were present in 30.4% of employed middle-aged and older adults in rural areas compared to 23.2% in urban areas.
A significant difference in the prevalence of depressive symptoms between urban and rural employed individuals was observed (P < 0.001).
Key determinants of depressive symptoms in urban areas included self-assessed health status, sleep duration, and life satisfaction.
In rural areas, factors such as gender, age, education, self-assessed health status, chronic diseases, sleep duration, and life satisfaction were associated with depressive symptoms.
The analysis indicated that age, education, self-assessed health status, and sleep duration contributed to the disparity in depressive symptoms between urban and rural populations.
Simplified
BACKGROUND: Globally, middle-aged and older adults who are employed are prone to experiencing , a phenomenon particularly pronounced in China due to its significant ageing population. Despite this, there is a relative scarcity of research focusing on depressive symptoms among this community, especially in China. The purpose of this study is to explore and measure the factors contributing to variations in depressive symptoms among employed middle-aged and older adults in urban and rural areas.
METHODS: The study utilized data from 3,156 employed middle-aged and older adults, derived from the fourth wave of The 2018 China Health and Retirement Longitudinal Study (CHARLS). The 10-item short version of the Center for Epidemiological Studies Depression Scale (CES-D-10) was used to assess depressive symptoms. Urban-rural differences were examined using chi-square tests and binary logistic regression analyses, while the technique was applied to explore the disparities and their respective contributions.
RESULTS: The study comprised a sample of 783 employed individuals of middle and older age residing in urban areas, alongside 2,373 counterparts in rural areas. The gender distribution within the sample was 68.1% male and 31.9% female. The prevalence of depressive symptoms was observed in 23.2% of the urban cohort, in contrast to 30.4% of the rural cohort, a difference that was statistically significant (P < 0.001). In urban settings, significant determinants of depressive symptoms included self-assessed health status, sleep duration, and life satisfaction. In contrast, in rural areas, factors such as gender, age, education, self-assessed health status, chronic diseases, sleep duration, and life satisfaction were identified. The Oaxaca-Blinder decomposition analysis identified age, education, self-assessed health status, and sleep duration as key factors in the disparity of depressive symptoms between urban and rural areas among employed middle-aged and older adults.
CONCLUSIONS: Depressive symptoms are more common in rural areas due to various factors found in these communities. It is imperative to create focused and advanced intervention plans to improve the mental well-being of this community and reducing the urban-rural disparity.
Key numbers
30.4%
Prevalence of (Rural vs. Urban)
30.4% of rural employed middle-aged and older adults exhibit .
23.2%
Prevalence of (Urban)
23.2% of urban employed middle-aged and older adults exhibit .
47.89%
Explained Component of Disparity
47.89% of the urban-rural disparity in is explainable by observable factors.
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Declarations. Ethics approval and consent to participate: All participants gave written informed consent after thoroughly understanding the information provided. Additionally, all participants demonstrated the necessary medical and ethical capacity to provide consent. The study was conducted in accordance with the Declaration of Helsinki, ethical approval for the study was granted by the Ethics Review Board of Peking University. (IRB00001052-11015) Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
