title: Social participation and mental health: moderating effects of gender, social role and rurality.
abstract: BACKGROUND
  Previous studies have reported that older people's social participation has positive effects on their health. However, some studies showed that the impacts of social participation on health differ by gender. We sought to examine whether the effects of social participation on mental health differ for men and women in a Japanese population. We also examined the moderating influence of social position within the organization as well as urban/rural locality.
  
  
  METHODS
  We used two waves of the Aichi Gerontological Evaluation Study's longitudinal survey, which targeted residents with aged 65 years or over (n=2,728) in a central part of Japan. The first wave survey was conducted in 2003, and the second wave in 2006. Depressive symptoms of the study participants were assessed using the short version of the Geriatric Depression Scale (GDS-15). A multilevel logistic regression model was used with individual-level as level 1 and the school district-level as level 2.
  
  
  RESULTS
  We found that higher social participation and performing key roles in the organization had protective effects on depressive symptoms for women. However, there were no main effects of these variables for the mental health of men. We found an interaction between social participation, organizational position, and rural residence among men only. That is, men who occupied leadership positions in organizations reported better mental health, but only in rural areas.
  
  
  CONCLUSIONS
  Our findings support the notion that increasing the opportunities for social participation improves older people's heath, especially for women. However, in the rural Japanese context, offering men meaningful roles within organizations may be important.
authors.affiliation: Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. dtakagi-utokyo@umin.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takagi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000517:prevention & control*; D005260:Female; D006798:Housing; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D055361:Multilevel Analysis; D009938:Organizations; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D058992:Social Participation
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