Associations between socioeconomic status markers and depressive symptoms by race and gender: results from the Multi-Ethnic Study of Atherosclerosis (MESA)

Purpose: Depression poses a significant public health burden, with varying prevalence by race/ethnicity, gender, and socioeconomic status (SES). It is unclear whether race/ethnicity and gender modify relationships between SES and depression. The purpose of this study was to investigate such effect modification. Methods: A cross-sectional analysis was performed on Multi-Ethnic Study of Atherosclerosis participants at the baseline (n = 5559). Multivariable logistic regression models stratified by race/ethnicity and gender were performed to evaluate associations between income, education, occupation, and neighborhood SES with depressive symptoms, defined by Center for Epidemiologic Studies Depression Scale values of 16 or greater. Results: Depressive symptom odds were lower with increasing income, and this was pronounced in white women, black men, and Hispanic women. Lower odds of depressive symptoms were seen in management/professional occupations for Hispanic men, and in blacks as neighborhood SES increased. Education was not associated with odds of depressive symptoms. Multiplicative interaction terms were significant for gender-income (P =.028) and race/ethnicity-neighborhood (P =.010). Race/ethnicity-neighborhood interaction was also observed on the additive scale. Conclusions: Associations varied across races/ethnicities and gender, and evidence for effect modification was seen by gender with income, and by race/ethnicity with neighborhood SES. These findings provide a nuanced understanding of race/ethnicity and gender differences in SES related to depressive symptoms.