The influence of Life’s Essential 8 on the link between socioeconomic status and depression in adults: a mediation analysis

Lin Zhang · Jiangjing Li · Hongxia Xiang · Yongfei Liu · Changjun Gao · Xude Sun

11 citations0/0 files storedBMC Psychiatry

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Health disparities and outcomes Cardiac Health and Mental Health Cardiovascular Health and Risk Factors

Abstract

BACKGROUND: Individuals with low socioeconomic status (SES) are at a higher risk of developing depression. However, evidence on the role of cardiovascular health (CVH) in this chain is sparse and limited. The purpose of this research was to assess the mediating role of Life's Essential 8 (LE8), a recently updated measurement of CVH, in the association between SES and depression according to a nationally representative sample of adults. METHODS: Data was drawn from the National Health and Nutrition Examination Survey (NHANES) in 2013-2018. Multivariate logistic regression analysis was applied to analyze the association of SES (measured via the ratio of family income to poverty (FIPR), occupation, educational level, and health insurance) and LE8 with clinically relevant depression (CRD) (evaluated using the Patient Health Questionnaire (PHQ-9)). Multiple linear regression analysis was performed to analyze the correlation between SES and LE8. Mediation analysis was carried out to explore the mediating effect of LE8 on the association between SES and CRD. Moreover, these associations were still analyzed by sex, age, and race. RESULTS: A total of 4745 participants with complete PHQ-9 surveys and values to calculated LE8 and SES were included. In the fully adjusted model, individuals with high SES had a significantly higher risk of CRD (odds ratio = 0.21; 95% confidence interval: 0.136 to 0.325, P < 0.01) compared with those with low SES. Moreover, LE8 was estimated to mediate 22.13% of the total association between SES and CRD, and the mediating effect of LE8 varied in different sex and age groups. However, the mediating effect of LE8 in this chain was significant in different sex, age, and racial subgroups except for Mexican American (MA) individuals. CONCLUSION: The results of our study suggest that LE8 could mediate the association between SES and CRD. Additionally, the mediating effect of LE8 in this chain could be influenced by the race of participants.

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References

2013The Epidemiology of Depression Across Cultures 1992Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease.2018Socioeconomic Status and Cardiovascular Outcomes 2021Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies 2006Using the patient health questionnaire-9 to measure depression among racially and ethnically diverse primary care patients 2016The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe)2016Addressing Social Determinants of Health and Health Inequalities 2016The Psychological Lives of the Poor

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