Social determinants of health explain disparities in mental health of older adults

23 Jul 2023
Social determinants of health explain disparities in mental health of older adults

Differences in social determinants of health (SDoH) tend to trigger racial/ethnic disparities in psychological health and well-being among older adults, suggests a study. Key SDoH include education, income, number of years worked, and insurance parity.

Compared with Whites, Black and Hispanic/Latinx adults reported worse depressive symptomatology, cognition, and self-rated health.

Some SDoH such as education, parental education, years worked, income, and insurance parity showed a significant association with a larger proportion of the Black‒White disparities in depression (51 percent), cognition (39 percent), and self-rated health (37 percent) compared with age, sex, measures of health, health behaviours, and healthcare utilization.

Likewise, SDoH correlated with a greater proportion of the Hispanic/Latinx‒White disparity in cognition (76 percent) and self-rated health (75 percent), while age and physical health contributed to the disparity in depressive symptomatology (28 percent).

In this study, the authors measured the disparities in depression, cognition, and self-rated health in a total of 2,306 non‒Hispanic/Latinx Black, 1,593 Hispanic/Latinx, and 7,244 non‒Hispanic/Latinx White adults who participated in the Health and Retirement Study (n=11,143).

In addition, the authors applied the Blinder-Oaxaca decomposition to determine whether differences in selected SDoH contributed to a bigger share of the disparities than age, sex, measures of health, health behaviours, and healthcare utilization. These SDoH included education, parental education, number of years worked, marital status, veteran status, geographic residence, nativity status, income, and insurance coverage.

Am J Psychiatry 2023;180:483-494