = .036), and economic strain and SES perception (r = -.32; p = .045) for the cardiac sample. Mediation analysis suggested a link between these variables within a cardiac sample with significant effects between SES change and economic strain (a = -1.97, SE = .741, p = .03) and total effect of SES change and depression (c = 2.13, SE = .29,p = .04). Results were not significant for a direct effect between SES change and depression with economic strain as mediator (c' = 1.51, SE = 1.28, p =.34). Conclusions: These results support growing evidence that economic strain is associated with more depressive symptoms related to economic crisis in CVD patients, and further our understanding of economic downturns and their effects on socioeconomic status and depression within a cardiac population.