title: Socioeconomic related inequality in depression among young and middle-adult women in Indonesia׳s major cities.
abstract: OBJECTIVE
  Difficult living conditions in urban areas could result in an increased risk of developing depression, particularly among women. One of the strong predictors of depression is poverty, which could lead to inequality in risk of depression. However, previous studies found conflicting results between poverty and depression. This study examines whether depression was unequally distributed among young and middle-adult women in Indonesia׳s major cities and investigate the factors contributed to the inequality.
  
  
  METHODS
  Data from 1117 young and middle-adult women in Indonesia׳s major cities (Jakarta, Surabaya, Medan, and Bandung) were analysed. Concentration Index (CI) was calculated to measure the degree of the inequality. The CI was decomposed to investigate the factor contributing most to the inequality.
  
  
  RESULTS
  The prevalence of depression was 15% and more concentrated among lower economic group (CI=-0.0545). Compared to the middle-adult group, the prevalence of depression among women in the young-adult group was significantly higher (18% vs 11%, p<0.05) and more equally distributed (CI=-0.0343 vs CI=-0.1001). Household consumption expenditure was the factor that contributed most to inequality in both group. Other factors contributing to inequality were smoking in young-adult group and marital status in middle-adult group. Contribution of education to inequality varied for different age groups.
  
  
  CONCLUSIONS
  Depression is more concentrated among the lower economic groups, with household expenditure being the major factor contributing to the inequality. This finding emphasises the importance of primary care level mental health services, particularly in poorer urban communities.
  
  
  CONCLUSIONS
  This study is based on a cross-sectional data, and only assesses social determinants of depression. These determinants are important to address in addition to biological determinants and other factors.
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Australia. Electronic address: yodi.christiani@newcastle.edu.au.
authors.forename: Yodi
authors.initials: Y
authors.lastname: Christiani
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Byles
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, University of Newcastle (Hunter Medical Research Institute), Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Tavener
authors.affiliation: Centre for Health Stewardship, Australian National University, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Dugdale
mesh_terms: D000328:Adult; D002947:Cities; D003430:Cross-Sectional Studies; D003863:Depression; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D017533:Marital Status; D008605:Mental Health Services; D008875:Middle Aged; D011203:Poverty / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012111:Residence Characteristics; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adult women; Concentration Index; Depression; Indonesia; Socio-economic inequality