Association between area-level socioeconomic deprivation and mental health in later life: A retrospective life course analysis in the Lothian Birth Cohort 1936

Abstract

Few studies have incorporated the complexity of lifetime residential movement into their area-level socioeconomic deprivation measure. We investigated the association between socioeconomic deprivation over the life course and self-assessed mental health status at age 70. Decade-based information on the residential location of participants from the Lothian Birth Cohort 1936 (LBC1936) was collected via a “life-grid” questionnaire. Addresses were geocoded, cleaned and an analysis sample defined by residence within the city of Edinburgh boundary (n=328). A historical index of multiple deprivation was created by taking the sum of z-scores from census data from 1931-1971 (tenure, infant mortality, overcrowding, population density, and amenities) and Carstairs deprivation index data for 1981 onwards. Based on their addresses, each participant was assigned a mean value for the following time periods: childhood (1936-1955), early adulthood (1956-1975), adulthood (1976-1995) and later adulthood (1996-2015). A negative binomial regression analysis was undertaken to test the association between several life course models (critical periods, accumulation, mobility) and the hospital anxiety and depression scale (HADS). After accounting for individual socioeconomic status, higher childhood deprivation (Q3 vs Q1&Q2) resulted in higher anxiety (OR 1.19, 95% CI 1.02-1.39), depression (OR 1.35, 95% CI 1.12-1.62) and total HADS score (OR 1.24, 95% CI 1.08-1.43). A downward socioeconomic trajectory in early life resulted in elevated anxiety (OR 1.29, 95% CI 1.06-1.58) and total HADS score (OR 1.28, 95% CI 1.06-1.55). Both living within and moving to a relatively deprived area during childhood had a negative effect on mental health decades later. As the elderly population continues to grow, policy makers could stem the concurrent rise in poor mental health status for socially disadvantaged groups by concentrating on interventions aimed at reducing inequality during childhood.

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Angers, France