Luna Guajardo, Eliazar Andrés;
(2023)
Social determinants of depression and its association with all-cause mortality among Chilean adult population: Evidence from the Chilean National Health
Surveys (ENS).
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Depression is a prevalent mental health condition with many factors involved and a wide range of consequences. Most of the evidence is limited to a few high-income countries, therefore, this thesis aims to assess the association between social determinants and depressive symptoms, and the association between depressive symptoms and all-cause mortality in Chilean adult population. Methods: Data from the Chilean National Health Surveys (ENS) was used. For aim 1, the data was complemented with the Chilean Socioeconomic Characterisation Survey (CASEN) for measures of distal social determinants of deprivation and economic inequality. Multilevel logistic regression was used with proximal and distal social determinants as exposures and depressive symptoms, measured with CIDI-SF≥5, as outcome. For aim 2, the main exposure was depressive symptoms, and the outcome was all-cause mortality. Cox survival analysis was performed based on the 2003 and 2010 data, linked to mortality from administrative records. All analyses were adjusted for covariates. Results: For aim 1, the proximal social determinants of sex, trust and reciprocity showed the largest and most consistent effect over the 2003-2017 period. Females more than double the odds of depressive symptoms compared to males at any point between 2003 and 2017. Secular trends were observed for the variables of area of residence, age and marital status. The distal social determinants showed a positive association with depressive symptoms only in 2010 models. For aim 2, In adjusted models, participants with depressive symptoms were 1.38 (95% CI 1.02—1.86) and 1.38 (95% CI 1.02—1.88) times more likely to die compared to those without such symptoms in the 2003 and 2010 cohort, respectively. Conclusion: Community-wide strategies with a gendered perspective can help to prevent and manage depressive symptoms. Moreover, addressing depressive symptoms in the Chilean population could contribute not only to living healthier lives but longer lives too.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Social determinants of depression and its association with all-cause mortality among Chilean adult population: Evidence from the Chilean National Health Surveys (ENS) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10172232 |
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