Poverty, Material Hardship and Depression

Colleen M Heflin, John Iceland, Colleen M Heflin, John Iceland

Abstract

Objective: Mental health disorders are of great social, economic, and policy concern. A higher incidence of major depressive disorder has been reported among those living in or near poverty. Our study examines the extent to which the relationship between income and depression is mediated by measures of material hardship.

Methods: We use measures of depression at two points in time from the longitudinal Fragile Families Survey to better discern the causal direction of the relationship between income poverty, hardship, and depression. More specifically, we use conditional logistic fixed-effect models that control for time-invariant unmeasured heterogeneity in the sample.

Results: We found a strong relationship between hardships and depression. The most prominent hardships were problems paying bills and phone turned off. We also found that hardship helped mediate much, though not all, of the link between poverty and depression in the conditional fixed effect logistic regression models.

Conclusion: Our policy simulations suggest that public health efforts to reduce depression may be enhanced from efforts that focus on specific forms of material hardship.

References

    1. Adams Peter, Hurd Michael, McFadden Daniel, Merrill Angela, Ribeiro Tiago. Healthy, Wealthy, and Wise? Test for Direct Causal Paths Between Health and Socioeconomic Status. Journal of Econometrics. 2003;112:3–56.
    1. Beverly Sondra. Presented at the Population Association of America. Los Angeles: 2000. Mar, Material Hardship in Working-Poor Households with Children.
    1. Beverly Sondra. Measures of Material Hardship: Rationale and Recommendations. Journal of Poverty. 2001;5(1):23–41.
    1. Boushey Heather, Brocht Chauna, Gundersen Bethney, Bernstein Jared. Hardships in America: The Real Story of Working Families. Washington, D.C.: Economic Policy Institute; 2001.
    1. Bradshaw J, Finch N. Overlaps in Dimensions of Poverty. Journal of Social Policy. 2003;32:513–525.
    1. Casey Patrick, Goolsby Susan, Berkowitz Carol, Frank Deborah, Cook John, Cutts Dina, Black Maureen, Zaldivar Nieves, Levenson Suzette, Heeren Tim, Meyers Alan the Children’s Sentinel Nutritional Assessment Program Study Group. Maternal Depression, Changing Public Assistance, Food Security, and Child Health Status. Pediatrics. 2004;113(2):298–304.
    1. Ecob Russell, Davey Smith George. Income and Health: What is the Nature of the Relationship? Social Science & Medicine. 1999;48:693–705.
    1. Evanson R, Simon Robin. Clarifying the Relationship between Parenthood and Depression. 2005;46(3)
    1. Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, et al. The economic burden of depression in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry. 2003;64:1465–1475.
    1. Hamilton William L, Cook John T, Thompson William W, Buron Lawrence F, Frongillo Edward A, Olson Christine M, Wehler Cheryl A. Technical report of the Food Security Measurement Project. Washington, D.C.: Food and Consumer Service, United States Department of Agriculture; 1997. Household Food Security in the United States in 1995.
    1. Hawkins Daniel N, Booth Alan. Unhappily Ever After: Effects of Long-Term, Low-Quality Marriages on Well-Being. Social Forces. 2005;84(1):451–471.
    1. Heflin Colleen, Siefert Kristine, Corcoran Mary E, Williams David R. Food Insufficiency and the Mental Health of Current and Recent Welfare Recipients: Findings from a Longitudinal Survey. Social Science & Medicine. 2005;61:1971–1982.
    1. Iceland John, Bauman Kurt J. Income Poverty and Material Hardship: How Strong is the Association? National Poverty Center Working Paper, #04-17. 2004 Dec;
    1. Iceland John. Poverty in America. 2nd Edition. Berkeley, CA: University of California Press; 2006.
    1. Johnson JG, Cohen P, Brook JS, et al. A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders. J Abnormal Psychol. 1999;108:490–499.
    1. Kessler Ronald C, McGonagle Katherine A, Zhao Shanyang, Nelson Christopher B, Hughes Michael, Eshlemann Suzann, Wittchen Hans-Ulrich, Kendler Kenneth S. Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States. Archives of General Psychiatry. 1994;15:8–19.
    1. Kessler RC, Andrews G, Mroczek D, Ustun B, Wittchen HU. The World Health Organization Composite International Diagnostic Interview Short-Form (CIDI-SF) International Journal of Methods in Psychiatric Research. 1998;7:171–185.
    1. Kessler R, Barker P, Colpe L, et al. Screening for Serious Mental Illness in the General Population. Archives of General Psychiatry. 2003;60:184–189.
    1. Kessler RC, Akiskal HS, Ames M, Birnbaum H, Greenberg P, Hirschfeld RMA. Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. American Journal of Psychiatry. 2006;163:1561–1568.
    1. Laraia Barbara A, Siega-Riz Anna Maria, Gundersen Craig, Dole Nancy. Psychological Factors and Socioeconomic Indicators are Associated with Household Food Insecurity Among Pregnant Women. Journal of Nutrition. 2006;136:177–182.
    1. Lynch John, Davey Smith George, Harper Sam, Hillemeier Marianne, Ross Nancy, Kaplan George, Wolfson Michael. Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review. Millbank Quarterly. 2004;82(1)
    1. Lynch John, Davey Smith George, Kaplan George A, House James S. Income Inequality and Mortality: Importance to Health of Individual Income, Psychosocial Environment, or Material Conditions. BMJ. 2000;320:1200–1204.
    1. Mayer Susan E, Jencks Christopher. Poverty and the Distribution of Material Hardship. Journal of Human Resources. 1989;24(1):88–114.
    1. McNeil Jack. Americans with Disabilities. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau; 2001. Current Population Reports P70–73.
    1. Macleod J, Davey Smith G. Psychosocial factors and public health: a suitable case for treatment. J Epidemiol Community Health. 2003;57:565–570.
    1. Macleod John, Davey Smith George, Heslop Pauline, Metcalfe Chris, Carroll Douglas, Hart Carole. Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. BMJ. 2002;324:1247–1251.
    1. Macleod John, Davey Smith George, Metcalfe Chris, Hart Carole. Is Subjective Social Status a more important determinant of health than objective social status? Social Science & Medicine. 2005 Nov;61(9):1916–1929.
    1. Marcotte DE, Wilcox-Gok V. Estimating the employment and earnings costs of mental illness: recent developments in the United States. Social Science and Medicine. 2001;53:21–27.
    1. Mayer SE. A Comparison of Poverty and Living Conditions in the United States, Canada, Sweden and Germany. In: McFate K, Lawson R, Wilson WJ, editors. Poverty, Inequality and the Future of Social Policy: Western States in the New World Order. New York: Russell Sage Foundation; 1995.
    1. Mayer Susan E, Jencks Christopher. Poverty and the Distribution of Material Hardship. Journal of Human Resources. 1989;24(1):88–114.
    1. Mayer Susan E, Jencks Christopher. Recent Trends in Economic Inequality in the United States: Income vs. Expenditures vs. Material Well- Being. In: Papadimitriou D, Wolff E, editors. Poverty and Prosperity in the USA in the Late Twentieth Century. MacMillan, London: 1993.
    1. Miech RA, Caspi A, Moffitt T, et al. Low socioeconomic status and mental disorders: a longitudinal study of selection and causation during young adulthood. American Journal of Sociology. 1999;104:112–147.
    1. Muntaner Carles, Eaton William W, Miech Richard, O’Campo Patrice. Socioeconomic Position and Major Mental Disorders. Epidemiologic Review. 2004;26:53–62.
    1. National Center for Health Statistics. Health, United States, 1998 With Socioeconomic Status and Health Chartbook. Hyattsville, Maryland: 1998.
    1. Citro Constance F, Michael Robert T., editors. National Research Council. Measuring Poverty: A New Approach. Washington, DC: National Academy Press; 1995.
    1. Ouellette Tammy, Burstein Nancy, Long David, Beecroft Erik. Measures of Material Hardship: Final Report. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. 2004
    1. Perreira Krista M, Deeb-Sossa Natalia, Harris Kathleen Mullan, Bollen Kenneth A. What Are We Measuring? An Evaluation of the CES-D across Race/Ethnicity and Immigrant Generation. Social Forces. 2005;83(4):1567–1601. (Jun., 2005)
    1. Perry B. The Mismatch Between Income Measures and Direct Outcome Measures of Poverty. Social Policy Journal of New Zealand. 2002;19:101–127.
    1. Pratt LA, Dey AN, Cohen AJ. Characteristics of adults with serious psychological distress as measured by the K6 scale: United States, 2001–2004. Hyattsville, MD: National Center for Health Statistics; 2007. (Advance data from vital health and statistics 382)
    1. Rector R, Johnson KA, Youssef SE. The Extent of Material Hardship and Poverty in the United States. Review of Social Economy. 1999;57(3):351–387.
    1. Reichman N, Teitler J, Garfinkel I, McLanahan S. Fragile Families: Sample and Design. Children and Youth Services Review. 2001;23(4–5):303–326.
    1. Ritsher Jennifer E, Warner Virginia, Johnson Jeffrey G, Dohrenwend Bruce P. Inter-generational longitudinal study of social class and depression: a test of social causation and social selection models. British Journal of Psychiatry. 2001;178(suppl. 40):S84–S90.
    1. Robins Lee N, Regier Darrel A. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: Free Press; 1991.
    1. Ruggles Patricia. Drawing the Line: Alternative Poverty Measures and Their Implications for Public Policy. Washington, DC: Urban Institute; 1990.
    1. Serido Joyce, Almeida David M, Wethington Elaine. Chronic Stressors and Daily Hassles: Unique and Interactive Relationships with Psychological Distress. ournal of Health and Social Behavior. 2004;45(1):17–33.
    1. Turner R. Jay, Taylor John, Van Gundy Karen. Personal Resources and Depression in the Transition to Adulthood: Ethnic Comparisons. Journal of Health and Social Behavior. 2004;45(1):34–52.
    1. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.
    1. World Health Organization. Composite International Diagnostic Review (CIDI, Version 1.0) Geneva, Switzerland: World Health Organization; 1990. 1990.
    1. Williams David R, Yu Y, Jackson James S, Anderson Barbara B. Racial differences in physical and mental health: socioeconomic status, stress and discrimination. Journal of Health Psychology. 1997;2(3):335–351.
    1. Wittchen HU. Reliability and validity studies of the WHO-Composite International Diagnostic Review (CIDI): a critical review. Journal of Psychiatric Research. 1994;28:57–84.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa