Twelve-year Trends in Depressive Symptoms Across Socioeconomic Strata in Chinese Adults: A Nationwide Age-Period-Cohort Analysis
1
Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
2
AI Thrust, Information Hub, The Hong Kong University of Science and Technology-Guangzhou Campus, Guangzhou, China
3
Key Laboratory of Health System Reform and Governance, National Health Commission of China, Beijing, China
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Depressive symptoms are a leading contributor to global disease burden. In China, rapid socioeconomic transitions have reshaped individual and contextual risk factors for depressive symptoms. However, the temporal dynamics and multilevel social gradients of depressive symptoms remain understudied. This study investigated secular trends and socioeconomic disparities in depressive symptoms among Chinese adults, disentangling age, period, and cohort (APC) effects.
METHODS:
We used data from seven waves (2010-2022) of the China Family Panel Studies (CFPS). Hierarchical APC cross-classified random effects models (HAPC-CCREM) were fitted to estimate APC effects and their interactions with gender and socioeconomic status (SES).
RESULTS:
A total of 162,596 samples were included in this study. The prevalence and severity of depressive symptoms increased significantly from 2010 to 2022, with persistent and widening inequalities by individual-level SES. Although urban-rural disparities in relative risk showed narrowed, rural residents continued to experience a higher absolute burden. Depressive symptoms followed an inverted U-shaped age pattern, with SES and gender disparities peaking in midlife. Individuals born before 1940 and after 1980 showed elevated risk. Gender disparities were more pronounced among low-SES and rural populations. Period effects indicated an overall worsening of depressive symptoms after 2014.
CONCLUSIONS:
Multilevel socioeconomic inequalities in depressive symptoms remain substantial and dynamic across age, cohort, and period dimensions in China. High-risk groups include individuals with low-SES, rural residents, and women, particularly those born before 1940 and after 1980. These findings underscore the urgency of addressing intersecting structural inequalities and tailoring interventions to different social contexts and generations.
Depressive symptoms are a leading contributor to global disease burden. In China, rapid socioeconomic transitions have reshaped individual and contextual risk factors for depressive symptoms. However, the temporal dynamics and multilevel social gradients of depressive symptoms remain understudied. This study investigated secular trends and socioeconomic disparities in depressive symptoms among Chinese adults, disentangling age, period, and cohort (APC) effects.
METHODS:
We used data from seven waves (2010-2022) of the China Family Panel Studies (CFPS). Hierarchical APC cross-classified random effects models (HAPC-CCREM) were fitted to estimate APC effects and their interactions with gender and socioeconomic status (SES).
RESULTS:
A total of 162,596 samples were included in this study. The prevalence and severity of depressive symptoms increased significantly from 2010 to 2022, with persistent and widening inequalities by individual-level SES. Although urban-rural disparities in relative risk showed narrowed, rural residents continued to experience a higher absolute burden. Depressive symptoms followed an inverted U-shaped age pattern, with SES and gender disparities peaking in midlife. Individuals born before 1940 and after 1980 showed elevated risk. Gender disparities were more pronounced among low-SES and rural populations. Period effects indicated an overall worsening of depressive symptoms after 2014.
CONCLUSIONS:
Multilevel socioeconomic inequalities in depressive symptoms remain substantial and dynamic across age, cohort, and period dimensions in China. High-risk groups include individuals with low-SES, rural residents, and women, particularly those born before 1940 and after 1980. These findings underscore the urgency of addressing intersecting structural inequalities and tailoring interventions to different social contexts and generations.
| eISSN: | 2654-1459 |
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