Exploring disparities in depressive symptoms between rural and urban middle-aged and elderly adults in China: evidence from CHARLS

Feb 26, 2025Psychology, health & medicine

Differences in depression symptoms between middle-aged and older adults living in rural and urban China

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Abstract

The proportion of depressive symptoms among middle-aged and older individuals in China was 38.16%, with higher rates in rural areas (44.47%) compared to urban areas (31.85%).

Rural middle-aged and elderly individuals exhibited a higher prevalence of depressive symptoms than their urban counterparts.
Differences in self-reported health status contributed 19.16% to the disparities in depressive symptoms.
Education level was associated with 14.45% of the differences in depressive symptoms between urban and rural populations.
Insurance status accounted for 8.28% of the observed disparities in depressive symptoms.
Factors such as gender, sleep time, falling history, age, physical examination, and chronic disease condition also played a role in the differences.

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The study was to investigate the relevant factors that were associated with differences in depressive symptoms between urban and rural middle-aged and elderly population in China, measuring the contribution of related influencing factors. We constructed binary logistic regression models to investigate the primary factors influencing depressive symptoms and employed Fairlie models to examine these factors contributing to the differences in depressive symptoms between urban and rural middle-aged and elderly individuals. The proportion of depressive symptoms among middle-aged and older individuals in China was 38.16%, with findings indicating that rural areas exhibited higher rates (44.47%) of depressive symptoms compared to urban areas (31.85%). The Fairlie decomposition analysis demonstrated 53.51% of the disparities in depressive symptoms could be accounted for, which was mainly linked to differences in self-reported health status (19.16%), education level (14.45%), insurance (8.28%), instrumental activities of daily living dysfunction (6.16%), gender (-3.72%), sleep time (2.35%), falling history (2.31%), age (-2.17%), physical examination (2.03%), and chronic disease condition (-0.50%). The prevalence of depressive symptoms in rural middle-aged and elderly was greater than urban, linked to demographics, lifestyle, health status and social status. This study aided policymakers in reducing health disparities and designing targeted mental health interventions for vulnerable populations.

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Exploring disparities in depressive symptoms between rural and urban middle-aged and elderly adults in China: evidence from CHARLS

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