A multilevel analysis of the relation of socioeconomic status to adolescent depressive symptoms: does school context matter?
OBJECTIVE
To determine whether the socioeconomic context of the school environment is associated with adolescent depressive symptoms independent of individual household income. Study design Data were drawn from a 1995 nationally representative study of 7th to 12th grade students. Multivariable linear regression at the school and individual levels assessed the relation between income and depressive symptoms. Multilevel modeling techniques were then used to understand how these factors are jointly associated with adolescent depressive symptoms.


METHODS
Adolescents (n=13,235) in grades 7 through 12 from 132 schools whose parent provided income information.


RESULTS
Linear regression analyses indicated that lower household income, average school income, and increasing school-level income inequality were significantly (P<.001) associated with depressive symptoms. Further examination of these relations through multilevel modeling indicated that both household income (P<.01) and average school income (P<.05) were significantly related to depressive symptoms after adjusting for covariates, with evidence for an interaction between the two. The impact of lower household income on depressive symptoms was approximately 2-fold greater for students attending a poor versus a rich school.


CONCLUSIONS
School context is associated with adolescents' depressive symptoms, even after adjusting for individual-level factors. The school environment may partially buffer the adverse influence of lower household income on adolescent depressive symptoms.
Schneider Institute for Health Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02454-9110, USA. goodman@brandeis.edu
Elizabeth
E
Goodman
Bin
B
Huang
Terrance J
TJ
Wade
Robert S
RS
Kahn
D000293:Adolescent; D000328:Adult; D002648:Child; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007182:Income; D016014:Linear Models; D008297:Male; D008603:Mental Health; D012044:Regression Analysis; D012923:Social Class