title: Income inequality and depressive symptoms in South Africa: A longitudinal analysis of the National Income Dynamics Study.
abstract: Research suggests that income inequality may detrimentally affect mental health. We examined the relationship between district-level income inequality and depressive symptoms among individuals in South Africa-one of the most unequal countries in the world-using longitudinal data from Wave 1 (2008) and Wave 3 (2012) of the National Income Dynamics Study. Depressive symptoms were measured using the Center for Epidemiological Studies of Depression Short Form while district Gini coefficients were estimated from census and survey sources. Age, African population group, being single, being female, and having lower household income were independently associated with higher depressive symptoms. However, in longitudinal, fixed-effects regression models controlling for several factors, district-level Gini coefficients were not significantly associated with depressive symptoms scores. Our results do not support the hypothesis of a causal link between income inequality and depressive symptoms in the short-run. Possible explanations include the high underlying levels of inequality in all districts, or potential lags in the effect of inequality on depression.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA 02115, USA. Electronic address: kafuig@post.harvard.edu.
authors.forename: Kafui
authors.initials: K
authors.lastname: Adjaye-Gbewonyo
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA 02115, USA; Department of Global Health and Social Medicine, King's College London, Strand Campus, Strand, London WC2R 2LS, United Kingdom. Electronic address: mavendan@hsph.harvard.edu.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Avendano
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA 02115, USA. Electronic address: svsubram@hsph.harvard.edu.
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA 02115, USA. Electronic address: ikawachi@hsph.harvard.edu.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007182:Income; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult