title: Late-life depression in Rural China: do village infrastructure and availability of community resources matter?
abstract: OBJECTIVE
  This study aimed to examine whether physical infrastructure and availability of three types of community resources (old-age income support, healthcare facilities, and elder activity centers) in rural villages are associated with depressive symptoms among older adults in rural China.
  
  
  METHODS
  Data were from the 2011 baseline survey of the Chinese Health and Retirement Longitudinal Study (CHARLS). The sample included 3824 older adults aged 60 years or older residing in 301 rural villages across China. A score of 12 on the 10-item Center for Epidemiologic Studies Depression Scale was used as the cutoff for depressed versus not depressed. Village infrastructure was indicated by an index summing deficiency in six areas: drinking water, fuel, road, sewage, waste management, and toilet facilities. Three dichotomous variables indicated whether income support, healthcare facility, and elder activity center were available in the village. Respondents' demographic characteristics (age, gender, marital status, and living arrangements), health status (chronic conditions and physical disability), and socioeconomic status (education, support from children, health insurance, household luxury items, and housing quality) were covariates. Multilevel logistic regression was conducted.
  
  
  RESULTS
  Controlling for individuals' socioeconomic status, health status, and demographic characteristics, village infrastructure deficiency was positively associated with the odds of being depressed among rural older Chinese, whereas the provision of income support and healthcare facilities in rural villages was associated with lower odds.
  
  
  CONCLUSIONS
  Village infrastructure and availability of community resources matter for depressive symptoms in rural older adults. Improving infrastructure, providing old-age income support, and establishing healthcare facilities in villages could be effective strategies to prevent late-life depression in rural China.
authors.affiliation: University of Michigan, School of Social Work, Ann Arbor, MI, USA.
authors.forename: Lydia W
authors.initials: LW
authors.lastname: Li
authors.affiliation: University of Michigan, School of Social Work, Ann Arbor, MI, USA.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Liu
authors.affiliation: Michigan State University, Department of Sociology, East Lansing, MI, USA.
authors.forename: Zhenmei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: University of Michigan, Survey Research Center, Ann Arbor, MI, USA.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Xu
mesh_terms: D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011998:Recreation / Q000523:psychology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012423:Rural Health / Q000706:statistics & numerical data*; D012944:Social Support
keywords: depressive symptoms; infrastructure deficiency; neighborhood effects; old-age income support; rural older adults